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Olfaction in Persons with Alzheimer's Disease

Abstract

The need for low cost, noninvasive procedures for aiding in the diagnosis and understanding of Alzheimer's Disease (AD) has led to theories and procedures examining the role of olfactory disorders because of the finding that the brains of AD patients invariably exhibit neuropathology hi the hippocampus and entorhinal cortex. This loss correlates with the increase in the number of plaques and tangles and with the severity of dementia. Considered together, these findings suggest that brain structures closely related to the olfactory system demonstrate significant histopathology in AD. A comprehensive review of the literature pertaining to olfaction in persons with AD revealed that the olfactory identification ability of patients with memory disorders is impaired relative to controls. Consistency is lacking, however, when olfactory detection thresholds are investigated. Also, there is inconsistency in regards to severity of illness and olfactory function. In addition to differentiating AD patients from normals, the olfactory paradigm has shown some limited usefulness in differentiating AD patients from some other demented patients.

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REFERENCES

  1. Albert, M., and Milberg, W. (1989). Semantic processing in patients with Alzheimer's disease. Brain and Language 37: 163-171.

    PubMed  Google Scholar 

  2. American Psychiatric Association. (1980). Diagnostic and Statistical Manual of Mental Disorders (3rd ed.), Author, Washington, DC.

    Google Scholar 

  3. American Psychiatric Association (1987). Diagnostic and Statistical Manual (3rd ed., revised), Author, Washington, DC.

    Google Scholar 

  4. Anderson, J., Maxwell, L., and Murphy, C. (1992). Odorant identification testing in the young child. Chemical Senses 17: 590.

    Google Scholar 

  5. Averback, P. (1983). Two new lesions in Alzheimer's disease. The Lancet 2: 1203.

    Google Scholar 

  6. Ball, M. J., Hachinski, V., Fox, A., Kirshen, A. J., Fishman, M., Blume, W., Kral, V. A., and Merskey, H. (1985). A new definition of Alzheimer's disease: A hippocampal dementia. Lancet 82: 4531-4534.

    Google Scholar 

  7. Buchsbaum, M. S., Kesslak, P., Lynch, G., Chui, H., Wu, J., Sicotte, N. Hazlett, E., and Cotman, C. W. (1991). Temporal and hippocampal metabolic rate during an olfactory memory task assessed by positron emission tomography in patients with dementia of the Alzheimer type and controls. Archives of General Psychiatry 48: 840-847.

    PubMed  Google Scholar 

  8. Buschke, H., and Fuld, P. A. (1974). Evaluating storage, retention, and retrieval in disordered memory and learning. Neurology 24: 1019-1025.

    PubMed  Google Scholar 

  9. Cain, W. S., and Krause, R. J. (1979). Olfactory testing: Rules for odor identification. Neurological Research 1: 1-9.

    PubMed  Google Scholar 

  10. Corwin, J., Serby, M., Conrad, P., and Rotrosen, J. (1985). Olfactory recognition deficit in Alzheimer's disease and Parkinsonian dementias. IRCS Medical Science 13: 260.

    Google Scholar 

  11. Crook, T., Gilbert, J. G., and Ferris, S. H. (1980). Guild Memory Test. Psychological Reports 47: 1315-1318.

    PubMed  Google Scholar 

  12. Desor, J. A., and Beauchamp, G. K. (1974). The human capacity to transmit olfactory information. Perceptual Psychophysics 16: 551-556.

    Google Scholar 

  13. Doty, R. L. (1983). The Smell Identification Test: Administration Manual, Sensonics, Philadelphia, PA.

    Google Scholar 

  14. Doty, R. L., Deems, D. A., and Stellar, S. (1988). Olfactory dysfunction in Parkinsonism: A general deficit unrelated to neurologic signs, disease stage, or disease duration. Neurology 38: 1237-1244.

    PubMed  Google Scholar 

  15. Doty, R. L., Riklan, M., Deems, D. A., Reynolds, C., and Stellar, S. (1989). The olfactory and cognitive deficits of Parkinson's disease: Evidence for independence. Annals of Neurology 25: 166-171.

