Sense of smell. A precursor of Alzheimer's.

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A new US study suggests that losing one's sense of smell in old age could be a precursor of Alzheimer's disease. Mild cognitive impairment (MCI), a mild thinking, learning and memory disorder that does not interfere significantly with daily living, is often a precursor to Alzheimer's diseases. Inability to recognize familiar odours has been associated with more rapid cognitive decline, and with the transition from MCI to Alzheimer's.

Dr Robert S. Wilson and colleagues from the Rush University, Chicago and also from the University of Pennsylvania decided to test the hypothesis that losing one's sense of smell could be a predictor of MCI in a longitudinal study. Their sense of smell at the start of the study was measured using a test where 12 familiar odours were placed under their nose. They were asked to identify each smell from four possible options. Also at the start of the study and then every year for five years, they had clinical evaluation that included medical history, a neurological exam and cognitive function testing.

The results showed that:
Over the 5 years, 177 participants (30 per cent) developed MCI.
Participants who scored below average (those with the lowest 25 per cent of scores) on the smell test were 50 per cent more likely to develop MCI than those who scored above average (in the highest 25 per cent of scores).

The researchers concluded that: "Among older persons without manifest cognitive impairment, difficulty in identifying odors predicts subsequent development of MCI."

They said their findings suggest that loss of sense of smell in older people could be an early sign of Alzheimer's, and that testing for this could be a useful diagnostic tool. But since loss of smell is also linked to other diseases like Parkinson's, more research is needed to identify exactly what is going on neurologically when "olfactory dysfunction" develops in older people.


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