Importance: To increase the opportunity to delay or prevent mild cognitive impairment (MCI) or Alzheimer disease (AD) dementia, markers of early detection are essential. Olfactory impairment may be an important clinical marker and predictor of these conditions and may help identify persons at increased risk.
Objective: To examine associations of impaired olfaction with incident MCI subtypes and progression from MCI subtypes to AD dementia.
Design, Setting, And Participants: Participants enrolled in the population-based, prospective Mayo Clinic Study of Aging between 2004 and 2010 were clinically evaluated at baseline and every 15 months through 2014. Participants (N = 1630) were classified as having normal cognition, MCI (amnestic MCI [aMCI] and nonamnestic MCI [naMCI]), and dementia. We administered the Brief Smell Identification Test (B-SIT) to assess olfactory function.
Main Outcomes And Measures: Mild cognitive impairment, AD dementia, and longitudinal change in cognitive performance measures.
Results: Of the 1630 participants who were cognitively normal at the time of the smell test, 33 died before follow-up and 167 were lost to follow-up. Among the 1430 cognitively normal participants included, the mean (SD) age was 79.5 (5.3) years, 49.4% were men, the mean duration of education was 14.3 years, and 25.4% were APOE ε4 carriers. Over a mean 3.5 years of follow-up, there were 250 incident cases of MCI among 1430 cognitively normal participants. We observed an association between decreasing olfactory identification, as measured by a decrease in the number of correct responses in B-SIT score, and an increased risk of aMCI. Compared with the upper B-SIT quartile (quartile [Q] 4, best scores), hazard ratios (HRs) (95% CI) were 1.12 (0.65-1.92) for Q3 (P = .68); 1.95 (1.25-3.03) for Q2 (P = .003); and 2.18 (1.36-3.51) for Q1 (P = .001) (worst scores; P for trend <.001) after adjustment for sex and education, with age as the time scale. There was no association with naMCI. There were 64 incident dementia cases among 221 prevalent MCI cases. The B-SIT score also predicted progression from aMCI to AD dementia, with a significant dose-response with worsening B-SIT quartiles. Compared with Q4, HR (95% CI) estimates were 3.02 (1.06-8.57) for Q3 (P = .04); 3.63 (1.19-11.10) for Q2 (P = .02); and 5.20 (1.90-14.20) for Q1 (P = .001). After adjusting for key predictors of MCI risk, B-SIT (as a continuous measure) remained a significant predictor of MCI (HR, 1.10 [95% CI, 1.04-1.16]; P < .001) and improved the model concordance.
Conclusions And Relevance: Olfactory impairment is associated with incident aMCI and progression from aMCI to AD dementia. These findings are consistent with previous studies that have reported associations of olfactory impairment with cognitive impairment in late life and suggest that olfactory tests have potential utility for screening for MCI and MCI that is likely to progress.
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http://dx.doi.org/10.1001/jamaneurol.2015.2952 | DOI Listing |
Age Ageing
January 2025
Division of Psychiatry, University College London, London, UK.
Background: Age-related hearing loss and mild cognitive impairment (MCI) independently increase dementia risk. The Ageing and Cognitive Health Evaluation in Elders randomised controlled trial (RCT) found hearing aids reduce cognitive decline in high-risk older adults with poor hearing.
Methods: This pilot RCT in London memory clinics randomised people with MCI (aged ≥55, untreated hearing loss defined as Pure Tone Average 0.
Aging Ment Health
January 2025
School of Nursing, Johns Hopkins University, Baltimore, MD, USA.
Objectives: This scoping review aims to map out the coping strategies among Persons with Mild Cognitive Impairment (PwMCI) and Persons with Mild Dementia (PwMD), identifying the facilitators and the barriers to the use of the strategies.
Method: We conducted a systematic search of peer-reviewed studies in PubMed, CINAHL, EMBASE, and PsycINFO. Under the guidance of the Coping Circumflex Model, we identified coping strategies and then conducted thematic synthesis.
Front Neurol
January 2025
Department of Psychosomatic Medicine, University Hospital Regensburg, Regensburg, Germany.
Background: Post COVID-19 condition (PCC) is increasingly recognized as a debilitating condition characterized by persistent symptoms following SARS-CoV-2 infection. Neuropsychological deficits, including cognitive impairments and fatigue, are prevalent in individuals with PCC. The PoCoRe study aimed to evaluate the burden of neuropsychological deficits in PCC patients undergoing multidisciplinary indoor rehabilitation and to describe possible changes in this symptomatology.
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January 2025
Neurology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.
Introduction: Evidence increasingly shows that facial emotion recognition (FER) is impaired in refractory mesial temporal lobe epilepsy (rMTLE), especially in patients with a right focus. This study explores FER in both mild (mMTLE) and refractory forms, examining the influence of epileptic focus lateralization on FER.
Methods: 50 MTLE patients, categorized by epilepsy severity and focus lateralization, were compared with healthy controls.
Front Aging Neurosci
January 2025
Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, China.
Background: As a clinical precursor to Alzheimer's disease (AD), amnestic mild cognitive impairment (aMCI) bears a considerably heightened risk of transitioning to AD compared to cognitively normal elders. Early prediction of whether aMCI will progress to AD is of paramount importance, as it can provide pivotal guidance for subsequent clinical interventions in an early and effective manner.
Methods: A total of 107 aMCI cases were enrolled and their electroencephalogram (EEG) data were collected at the time of the initial diagnosis.
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