Smell Perception Testing in Early Diagnosis of Neurodegenerative Dementia

Czech version

Authors: H. Magerová; M. Vyhnálek; J. Laczó; M. Bojar; J. Hort
Authors‘ workplace: Neurologická klinika UK ; 2. LF a FN Motol, Praha ; Centrum pro poruchy kognitivních funkcí
Published in: Cesk Slov Neurol N 2008; 71/104(3): 298-302
Category: Original Paper

Overview

Objective:
The aim of this study is to investigate the rate and prognostic value of smell impairment in the most common types of dementia and in patients in prodromal stages of these diseases. We also present a new smell identification test developed at our Memory Clinic – the Motol Hospital Smell Test (MHST).

Subjects and Methods:
Based on the results of neuropsychological testing and MRI, 138 patients were classified into several groups as Alzheimer's disease (AD), Frontotemporal Lobar Degeneration (FTLD), Mild Cognitive Impairment (MCI) – amnestic (aMCI) and nonamnestic (naMCI), Subject Memory Complaint (SMC) and a control group. Smell identification was examined using MHST and the University of Pennsylvania Smell Identification Test (UPSIT).

Results:
Smell identification was significantly impaired in AD (p < 0.001), FTLD (p < 0.001) and aMCI (p <0.01) when compared to the control group. The naMCI and SMC patients did not differ from control group. MHST results correlated with UPSIT results (r = 0.68, p < 0.0005).

Conclusions:
Impaired smell identification in AD and aMCI and intact smell identification in naMCI correspondent with the hypothesis that aMCI represents a prodromal stage of AD, whereas naMCI typically converts to non-AD dementia. Results obtained by MHST and UPSIT show that sensitivity and specificity for assessment of smell identification impairment is at the same level in both tests.

Key words:
smell perception testing – Alzheimer’s disease – frontotemporal lobar degeneration – mild cognitive impairment – subject memory complaint – Motol Hospital Smell Test – University of Pennsylvania Smell Identification Test

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