The 8-item NHANES pocket smell test: Normative data.

This study provides normative data useful for interpreting scores from the Pocket Smell Test (PST), a brief "scratch & sniff" neuropsychological olfactory screening test comprised of 8 items from the 40-item University of Pennsylvania Smell Identification Test (UPSIT). We combined 3,485 PST scores from the 2013 to 2014 National Health and Nutrition Survey (NHANES) of persons 40 years of age and older with equivalent PST items extracted from an UPSIT database of 3,900 persons ranging in age from 5 to 99 years. Decade-related age- and gender-adjusted percentile normative data were established across the entire age spectrum. Cut-points for defining clinically useful categories of anosmia, probable microsmia, and normosmia were determined using receiver operating characteristic (ROC) curve analyses. An age-related decline in test scores was evident for both sexes after the age of 40 years, with women outperforming men. Based on the ROC analyses, subjects scoring 3 or less (AUC = 0.81) defines anosmia. Regardless of sex, a score of 7 or 8 on the N-PST signifies normal function (AUC of 0.71). Probable microsmia is classified as scores extending from 3 to 6. These data provide an accurate means for interpreting PST scores within a number of clinical and applied settings.