Olfactory Dysfunction in Aging Adults

项目总结/摘要： 据报道，超过50%的老年人患有嗅觉功能障碍（OD）， 与5年死亡率相关。不幸的是，以前关于OD的研究的一个关键弱点是， 老龄化主要来自广泛的人口健康调查，使用有限的筛查测试 对于OD。其结果是，目前还没有任何方法来组织老年OD患者 根据疾病部位或机制。嗅觉通路沿着的各种解剖部位 可能与衰老中的OD有关，包括鼻腔、嗅觉神经上皮、嗅觉 神经、筛板和中央嗅觉结构。在这些解剖部位，OD可能 通过不同的机制发生，这些机制与独特的嗅觉特异性 生物标志物。虽然先前的研究已经证明OD是高度 在老年人中普遍存在，大多数不是为了全面评估嗅觉， 可以将OD分类为亚型的具体措施。我们的假设是 老年OD患者可根据以下因素分为临床相关表型： 解剖部位的功能障碍，将提供重要的机制见解。我们漫长 长期目标是为患者开发更好的诊断方案和个性化治疗 与衰老的OD有关。然而，为了开发有针对性的治疗方法，首先必须能够 根据疾病的潜在部位和可能的机制对患者进行分类。这一假设 将使用以下目的进行测试：1）建立可靠的和临床相关的表型， 2）确定OD对老年人健康和生活质量（QOL）的影响 3）确定哪些基线因素预测老年人随着时间的推移嗅觉变化 成年人了国家耳聋和其他沟通障碍研究所（National Institute on Deafness and Other Communication Disorders）表示， 在这方面的兴趣，“随着人口老龄化，（以）确定有多少更多的人报告.气味 影响生活质量的问题”。这一建议将提高我们对临床的认识。 分类，机制，QOL的影响和老年人OD的自然史，并奠定了 为今后研究预防、延迟发病或治疗 老化OD。

PROJECT SUMMARY/ABSTRACT: Olfactory dysfunction (OD) has been reported in more than 50% of older adults and is strongly associated with 5 year mortality. Unfortunately, a key weakness of prior research on OD in aging is that it comes primarily from broad population health surveys using limited screening tests for OD. The result is that currently there are no methods for organizing patients with OD in aging based on either disease site or mechanism. Various anatomic sites along the olfactory pathway may be involved in OD in aging, including the nasal cavity, olfactory neuroepithelium, olfactory nerves, cribriform plate, and central olfactory structures. At these anatomic sites, OD then likely occurs through distinct mechanisms that will be associated with unique olfactory-specific biomarkers. Although prior studies have been instrumental in demonstrating that OD is highly prevalent in older individuals, most were not designed to comprehensively evaluate the olfactory- specific measures that would allow classification into subtypes of OD. Our hypothesis is that patients with OD in aging can be grouped into clinically relevant phenotypes based on anatomic sites of dysfunction that will provide important mechanistic insights. Our long term objective is to develop better diagnostic protocols and personalized treatments for patients with OD in aging. However, in order to develop targeted treatments one must first be able to classify patients based on the underlying site of disease and likely mechanism. This hypothesis will be tested using the following Aims: 1) Establish reliable and clinically relevant phenotypes of OD in older adults, 2) Determine the impact of OD on health and quality of life (QOL) in older adults, and 3) Determine which baseline factors predict olfactory changes over time in older adults. The National Institute on Deafness and Other Communication Disorders has a stated its interest in this area, “as the population ages, (to) determine how many more people report…smell problems that affect quality of life.” This proposal will improve our understanding of clinical classifications, mechanisms, QOL impact and natural history of OD in older adults and lay the groundwork for future studies examining therapeutic options to prevent, delay the onset or treat OD in aging.