Olfactory Dysfunction in Aging Adults

项目摘要/摘要： 据报道，超过50%的老年人存在嗅觉功能障碍(OD)，而且 与5年死亡率相关。不幸的是，之前关于OD的研究的一个关键弱点是 老龄化主要来自广泛的人群健康调查，使用有限的筛查测试 服药过量。结果是，目前还没有方法来组织老年OD患者 基于疾病部位或发病机制。嗅路的不同解剖位置 可能参与衰老的OD，包括鼻腔、嗅神经上皮、嗅觉 神经、筛板和中央嗅觉结构。在这些解剖部位，外径很可能 通过不同的机制发生，这些机制将与独特的嗅觉专有 生物标志物。尽管之前的研究已经有助于证明过量服药的高度 在老年人中很普遍，大多数都不是为了全面评估嗅觉而设计的- 将允许分类为OD亚类的具体措施。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 功能障碍的解剖部位，将提供重要的机械学见解。我们的龙 学期目标是为患者开发更好的诊断方案和个性化治疗 随着年龄的增长，吸食过量。然而，为了开发有针对性的治疗方法，首先必须能够 根据潜在的疾病部位和可能的机制对患者进行分类。这一假设 将使用以下目标进行测试：1)建立可靠的和临床相关的表型 老年人服药过量，2)确定服药过量对老年人健康和生活质量的影响 成年人，以及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。国家耳聋和其他沟通障碍研究所已经声明了其 对这一领域的兴趣，随着人口的老龄化，决定了有多少人报告了…闻 影响生活质量的问题。这一建议将提高我们对临床的理解 老年人服药过量的分类、机制、生活质量影响和自然病史 为未来研究检查预防、延迟发病或治疗的治疗方案奠定基础 衰老中的过量。

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.