Self-Reported Versus Objectively Assessed Olfaction and Parkinson’s Disease Risk

Article type: Research Article

Authors: Cao, Zichun^a | Luo, Zhehui^a | Huang, Xuemei^b | Pinto, Jayant M.^c | Simonsick, Eleanor M.^d | Shiroma, Eric J.^d | Chen, Honglei^{a; *}

Affiliations: [a] Department of Epidemiology and Biostatistics, College of Human Medicine, Michigan State University, East Lansing, MI, USA | [b] Department of Neurology, Pennsylvania State University College of Medicine, Hershey, PA, USA | [c] Section of Otolaryngology-Head and Neck Surgery, Department of Surgery, The University of Chicago Medicine and Biological Sciences, Chicago, IL, USA | [d] Laboratory of Epidemiology and Population Science, Intramural Research Program of the National Institutes of Health, National Institute on Aging, Bethesda, MD, USA

Correspondence: [*] Correspondence to: Honglei Chen, MD, PhD, Department of Epidemiology and Biostatistics, College of Human Medicine, Michigan State University, 909 Wilson Rd, East Lansing, MI, 48824, USA. Tel.: +1 517 353 8623; E-mail: chenho19@msu.edu.

Abstract: Background:Poor olfaction is a prodromal symptom of Parkinson’s disease (PD); however, self-reported sense of smell is often dismissed as unreliable. Objective:To assess self-reported and objectively assessed sense of smell, independently and jointly, in relation to future risk for PD. Methods:We conducted a prospective analysis using data from 2,424 participants, ages 71–82 at baseline, from the Health, Aging, and Body Composition study. Exposures were self-reported poor sense of smell or taste and the objectively measured 12-item Brief Smell Identification Test score. The outcome was incident PD, analyzed using Cox proportional hazard models adjusted for age, sex, race, and cognitive function. Results:After approximately 10 years of follow-up, both self-reported and objectively tested poor sense of smell were independently associated with a higher risk of developing PD: the hazard ratios (95% confidence interval) were 2.8 (1.3, 5.9) and 4.0 (2.1, 7.5), respectively. When analyzed jointly, compared with participants who reported and tested normal, the hazard ratio was 2.2 (1.0, 4.6) for those reported poor sense of smell but tested normal, 3.6 (1.9, 6.9) for reported normal but tested poor, and 7.8 (3.2, 19.4) for both reported and tested poor. We did not find significant interactions between self-reported and objectively tested sense of smell in predicting PD risk. Conclusion:This study provides preliminary evidence that self-reported poor sense of smell or taste should not be simply dismissed as useless in predicting risk of PD. Future studies should confirm our finding and evaluate whether structured questionnaires may further improve the predictability.

Keywords: Parkinson’s disease, self-report, olfaction, sense of smell

DOI: 10.3233/JPD-202164

Journal: Journal of Parkinson's Disease, vol. 10, no. 4, pp. 1789-1795, 2020