Smell Loss Predicts Mortality Risk Regardless of Dementia Conversion

Ekström, Ingrid; Sjölund, Sara; Nordin, Steven; Adolfsson, Annelie Nordin; Adolfsson, Rolf; Nilsson, Lars Göran; Larsson, Maria; Olofsson, Jonas

doi:10.1111/jgs.14770

Cited by 85 publications

(81 citation statements)

References 42 publications

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“…In regard to age groups, results vary between studies. Some found a stronger OI-mortality link in older subjects, while others demonstrated a slightly stronger relationship in middleaged groups (Gopinath et al, 2012;Ekström et al, 2017;Liu et al, 2019). This latter finding may be due to the increased prevalence of anosmia with advancing age.…”

Section: Summary Of Existing Studies Linking Olfactory Impairment Andmentioning

confidence: 99%

“…Until now, seven longitudinal studies have been published on the relationship between olfactory function at baseline and risk of mortality (Wilson et al, 2011;Gopinath et al, 2012;Pinto et al, 2014;Devanand et al, 2015;Schubert et al, 2016;Ekström et al, 2017;Liu et al, 2019). Demographics and methods are summarized in Table 1.…”

Section: Summary Of Existing Studies Linking Olfactory Impairment Andmentioning

confidence: 99%

“…One proposed explanation is that dysfunction or absence of olfactory bulb might result in the dysfunction of various cellular processes and pathways within the hippocampus (Morales-Medina et al, 2017). Some of the mortality studies reported that the subjects who died showed more depressive signs (Wilson et al, 2011;Ekström et al, 2017). However, the association of OI with mortality persisted after controlling for depressive symptoms (Wilson et al, 2011).…”

Section: Effects Of Olfactory Loss On Eating Behavior Danger Warningmentioning

confidence: 99%

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Mechanisms Linking Olfactory Impairment and Risk of Mortality

et al. 2020

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Olfaction is a sense involved in a complex set of tasks, influencing eating behavior, increasing awareness of environmental hazards and affecting social communication. Surprisingly, smell disorders are very frequent, especially in the elderly population. Several recent studies conducted mostly in older subjects have demonstrated a strong association between olfactory impairment and overall mortality risk, with anosmia being even more predictive of 5 years mortality risk than cardiovascular disease. Presently, the underlying pathophysiology linking olfactory impairment to mortality remains unknown and only putative mechanisms are suggested. This review aims to examine the link between olfactory impairment and mortality and to discuss existing ideas on underlying existing mechanisms including, (1) the effect of olfactory loss on nutrition, life-threatening situations and social interactions, (2) associated neurodegenerative diseases, (3) accelerated brain aging, and (4) reflection of general health status being reflected in olfactory function.

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Section: Summary Of Existing Studies Linking Olfactory Impairment Andmentioning

confidence: 99%

Section: Summary Of Existing Studies Linking Olfactory Impairment Andmentioning

confidence: 99%

Section: Effects Of Olfactory Loss On Eating Behavior Danger Warningmentioning

confidence: 99%

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Mechanisms Linking Olfactory Impairment and Risk of Mortality

et al. 2020

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“…Olfactory dysfunction is a more robust indicator than auditory or visual impairment of future mild cognitive impairment (MacDonald et al 2018). Olfactory dysfunction, whether assessed objectively or by selfreport, is consistently found to predict future dementia and increased mortality risk (Ekström et al, 2017(Ekström et al, , 2019Stanciu et al 2014;Devanand et al 2000;Devanand et al 2015a, b). The parallel decline of visual-based cognitive abilities and olfactory capabilities in early-stage dementia might be due to atrophy in regions such as parahippocampal and orbitofrontal cortex that process both olfactory and multisensory information (Devanand et al 2008;Dintica et al 2019).…”

