Roos Dareia S, Berendse Henk W, Doty Richard L, Twisk Jos W R, Klein Martin
Department of Neurology, Amsterdam UMC Location Vrije Universiteit Amsterdam, de Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands.
Amsterdam Neuroscience, Neurodegeneration, Amsterdam, The Netherlands.
J Neurol. 2025 Sep 2;272(9):604. doi: 10.1007/s00415-025-13337-0.
Olfactory dysfunction is an early, common, and progressive symptom in Parkinson's disease (PD). Whether the decline in olfactory function is longitudinally associated with a deterioration of (non-)motor symptoms remains debated.
This study aimed to investigate the longitudinal relationship between olfactory function and (non-)motor symptoms, particularly cognitive decline, in PD patients over a ten-year follow-up period.
Ninety patients were assessed at baseline and after approximately ten years. Olfactory function was measured using the 40-item University of Pennsylvania Smell Identification Test (UPSIT®). (non-)Motor symptoms were evaluated using various scales and questionnaires, including the MMSE to assess global cognitive function. Linear regression was used to analyze the change in olfactory function over time in relation to changes in (non-)motor function, and to determine whether baseline olfactory test scores would be associated with (non-)motor function at follow-up. In a subset of 62 patients, in whom comprehensive cognitive testing was performed, we analyzed the longitudinal relationship between olfactory function and performance on specific cognitive tests.
Statistically significant associations were found between a decrease in UPSIT® scores and decline in MMSE, and between baseline UPSIT® scores and MMSE performance at follow-up. In the subgroup with comprehensive cognitive testing, a decrease in UPSIT® scores was associated with worsening semantic fluency. Furthermore, an association was found between baseline UPSIT® score and semantic fluency at follow-up.
Decline in olfactory function in PD is longitudinally associated with worsening global cognitive function, particularly a deterioration in semantic fluency. Baseline olfactory function may be predictive of later cognitive decline, especially in the semantic domain.
嗅觉功能障碍是帕金森病（PD）早期常见的进行性症状。嗅觉功能下降与（非）运动症状的恶化是否存在纵向关联仍存在争议。
本研究旨在调查PD患者在十年随访期内嗅觉功能与（非）运动症状，特别是认知衰退之间的纵向关系。
90名患者在基线时和大约十年后接受评估。使用40项宾夕法尼亚大学嗅觉识别测试（UPSIT®）测量嗅觉功能。使用各种量表和问卷评估（非）运动症状，包括简易精神状态检查表（MMSE）以评估整体认知功能。采用线性回归分析嗅觉功能随时间的变化与（非）运动功能变化的关系，并确定基线嗅觉测试分数是否与随访时的（非）运动功能相关。在62名进行了全面认知测试的患者亚组中，我们分析了嗅觉功能与特定认知测试表现之间的纵向关系。
发现UPSIT®分数下降与MMSE下降之间以及基线UPSIT®分数与随访时的MMSE表现之间存在统计学上的显著关联。在进行全面认知测试的亚组中，UPSIT®分数下降与语义流畅性恶化相关。此外，还发现基线UPSIT®分数与随访时的语义流畅性之间存在关联。
PD患者嗅觉功能下降与整体认知功能恶化纵向相关，尤其是语义流畅性的恶化。基线嗅觉功能可能预测后期认知衰退，尤其是在语义领域。
