Dataset Information

Olfactory Dysfunction and Its Relationship with Clinical Symptoms of Alzheimer Disease.

ABSTRACT: Our study aimed to analyse the olfactory dysfunction (OD) evaluations between self-report, the Hyposmia Rating Scale (HRS) and the Sniffin' Sticks test, and the relationship between OD and clinical features of AD. Sixty patients with AD dementia, 37 patients with mild cognitive impairment (MCI) due to AD and 30 healthy controls were consecutively recruited. Olfactory function was evaluated by self-report, HRS and Sniffin' Sticks test. Patients were divided into AD with OD (AD-OD) and AD with no OD (AD-NOD) groups based on the results of the Sniffin' Sticks test. Cognitive symptoms and neuropsychiatric symptoms were assessed by corresponding scales, and activities of daily living (ADL) were assessed by the ADL scale. In the control, MCI due to AD and AD dementia groups, the frequency of OD was 10.0%, 13.5% and 18.3%, respectively, by self-report; 6.7%, 24.3% and 48.3%, respectively, by HRS; and 3.3%, 13.5% and 65.0%, respectively, by the Sniffin' Sticks test. Compared to the results of the Sniffin' Sticks test, the diagnostic coincidence rates of OD by HRS in patients with MCI due to AD and AD dementia were 89.2% and 66.7%, respectively. Compared to the AD-NOD group, the scores of global cognition and memory, visuospatial ability and attention were all decreased (P<0.05), the apathy score was increased (P<0.05), and the ADL score was elevated (P<0.01). The frequency and accuracy of OD by self-report is relatively low. HRS can be used for screening olfaction in patients with MCI due to AD. The Sniffin' Sticks test can be used for validating OD in AD patients. AD-OD patients have severe impairments in global cognition and multiple cognitive domains of memory, visuospatial ability and attention, as well as neuropsychiatric symptoms of apathy, and thus have seriously compromised ADL.

SUBMITTER: Yu Q

PROVIDER: S-EPMC6284764 | biostudies-literature | 2018 Dec

REPOSITORIES: biostudies-literature

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Olfactory Dysfunction and Its Relationship with Clinical Symptoms of Alzheimer Disease.

Yu Qiujin Q Guo Peng P Li Danning D Zuo Lijun L Lian Tenghong T Yu Shuyang S Hu Yang Y Liu Li L Jin Zhao Z Wang Ruidan R Piao Yingshan Y Li Lixia L Wang Xiaomin X Zhang Wei W

Aging and disease 20181204 6

Our study aimed to analyse the olfactory dysfunction (OD) evaluations between self-report, the Hyposmia Rating Scale (HRS) and the Sniffin' Sticks test, and the relationship between OD and clinical features of AD. Sixty patients with AD dementia, 37 patients with mild cognitive impairment (MCI) due to AD and 30 healthy controls were consecutively recruited. Olfactory function was evaluated by self-report, HRS and Sniffin' Sticks test. Patients were divided into AD with OD (AD-OD) and AD with no ...[more]

PMID: 30574420

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Project description:Objective: To conduct an investigation into the reliability of assessing the olfactory function of patients with Parkinson's disease (PD) in a clinical setting of crowding patients in populated countries, such as China, by the hyposmia rating scale (HRS) and compare other non-motor features between patients with PD with olfactory dysfunction (PD-OD) and patients with PD without olfactory dysfunction (PD-NOD), according to the result of olfactory function assessed by the Sniffin' Sticks test. Methods: A total of 320 patients with clinically confirmed or clinically possible PD were recruited. Olfactory function of all participants was assessed with the HRS and the Sniffin' Sticks test. Demographic data and clinical information were collected, and patients were evaluated using standardized assessment protocols. With reference to the Sniffin' Sticks test, the specificity, sensitivity, coincidence rate, and kappa value of the HRS was computed, and then its reliability was evaluated. We divided patients into PD-OD and PD-NOD groups based on the results of olfactory function assessed by the Sniffin' Sticks test. Clinical manifestations were compared between PD-OD and PD-NOD. Results: The percentage of patients with OD determined by the Sniffin' Sticks test was 65.6%, and the percentage of those with OD was 55.6% when using the HRS measured olfactory function. With reference to the Sniffin' Sticks test, the specificity, sensitivity, coincidence rate, and kappa value of the HRS were 82.73, 75.71, 78.13%, and 0.55, respectively. The area under the receiver operating characteristic curve for the HRS was 0.793. There were no differences in demographic characteristics between the PD-OD and PD-NOD groups. The patients with hyposmia had more severe non-motor symptoms. Conclusion: The HRS is of great value as a self-assessment scale for evaluating olfactory function, especially in PD patients over 55 years old. Moreover, PD patients with hyposmia have more severe non-motor features than PD patients without hyposmia, mainly in terms of mood and constipation.

