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Olfactory Impairment in Mild Cognitive Impairment with Lewy Bodies and Alzheimer’s Disease

Lookup NU author(s): Professor Alan ThomasORCiD, Dr Calum Hamilton, Sally Barker, Rory Durcan, Dr Sarah Lawley, Nicola Barnett, Dr Michael FirbankORCiD, Dr Gemma Roberts, Dr Louise Allan, Professor John O'Brien, Professor John-Paul TaylorORCiD, Dr Paul DonaghyORCiD

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This is the authors' accepted manuscript of an article that has been published in its final definitive form by Cambridge University Press, 2021.

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Abstract

Objectives Impaired olfaction may be a biomarker for early Lewy body disease but its value in Mild Cognitive Impairment with Lewy bodies (MCI-LB) is unknown. We compared olfaction in MCI-LB with MCI due to Alzheimer’s disease (MCI-AD) and healthy older adults. We hypothesised that olfactory function would be worse in probable MCI-LB than in both MCI-AD and healthy comparison subjects (HC). Design Cross-sectional study assessing olfaction using Sniffin’ Sticks 16 (SS-16) in MCI-LB, MCI-AD and HC with longitudinal follow-up. Differences were adjusted for age and receiver operating characteristic curves were used for discriminating MCI-LB from MCI-AD andHC. Setting Participants were recruited from Memory Services in the North East of England Participants 38 probable MCI-LB, 33 MCI-AD, 19 possible MCI-LB and 32HC. Measurements Olfaction was assessed using SS-16 and a questionnaire. Results Participants with probable MCI-LB had worse olfaction than both MCI-AD (Age-adjusted mean difference (B)=2.05,95% CI:0.62-3.49, p=.005) and HC (B=3.96, 95% CI:2.51–5.40, p<.001). The previously-identified cut-off score for the SS-16 of ≤ 10 had 84% sensitivity for probable MCI-LB (95% CI: 69-94%) but 30% specificity vs MCI-AD. ROC analysis found a lower cut-off of ≤ 7 was better (63% sensitivity for MCI-LB, with 73% specificity vs MCI-AD and 97% vsHC). Asking about olfactory impairments was not useful in identifying them. Conclusions MCI-LB had worse olfaction than MCI-AD and normal ageing. A lower cut-off score of ≤ 7 is required when using SS-16 in such patients. Olfactory testing may have value in identifying early LB disease in memory services.


Publication metadata

Author(s): Thomas AJ, Hamilton CA, Barker S, Durcan R, Lawley S, Barnett N, Firbank M, Roberts G, Allan L, O'Brien J, Taylor JP, Donaghy PC

Publication type: Article

Publication status: Published

Journal: International Psychogeriatrics

Year: 2021

Issue: ePub ahead of Print

Online publication date: 20/09/2021

Acceptance date: 07/09/2021

Date deposited: 20/09/2021

ISSN (print): 1041-6102

ISSN (electronic): 1741-203X

Publisher: Cambridge University Press

URL: https://doi.org/10.1017/S1041610221001265

DOI: 10.1017/S1041610221001265


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