    PubMed  Google Scholar 

  16. Doty, R. L., Shaman, P., and Dann, M. (1984). Development of the University of Pennsylvania Smell Identification Test: A standardized microencapsulated test of olfactory function. Physiological Behavior 32: 489-502.

    Google Scholar 

  17. Doty, R. L., Reyes, P. F., and Gregor, T. (1987). Presence of both odor identification and detection deficits in Alzheimer's disease. Brain Research Bulletin 18: 597-600.

    PubMed  Google Scholar 

  18. Esiri, M. M., and Wilcock, G. K. (1984). The olfactory bulbs in Alzheimer's disease. Journal of Neurology, Neurosurgery, and Psychiatry 47: 56-60.

    Google Scholar 

  19. Folstein, M. F., Folstein, S. E., and McHugh, P. R. (1975). Mini Mental State: A practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research 12: 189-198.

    PubMed  Google Scholar 

  20. Golden, C., and Chronopolous, A. (in press). Dementia. In Hersen, M., and Van Hasselt, V. (eds.), Handbook of Gerontology, Plenum, New York.

  21. Hyman, B. T., Van Hoesen, G. W., Damasio, A. R., and Barnes, C. L. (1984). Alzheimer's disease: cell-specific pathology isolates the hippocampal formation. Science 225: 1168-1170.

    PubMed  Google Scholar 

  22. Kesslak, J. P., Cotman, C. W., Chui, H. C., Van Den Noort, S., Fang, H., Pfeffer, R., and Lynch, G. (1988). Olfactory tests as possible probes for detecting and monitoring Alzheimer's disease. Neurobiology of Aging 9: 399-403.

    PubMed  Google Scholar 

  23. Kesslak, J. P., Nalcioglu, O., and Cotman, C. W. (1991). Quantification of magnetic resonance scans for hippocampal and parahippocampal atrophy in Alzheimer's disease. Neurology 41: 51-54.

    PubMed  Google Scholar 

  24. Knupfer, L., and Spiegel, R. (1986). Differences in olfactory test performance between normal and aged Alzheimer and vascular type dementia individuals. International Journal of Geriatric Psychiatry 1: 3-14.

    Google Scholar 

  25. Koss, E. (1986). Olfactory dysfunction in Alzheimer's disease. Developmental Neuropsychology 2: 89-99.

    Google Scholar 

  26. Koss, E., Weiffenbach, J. M., Haxby, J. V., and Friedland, R. P. (1988). Olfactory detection and identification performance are dissociated in early Alzheimer's disease. Neurology 38: 1228-1232.

    PubMed  Google Scholar 

  27. Lehrner, J. P., Brucke, T., Dalbianco, P., Gatterer, G., and Kryspin-Exner, I.(1997). Olfactory functions in Parkinson's disease and Alzheimer's disease. Chemical Senses 22: 105-110.

    PubMed  Google Scholar 

  28. Luria, A. R. (1973). The Working Brain, Basic Books, New York.

    Google Scholar 

  29. Mattis, S. (1976). Mental status examination for organic mental syndrome in the elderly patient. In Bellak, L., and Karasu, T. B. (eds.), Geriatric Psychiatry: Handbook for Psychiatrists and Primary Care Physicians, Grune and Stratton, New York, pp. 77-121.

    Google Scholar 

  30. McKhann, G., Drachman, D., Folstein, M., Katzman, R., Price, D., and Stadlan, E. M. (1984). Clinical diagnosis of Alzheimer's disease: Report of the NINCDS-ADRDA work group under the auspices of Department of Health and Human Services Task Force on Alzheimer's Disease. Neurology 34: 939-944.

    PubMed  Google Scholar 

  31. Moberg, P. J., Pearlson, G. D., Speedie, L. J., Lipsey, J. R., Strauss, M. E., and Folstein, S. E. (1987). Olfactory recognition: Differential impairments in early and late Huntington's and Alzheimer's diseases. Journal of Clinical Experimental Neuropsychology 9: 650-664.

