Smell Loss Predicts Mortality Risk Regardless of Dementia Conversion
Smell Loss Predicts Mortality Risk Regardless of Dementia Conversion
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DOI：
10.1111/jgs.14770
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发表时间：
2017-06-01
影响因子：
6.3
通讯作者：
Olofsson, Jonas K.
中科院分区：
文献类型：
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作者：
Ekstrom, Ingrid;Sjolund, Sara;Olofsson, Jonas K.
在长达10年的随访期内，确定痴呆是否可以解释嗅觉能力差与死亡风险之间的关联。设计前瞻性队列研究。设置Betula研究，瑞典Umea。研究对象为基线年龄为40至90岁的无痴呆的成年参与者，（N = 1，774）.使用斯堪的纳维亚气味识别测试（SOIT）和自我报告的嗅觉功能测量嗅觉表现;基线时的几个社会、认知和医学风险因素;结果在10年的随访中，1,774名参与者中有411人（23.2%）死亡。在考克斯模型中，较高的SOIT评分与较低的死亡率之间的相关性是显著的（风险比（HR）= 0.74/点区间，95%置信区间（CI）= 0.71-0.77，P <0.001）。在控制了年龄、性别、教育、健康相关和认知变量后，这种影响有所减弱，但仍然显著（HR = 0.92，95%CI = 0.87-0.97，P = 0.001）。在控制了死亡前痴呆转换后，SOIT评分与死亡率之间的相关性仍然存在（HR = 0.92，95% CI = 0.87-0.97，P = 0.001）。自我报告的嗅觉dysfunctions.ConclusionPoor气味识别和自我报告的嗅觉功能差与未来死亡率的可能性更大。痴呆症并没有减弱嗅觉丧失和死亡率之间的联系，这表明嗅觉丧失可能标志着健康状况的恶化，而与痴呆症无关。
ObjectivesTo determine whether dementia could explain the association between poor olfactory performance and mortality risk within a decade-long follow-up period.DesignProspective cohort study.SettingBetula Study, Umea, Sweden.ParticipantsA population-based sample of adult participants without dementia at baseline aged 40 to 90 (N = 1,774).MeasurementsOlfactory performance using the Scandinavian Odor-Identification Test (SOIT) and self-reported olfactory function; several social, cognitive, and medical risk factors at baseline; and incident dementia during the following decade.ResultsWithin the 10-year follow-up, 411 of 1,774 (23.2%) participants had died. In a Cox model, the association between higher SOIT score and lower mortality was significant (hazard ratio (HR) = 0.74 per point interval, 95% confidence interval (CI) = 0.71-0.77, P < .001). The effect was attenuated, but remained significant, after controlling for age, sex, education, and health-related and cognitive variables (HR = 0.92, 95% CI = 0.87-0.97, P = .001). The association between SOIT score and mortality was retained after controlling for dementia conversion before death (HR = 0.92, 95% CI = 0.87-0.97, P = .001). Similar results were obtained for self-reported olfactory dysfunction.ConclusionPoor odor identification and poor self-reported olfactory function are associated with greater likelihood of future mortality. Dementia does not attenuate the association between olfactory loss and mortality, suggesting that olfactory loss might mark deteriorating health, irrespective of dementia.