Project description:OBJECTIVE:To investigate the relationship between cognitive reserve (CR) and clinical progression across the Alzheimer disease (AD) spectrum. METHODS:We selected 839 β-amyloid (Aβ)-positive participants with normal cognition (NC, n = 175), mild cognitive impairment (MCI, n = 437), or AD dementia (n = 227) from the Alzheimer's Disease Neuroimaging Initiative (ADNI). CR was quantified using standardized residuals (W scores) from a (covariate-adjusted) linear regression with global cognition (13-item Alzheimer's Disease Assessment Scale-cognitive subscale) as an independent variable of interest, and either gray matter volumes or white matter hyperintensity volume as dependent variables. These W scores, reflecting whether an individual's degree of cerebral damage is lower or higher than clinically expected, were tested as predictors of diagnostic conversion (i.e., NC to MCI/AD dementia, or MCI to AD dementia) and longitudinal changes in memory (ADNI-MEM) and executive functions (ADNI-EF). RESULTS:The median follow-up period was 24 months (interquartile range 6-42). Corrected for age, sex, APOE4 status, and baseline cerebral damage, higher gray matter volume-based W scores (i.e., greater CR) were associated with a lower diagnostic conversion risk (hazard ratio [HR] 0.22, p < 0.001) and slower decline in memory (β = 0.48, p < 0.001) and executive function (β = 0.67, p < 0.001). Stratified by disease stage, we found similar results for NC (diagnostic conversion: HR 0.30, p = 0.038; ADNI-MEM: β = 0.52, p = 0.028; ADNI-EF: β = 0.42, p = 0.077) and MCI (diagnostic conversion: HR 0.21, p < 0.001; ADNI-MEM: β = 0.43, p = 0.003; ADNI-EF: β = 0.59, p < 0.001), but opposite findings (i.e., more rapid decline) for AD dementia (ADNI-MEM: β = -0.91, p = 0.002; ADNI-EF: β = -0.77, p = 0.081). CONCLUSIONS:Among Aβ-positive individuals, greater CR related to attenuated clinical progression in predementia stages of AD, but accelerated cognitive decline after the onset of dementia.

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Project description:Background and objectivesTo investigate the prevalence and trajectories of neuropsychiatric symptoms (NPS) in relation to cognitive functioning in a cohort of β-amyloid-positive (A+) individuals across the Alzheimer disease (AD) clinical spectrum.MethodsIn this single-center observational study, we included all individuals who visited the Alzheimer Center Amsterdam and had a clinical diagnosis of subjective cognitive decline (SCD), mild cognitive impairment (MCI), or probable AD dementia and were A+. We measured NPS with the Neuropsychiatric Inventory (NPI), examining total scores and the presence of specific NPI domains. Cognition was assessed across 5 cognitive domains and with the Mini-Mental State Examination (MMSE). We examined trajectories including model-based trends for NPS and cognitive functioning over time. We used linear mixed models to relate baseline NPI scores to cognitive functioning at baseline (whole-sample) and longitudinal time points (subsample n = 520, mean 1.8 [SD 0.7] years follow-up).ResultsWe included 1,524 A+ individuals from the Amsterdam Dementia Cohort with A+ SCD (n = 113), A+ MCI (n = 321), or A+ AD dementia (n = 1,090). NPS were prevalent across all clinical AD stages (≥1 NPS 81.4% in SCD, 81.2% in MCI, 88.7% in dementia; ≥1 clinically relevant NPS 54.0% in SCD, 50.5% in MCI, 66.0% in dementia). Cognitive functioning showed a uniform gradual decline; while in contrast, large intraindividual heterogeneity of NPS was observed over time across all AD groups. At baseline, we found associations between NPS and cognition in dementia that were most pronounced for NPI total scores and MMSE (range β = -0.18 to -0.11, false discovery rate [FDR]-adjusted p < 0.05), while there were no cross-sectional relationships in SCD and MCI (range β = -0.32 to 0.36, all FDR-adjusted p > 0.05). There were no associations between baseline NPS and cognitive functioning over time in any clinical stage (range β = -0.13 to 0.44, all FDR-adjusted p > 0.05).DiscussionNPS and cognitive symptoms are both prevalent across the AD clinical spectrum, but show a different evolution during the course of the disease.

Dataset Information

Olfactory Dysfunction and Its Relationship with Clinical Symptoms of Alzheimer Disease.

Publications

Olfactory Dysfunction and Its Relationship with Clinical Symptoms of Alzheimer Disease.

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