    Google Scholar 

  32. Nordin, S., and Murphy, C. (1996). Impaired sensory and cognitive olfactory function in qustionable Alzeimer's disease. Neuropsychology 10: 113-119.

    Google Scholar 

  33. Reisberg, G., Farris, S. H., DeLeon, M. J., and Cook, T. (1982). The Global Deterioration Scale for assessment of primary degenerative dementia. American Journal of Psychiatry 139: 1136-1139.

    PubMed  Google Scholar 

  34. Rezek, D. J. (1987). Olfactory deficits as a neurologic sign in dementia of the Alzheimer type. Archives of Neurology 44: 1030-1032.

    PubMed  Google Scholar 

  35. Rosen, W. G., Terry, R. D., Fuld, P. A., Katzman, R., and Peck, A. (1980). Pathological verification of ischemic score in differentiation of dementias. Annals of Neurology 7: 486-488.

    PubMed  Google Scholar 

  36. Schiffman, S. (1983). Taste and smell in disease. New England Journal of Medicine 308: 1275-1279.

    PubMed  Google Scholar 

  37. Schumacher, G. A., Beebe, G., Kibler, R. F., Kurland, L. T., Kurtzke, J. F., McDowell, F., Nagler, B., Sibley, W. A., Tourtellote, W. W., and Wilson, T. L. (1965). Problems of experimental trials of therapy in multiple sclerosis; report by the panel on the evaluation of experimental trials of therapy of multiple sclerosis. Annals of the New York Academy of Science 122: 522-528.

    Google Scholar 

  38. Smith, S. R., Murdoch, B. E., and Chenery, H. J. (1989). Semantic abilities in dementia of the Alzheimer type: I. Lexical semantics. Brain and Language 36: 314-324.

    PubMed  Google Scholar 

  39. Tierney, M. C., Fisher, R. H., Lewis, A. J., Zorzitto, M. L., Snow, W. G., Reid, D. W., and Nieuwstraten, P. (1988). The NINCDS-ADRDA Work Group criteria for the clinical diagnosis of probable Alzheimer's disease: A clinicopathologic study of 57 cases. Neurology 38: 359-364.

    PubMed  Google Scholar 

  40. Tippett, L. J., and Farah, M. J. (1994). A computational model of naming in Alzheimer's disease: Unitary or multiple impairments. Neuropsychology 8: 3-13.

    Google Scholar 

  41. Vollmecke, T. A., and Doty, R. L. (1985). Development of the Picture Identification Test (PIT): A research companion to the University of Pennsylvania Smell Identification Test. Chemical Senses 9: 413-414.

    Google Scholar 

  42. Warner, M. D., Peabody, C. A., Flattery, J. J., and Tinklenberg, J. R. (1986). Olfactory deficits and Alzheimer's disease. Biological Psychiatry 21: 116-118.

    PubMed  Google Scholar 

  43. Waldton, S. (1974). Clinical observations of impaired cranial nerve function in senile dementia. Acta Psychiatrica Scandinavica 50: 539-547.

    PubMed  Google Scholar 

  44. Wedding, D., and Cody, S. (1990). Neurological Disorders in the Elderly. In Horton, A. M., Jr., (ed.), Neuropsychology Across the Life-Span, Springer Publishing Company, New York.

    Google Scholar 

  45. Winer, B. J. (1971). Statistical Principles in Experimental Design (2nd ed.), McGraw-Hill, New York.

    Google Scholar 

  46. Zucco, G. M., Zaglis, D., and Wambsganss, C. S. (1991). Olfactory deficits in elderly subjects and Parkinson patients. Perceptual and Motor Skills 73: 895-898.

    PubMed  Google Scholar 

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Thompson, M.D., Knee, K. & Golden, C.J. Olfaction in Persons with Alzheimer's Disease. Neuropsychol Rev 8, 11–23 (1998). https://doi.org/10.1023/A:1025627106073

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  • Olfactory
  • neuropsychology
  • Alzheimer's disease
  • Parkinson's disease
  • smell
  • dementia