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Unawareness of Hyposmia in Elderly People With and Without Parkinson's Disease.

ABSTRACT: Background:Hyposmia is common in Parkinson's disease (PD) and is also observed with normal aging. It can be ascertained through objective testing, but it is unclear whether patients are aware of deficits and whether this has implications for cognitive status. Methods:Subjects in the Arizona Study of Aging and Neurodegenerative Disorders were studied with annual motor and cognitive testing with objective smell testing (University of Pennsylvania Smell Identification Test; UPSIT) done every third year beginning in 2002. Those with a baseline UPSIT <25th percentile (hyposmia) were studied for presence of unawareness of hyposmia and cognitive status. Results:There were 75 subjects with PD and 143 nonparkinsonian controls with hyposmia. Lack of awareness of hyposmia was present in 16% of PD subjects and 47% of those without PD. In PD, there was no increase in unawareness in PD with dementia. In non-PD controls, unawareness was correlated with presence of dementia. Unawareness of hyposmia correlated most strongly with the neuropsychiatric tests of learning and memory. In controls without dementia or PD, 48% were unaware. Conclusions:Querying patients about anosmia might be useful in parkinsonian disorders without objective testing. However, in elderly controls, it should be followed by objective testing and lack of awareness has implications for worsened cognitive status.

SUBMITTER: Shill HA

PROVIDER: S-EPMC6178706 | biostudies-other | 2016 Jan-Feb

REPOSITORIES: biostudies-other

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Unawareness of Hyposmia in Elderly People With and Without Parkinson's Disease.

Shill Holly A HA Hentz Joseph G JG Caviness John N JN Driver-Dunckley Erika E Jacobson Sandra S Belden Christine C Sabbagh Marwan N MN Beach Thomas G TG Adler Charles H CH

Movement disorders clinical practice 20150717 1

<h4>Background</h4>Hyposmia is common in Parkinson's disease (PD) and is also observed with normal aging. It can be ascertained through objective testing, but it is unclear whether patients are aware of deficits and whether this has implications for cognitive status.<h4>Methods</h4>Subjects in the Arizona Study of Aging and Neurodegenerative Disorders were studied with annual motor and cognitive testing with objective smell testing (University of Pennsylvania Smell Identification Test; UPSIT) do ...[more]

PMID: 30363525

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Project description:BACKGROUND:To explore the prevalence and determinants of unawareness of diabetes, hypertension and hypercholesterolemia and its association with poor disease control in a multi-ethnic Asian population without cardiovascular disease (CVD). METHODS:We included 6904 Chinese, Malay and Indian individuals (mean age [SD] 58.2 [10.2]?years; 52.6% female) with diabetes, hypertension and/or hypercholesterolemia from the cross-sectional population-based Singapore Epidemiology of Eye Diseases study (2004-2011). Diabetes was defined as random blood glucose ??11.1?mmol/L or HbA1c >?6.5% or self-reported use of diabetes medication; hypertension as systolic blood pressure ??140?mmHg or diastolic blood pressure ??90?mmHg or self-reported use of anti-hypertensive treatment; and hypercholesterolemia as total cholesterol ??6.2?mmol/L or self-reported use of lipid-lowering medications. Unawareness was based on participants' answers to the questions: "Did your medical practitioner ever tell you that you have diabetes/hypertension/high cholesterol?" The determinants of unawareness, and its association with poor disease control, were assessed using multivariable binary logistic regression models adjusted for known potential confounders. RESULTS:Of the 2380 (34.5%), 5386 (78.0%) and 3607 (52.2%) with diabetes, hypertension and hypercholesterolemia, respectively, unawareness rates were 30.7%, 43.1% and 40.9%, respectively. Having a higher BMI, particularly if obese, and Malay ethnicity were associated with greater unawareness of diabetes; Malay and Indian ethnicities and current smoking with greater unawareness of hypertension; and education ?6?years, current smoking, and blue collar jobs or unemployment with greater unawareness of hypercholesterolemia (all P < 0.05). Lack of awareness of each condition was independently associated with poorer disease control in the case of hypertension and hypercholesterolemia, while the converse was true for diabetes (all P < 0.05). CONCLUSIONS:Unawareness of diabetes, hypertension, or hypercholesterolemia is high in Singapore, with risk factors varying across all three diseases, although Malay ethnicity is a consistent one. Unawareness was also associated with poor management for hypertension and hypercholesterolemia. Public health education and screening programs should target at-risk individuals, especially Malays, to reduce the likelihood of incident CVD.

Dataset Information

Unawareness of Hyposmia in Elderly People With and Without Parkinson's Disease.

Publications

Unawareness of Hyposmia in Elderly People With and Without Parkinson's Disease.

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