Section: Introductionmentioning

confidence: 99%

Interaction Between Odor Identification Deficit and APOE4 Predicts 6-Year Cognitive Decline in Elderly Individuals

et al. 2019

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Olfactory identification impairment might indicate future cognitive decline in elderly individuals. An unresolved question is to what extent this effect is dependent on the ApoE-ε4, a genotype associated with risk of Alzheimer's Disease (AD). Given the current concern about reproducibility in empirical research, we assessed this issue in a large sample (n = 1637) of older adults (60 -96 years) from the population-based longitudinal Swedish National Study on Aging and Care in Kungsholmen (SNAC-K). A hierarchical regression analysis was carried out to determine if a low score on an odor identification test, and the presence of ApoE-ε4, would predict the magnitude of a prospective 6-year change in the Mini-Mental State Examination (MMSE) after controlling for demographic, health-related, and cognitive variables. We found that overall, lower odor identification performance was predictive of cognitive decline, and, as hypothesized, we found that the effect was most pronounced among ApoE-ε4 carriers. Our results from this high-powered sample suggest that in elderly carriers of the ApoE-ε4 allele, odor identification impairment provides an indication of future cognitive decline, which has relevance for the prognosis of AD.

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“…To date, numerous studies have sought to find good and reliable biomarkers of aging whose changes with age would measure the intensity of homeostenosis and chronic systemic inflammation in older adults (Brito et al 2014;Milman et al 2014;Nilsson et al 2014;Sayer and Kirkwood 2015;Chmielewski et al 2016b;Marioni et al 2016a;Ekström et al 2017). Recently, it has been demonstrated that leukocytes (white blood cells, WBCs), which are measured at very low cost and with high precision for routine medical check-ups, are not only important inflammatory markers and harbingers of disease progression and poor prognosis in older patients but also very useful predictors of long-term survival in older individuals (Brown et al 2001;Erlinger et al 2004;Wheeler et al 2004;Leng et al 2005a;2005b;Margolis et al 2005;2007;Tamakoshi et al 2007;Leng et al 2009;Kabat et al 2017;Wang et al 2017).…”

Section: Introductionmentioning

confidence: 99%

Leukocyte count, systemic inflammation, and health status in older adults: a narrative review

Chmielewski

2018

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Epidemiological and clinical studies suggest that elevated leukocyte count within the normal range can predict cardiovascular and total mortality in older adults. These findings are remarkable because this simple and common laboratory test is included in routine medical check-ups. It is well known that chronic systemic inflammation (inflammaging) is one of the hallmarks of aging and an important component of obesity-associated insulin resistance that can lead to type 2 diabetes and other health problems in both overweight individuals and elderly people. To understand the molecular mechanisms linking increased systemic inflammation with aging-associated diseases and elevated leukocyte counts in the elderly is to unravel the multiplicity of molecular factors and mechanisms involved in chronic low-grade systemic inflammation, the gradual accumulation of random molecular damage, age-related diseases, and the process of leukopoiesis. There are several possible mechanisms through which chronic low-grade systemic inflammation is associated with both higher leukocyte count and a greater risk of aging-associated conditions in older adults. For example, the IL-6 centric model predicts that this biomediator is involved in chronic systemic inflammation and leukopoiesis, thereby suggesting that elevated leukocyte count is a signal of poor health in older adults. Alternatively, an increase in neutrophil and monocyte counts can be a direct cause of cardiovascular events in the elderly. Interestingly, some authors assert that the predictive ability of elevated leukocyte counts with regard to cardiovascular and allcause mortality among older adults surpass the predictive value of total cholesterol. This review reports the recent findings on the links between elevated but normal leukocyte counts and the increased risks of all-cause, cardiovascular, and cancer mortality. The possible molecular mechanisms linking higher but normal leukocyte counts with increased risk of aging-associated diseases in the elderly are discussed here.

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Smell Loss Predicts Mortality Risk Regardless of Dementia Conversion

Cited by 85 publications

References 42 publications

Mechanisms Linking Olfactory Impairment and Risk of Mortality

Mechanisms Linking Olfactory Impairment and Risk of Mortality

Interaction Between Odor Identification Deficit and APOE4 Predicts 6-Year Cognitive Decline in Elderly Individuals

Leukocyte count, systemic inflammation, and health status in older adults: a narrative review

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