Psychiatry Investig.  2020 Oct;17(10):1021-1030. 10.30773/pi.2020.0203.

Cut-Off Scores of an Olfactory Function Test for Mild Cognitive Impairment and Dementia

Affiliations
  • 1Department of Psychiatry, Chung-Ang University College of Medicine, Seoul, Republic of Korea
  • 2Department of Otorhinolaryngology, Head and Neck Surgery, Chung-Ang University College of Medicine, Seoul, Republic of Korea
  • 3Institute of Geriatric Medicine, Incheon Eun-Hye Hospital, Incheon, Republic of Korea

Abstract


Objective
We aimed to find the optimal cut-off scores for screening of odor detection threshold, odor discrimination, and odor identification tests for detection of mild cognitive impairment (MCI) and dementia in Korean elderly.
Methods
A total of 195 elderly people were divided into three groups: the normal cognition (NC), MCI, and dementia groups. All participants underwent neurocognitive and olfactory function tests. We used k-means cluster analysis and receiver operating characteristic (ROC) analysis to identify the most appropriate cut-off value.
Results
To distinguish the MCI from NC groups, odor identification [area under the curve (AUC)=0.670, p<0.007] with a cut-off point of 7 showed greater validity for screening (sensitivity/specificity=0.462/0.837) than did other olfactory function tests. To distinguish the MCI and dementia from NC as well, odor identification (AUC=0.817, p=0.002) with a cut-off point of 7 showed the highest validity for screening (0.785/0.654). To distinguish MCI from AD, an odor detection threshold (AUC=0.722, p=0.001) with a cut-off point of 2 showed the highest validity for screening (0.785/0.654).
Conclusion
Olfactory function tests may be a useful screening tool for cognitive decline before clinical symptoms of dementia have completely developed. This tool can be used as a supplementary tool to enhance the sensitivity of traditional cognitive tests to screen for dementia.

Keyword

Dementia, Alzheimer’s disease, Mild cognitive impairment, Olfaction, Clinical marker
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