Olfactory Dysfunction Is Already Present with Subjective Cognitive Decline and Deepens with Disease Severity in the Alzheimer’s Disease Spectrum

Article type: Research Article

Authors: Wang, Qiang^{a; b; 1} | Chen, Ben^{a; 1} | Zhong, Xiaomei^{a; 1} | Zhou, Huarong^a | Zhang, Min^a | Mai, Naikeng^c | Wu, Zhangying^a | Huang, Xingxiao^a | Haehner, Antje^f | Chen, Xinru^a | Auber, Lavinia Alberi^{g; h} | Peng, Qi^a | Hummel, Thomas^f | Ning, Yuping^{a; d; e; *}

Affiliations: [a] Memory Clinic, Department of Geriatric Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, Guangdong Province, China | [b] Department of Geriatric Psychiatry, The Second People’s Hospital of Dali Bai Autonomous Prefecture, Dali, Yunnan Province, China | [c] Department of Neurology, The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, Guangdong Province, China | [d] The first School of Clinical Medicine, Southern Medical University, Guangzhou, Guangdong Province, China | [e] Guangdong Engineering Technology Research Center for Translational Medicine of Mental Disorders, Guangzhou, China | [f] Smell and Taste Clinic, Department of Otorhinolaryngology, Technische Universität Dresden, Germany | [g] Department of Medicine, University of Fribourg, Fribourg, Switzerland | [h] Swiss Integrative Center of Human Health, Fribourg, Switzerland

Correspondence: [*] Correspondence to: Yuping Ning PhD, Memory Clinic, Department of Geriatric Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, Guangdong Province 0086 510370, China. Tel.: +86 020 81268181; Fax: +86 020 81891351; E-mail: ningjeny@126.com.

Note: [1] These authors contributed equally to this work.

Abstract: Background:Odor identification dysfunction occurs early in Alzheimer’s disease (AD) and is considered a preclinical symptom along with subjective cognitive decline (SCD). Nevertheless, whether subjects with SCD are co-symptomatic with odor identification dysfunction remains unclear. Objective:To compare the degree of odor identification dysfunction and assess the relation between odor identification and cognitive performance in the AD spectrum (including SCD, mild cognitive impairment (MCI), and AD). Methods:Patients (84 SCD, 129 MCI, 52 AD) and 35 controls underwent the Sniffin’ Sticks Screen 16 test and comprehensive neuropsychological examination. Results:Odor identification scores were progressively lower moving from normal older adult to SCD, MCI, and AD. Additionally,the proportion of odor identification dysfunction were increasingly higher in the AD spectrum (p for trend <0.001), but no significant difference was found in the proportion of subjective olfactory dysfunction. No significant correlation was found between odor identification and cognition in the normal older adults and SCD subjects, but odor identification correlated with global cognition in the MCI (r = 0.199, p = 0.033) and in the AD (r = 0.300, p = 0.036) patients. Multiple linear regression showed that odor identification dysfunction was most strongly associated with memory among different cognitive subdomains and was most strongly associated with immediate verbal recall among different memory subdomains. Conclusion:Odor identification dysfunction is already present with SCD and deepens with disease severity in the AD spectrum, and it may contribute to predicting cognitive decline and identifying SCD subjects who are at risk of developing AD.

Keywords: Alzheimer’s disease, mild cognitive impairment, neuropsychology, olfactory dysfunction, subjective cognitive decline

DOI: 10.3233/JAD-201168

Journal: Journal of Alzheimer's Disease, vol. 79, no. 2, pp. 585-595, 2021