The rhinologic evaluation of alzheimer's disease

Feldman, Jeffrey I.; Murphy, Claire; Davidson, Terence M.; Jalowayski, Alfredo A.; Jaime, Gabriella Galindo De

doi:10.1288/00005537-199111000-00007

Cited by 31 publications

(9 citation statements)

References 19 publications

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“…Odor identification testing may be sensitive to AD because of early neurofibrillary tangles in the entorhinal cortex, 24,25 b-amyloid deposits in the olfactory bulb regions, 26 or reduced numbers of mitral cells in the olfactory bulb. 27 Pathological functioning of "upstream" structures (e.g., nasal epithelium) are not specific to AD patients, 28,29 and "downstream" areas (e.g., mesial temporal lobe) are only beginning to receive attention for their role in impaired olfaction. 30 Conversely, there is no current neuropathological evidence to suggest that the entorhinal cortex or other olfactory system components would be affected in MD.…”

Section: Discussionmentioning

confidence: 99%

The Pocket Smell Test

Duff¹,

McCaffrey²,

Solomon³

2002

JNP

100

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The present study extended previous work on olfactory dysfunction (odor identification deficits) by using the Pocket Smell Test (PST) to discriminate between groups of patients with Alzheimer's disease (AD), vascular dementia (VaD), and major depression (MD). Sixty patients meeting the DSM-IV criteria for either AD, VaD, or MD (20 per group) underwent assessment with the PST, a three-item screening measure of odor identification, and the Mini-Mental State Examination (MMSE). Patients with AD scored significantly lower than patients with either VaD or MD on the PST, even after controlling for MMSE scores. A PST score of > or =1 (i.e., 1 or 0 correct) discriminated between patients with and without AD with a classification accuracy of 95% (sensitivity 100%, specificity 92.5%). Olfactory assessment may be of diagnostic utility in the differential diagnosis of AD versus VaD versus MD in elderly patients.

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Section: Discussionmentioning

confidence: 99%

The Pocket Smell Test

Duff¹,

McCaffrey²,

Solomon³

2002

JNP

100

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“…The patients with deviated septum had chief complaints of nasal breathing difficulties and/or poor odor sensitivity. Diagnoses were based on 1. computed tomographic scans of the anterior cranial fossa, nasal cavity, and paranasal sinuses, and 2. rhinomanometry, 34 nasal cytology, 35,36 nasal endoscopy, allergic evaluation, and general ear, nose, and throat examination 35,37 . It should be noted that this patient distribution does not reflect the general distribution of patients at chemosensory clinics throughout the United States.…”

Section: Methodsmentioning

confidence: 97%

Prevalence and Assessment of Qualitative Olfactory Dysfunction in Different Age Groups

et al. 1996

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The prevalence of parosmia and phantosmia among 363 chemosensory and nasal/sinus patients was studied, as was the accuracy with which our clinical questionnaire could assess these dysfunctions. We then investigated whether patients with parosmia or phantosmia, matched for odor intensity, perform poorer on odor identification than do patients with no dysosmia. More than 40% of the study group evidenced either parosmia (18.7%) and/or phantosmia (25.6%), a finding that suggests that more attention should be paid by the medical practitioner in addressing qualitative olfactory dysfunction. Furthermore, it appears that assessment of these dysfunctions may aid in differential diagnosis, and that questionnaires can be used with reasonable validity irrespective of the patient's age. Finally, the results imply that parosmia may be reflected in a discrepancy between odor identification and detection.

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“…In a recent study, we assessed nasal airway resistance, gross appearance of the nasal cavities and nasal epithelium, and the extent of allergic rhinitis and bacterial infection in Alzheimer's patients and in normal elderly controls to determine their influence on olfactory threshold differences. A summary of these findings can be found in Feldman et al 43 We tested olfactory thresholds for butanol, using the two-alternative, forced-choice, staircase procedure. Nasal airway resistance was calculated from simultaneous measurements of nasal inspiratory flow-rates and pressures, using the active, uninasal, anterior, rhinomanometric technique described in Jalowayski et al 44 We took nasal mucosal samples from the midinferior portion of the inferior turbinate, using a disposable, plastic rhinoprobe.…”

Section: B Nasal Diseasementioning

confidence: 94%

Nutrition and chemosensory perception in the elderly

Murphy

1993

Critical Reviews in Food Science and Nutrition

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114

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The elderly person's perception of foods and food flavor is affected by age-associated changes in the chemical senses (taste, smell, and trigeminal sensation). Both classic and modern psychophysical techniques have been applied to achieve some understanding of these changes. Taste threshold sensitivity declines with age; however, the magnitude of the decline and the degree to which taste qualities are differentially affected remains to be understood. Suprathreshold taste intensity perception is affected by age, but there is a differential effect of taste quality. Experiments with blended foods have indicated that both olfactory and taste deficits contribute to older people's difficulty with food identification. Experiments assessing threshold sensitivity, suprathreshold intensity, and suprathreshold identification have all demonstrated significant impairment in olfaction in old age. In fact, these effects are far greater than in the taste system. Patients with Alzheimer's disease show even greater olfactory deficits than normal elderly and the effect is related to the degree of dementia. We have ruled out nasal disease in these patients as the primary causes of olfactory insensitivity, because significant impairment remains when the influence of nasal airflow and nasal cytology has been removed statistically. Both normal elderly and patients with Alzheimer's disease show impairment in odor memory. Sensitivity to, familiarity with, and identifiability of the odors all play a role in odor memory performance. Flavor preference also changes over the lifespan. Older subjects, for instance, rate high concentration of sugar and salt as pleasanter than young subjects do. Multiple influences contribute to this phenomenon. Elderly persons and those of lower nutritional status have shown preferences for higher concentrations of casein hydrolysate than young persons and those of higher nutritional status, suggesting that dietary preference can be related to chemosensory cues. There are significant age-associated changes in chemosensory perception that have the potential to interact with dietary selection and nutrition in the elderly. A better understanding of these phenomena may promote health and well-being in the elderly.

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The rhinologic evaluation of alzheimer's disease

Cited by 31 publications

References 19 publications

The Pocket Smell Test

The Pocket Smell Test

Prevalence and Assessment of Qualitative Olfactory Dysfunction in Different Age Groups

Nutrition and chemosensory perception in the elderly

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