Olfactory identification and incidence of mild cognitive impairment in older age
Olfactory identification and incidence of mild cognitive impairment in older age
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DOI：
10.1001/archpsyc.64.7.802
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发表时间：
2007-07-01
影响因子：
--
通讯作者：
Bennett, David A.
中科院分区：
文献类型：
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作者：
Wilson, Robert S.;Schneider, Julie A.;Bennett, David A.
背景：轻度认知障碍 (MCI) 通常是阿尔茨海默病的先兆，但对预测其发展的因素的了解有限。目的：检验气味识别受损与 MCI 事件风险增加相关的假设。设计：纵向队列研究。背景：学术研究。参与者：受试者为 589 名在研究基线时没有认知障碍的社区居住老年人，当时使用 12 项简短气味评估气味识别能力识别测试（平均+/- SD分数，9.3 +/- 1.9）。主要结果指标：MCI的发生率和认知功能下降率。结果：在长达5年的年度观察中，177名受试者出现MCI。在根据年龄、性别和教育程度进行调整的比例风险模型中，气味识别评分预测 MCI 的发展（相对风险，1.15；95% 置信区间，1.07-1.23），与气味识别评分高于平均水平（11 分 [75 个百分位]）的人相比，低于平均水平（得分为 8 [第 25 个百分位]）的人风险增加 50%。在控制认知功能或残疾水平、中风存在或基线吸烟状况或要求 MCI 持续至少 1 年的后续分析中，结果没有显着变化。气味识别受损还与基线时整体认知水平较低以及情景记忆、语义记忆和知觉速度更快下降有关。结论：在没有明显认知障碍的老年人中，识别气味困难预示着随后会发生 MCI。
Context: Mild cognitive impairment (MCI) is often a precursor to Alzheimer disease, but knowledge about factors that predict its development is limited.Objective: To test the hypothesis that impaired odor identification is related to increased risk of incident MCI.Design: Longitudinal cohort study.Setting: Academic research.Participants: Subjectswere 589 community- dwelling older persons without cognitive impairment at study baseline, at which time odor identification was assessed using the 12-item Brief Smell IdentificationTest( mean +/- SD score, 9.3 +/- 1.9).Main Outcome Measures: Incidence of MCI and rate of decline in cognitive function.Results: During annual observation of up to 5 years, 177 subjects developed MCI. In a proportional hazards model adjusted for age, sex, and education, odor identification score predicted development of MCI (relative risk, 1.15; 95% confidence interval, 1.07-1.23), with risk increased by 50% in persons with below-average (score of 8 [25th percentile]) compared with above- average (score of 11 [75th percentile]) odor identification scores. Results were not substantially changed in subsequent analyses that controlled for level of cognitive function or disability, presence of stroke, or smoking status at baseline or that required MCI to persist for at least 1 year. Impaired odor identification was also associated with a lower level of global cognition at baseline and with more rapid decline in episodic memory, semantic memory, and perceptual speed.Conclusion: Among older persons without manifest cognitive impairment, difficulty in identifying odors predicts subsequent development of MCI.