Severe Hyposmia Distinguishes Neuropathologically Confirmed Dementia with Lewy Bodies from Alzheimer’s Disease Dementia
Severe Hyposmia Distinguishes Neuropathologically Confirmed Dementia with Lewy Bodies from Alzheimer’s Disease Dementia
Abstract Due to the absence of core clinical features, many subjects with neuropathologically-confirmed dementia with Lewy bodies (DLB) are never diagnosed as such during life. Most of these are diagnosed with Alzheimer’s disease dementia (ADD) or unspecified dementia. Unrecognized DLB therefore is a critical impediment to clinical studies and treatment trials of both ADD and DLB. There are numerous published studies that suggest that olfactory function tests may be able to differentiate some neurodegenerative conditions from each other and from normal subjects, but there are very few studies with neuropathological confirmation of diagnosis. We compared University of Pennsylvania Smell Identification Test (UPSIT) results in 209 subjects: 1) 29 concurrently meeting intermediate or high consensus clinicopathological criteria for both DLB and ADD 2) 96 meeting criteria for ADD without DLB 3) 84 control subjects that were non-demented and without parkinsonism at death. The DLB subjects had significantly lower (one-way ANOVA p < 0.0001, pairwise Bonferroni p < 0.05) first and mean UPSIT scores (13.7 and 13.2) than ADD (23.3 and 22.2) or controls (29.6 and 28.9). For subjects with first and mean UPSIT scores less than 20 and 17, respectively, Firth logistic regression analysis, adjusted for age, gender and mean MMSE score, conferred statistically significant odds ratios of 17.5 and 18.0 for predicting a DLB vs ADD diagnosis, as compared to 3.3 for the presence or absence of visual hallucinations throughout the clinical observation period. To our knowledge, this is the largest study to date comparing olfactory function in subjects with neuropathologically confirmed DLB and ADD. Olfactory function testing may be a convenient and inexpensive strategy for enriching dementia studies or clinical trials with DLB subjects, or conversely, reducing the inclusion of DLB subjects in ADD studies or trials.
Zhang N、Serrano GE、Driver-Dunckley Erika、Zamrini E、Belden CM、Walker JE、Oliver JC、Callan M、Intorcia AJ、Reiman EM、Beach TG、Long KE、Sue LI、Caselli RJ、Adler CH、Nicholson LR、Arce R、Gerkin RC、Shprecher DR、Glass MJ、Shill HA、Davis KJ、Mehta Shayamal H.、Sabbagh MN
Department of BiostatisticsBanner Sun Health Research InstituteDepartment of NeurologyBanner Sun Health Research InstituteBanner Sun Health Research InstituteBanner Sun Health Research InstituteBanner Sun Health Research InstituteBanner Sun Health Research InstituteBanner Sun Health Research InstituteBanner Alzheimer?ˉs InstituteBanner Sun Health Research InstituteBanner Sun Health Research InstituteBanner Sun Health Research InstituteDepartment of NeurologyDepartment of NeurologyBanner Sun Health Research InstituteBanner Sun Health Research InstituteSchool of Life Sciences, Arizona State UniversityBanner Sun Health Research InstituteBanner Sun Health Research InstituteBarrow Neurological InstituteBanner Sun Health Research InstituteDepartment of NeurologyCleveland Clinic Lou Ruvo Center for Brain Health
神经病学、精神病学医学研究方法基础医学
olfactoryautopsyprodromalalpha-synucleindiagnosisbiomarker
Zhang N,Serrano GE,Driver-Dunckley Erika,Zamrini E,Belden CM,Walker JE,Oliver JC,Callan M,Intorcia AJ,Reiman EM,Beach TG,Long KE,Sue LI,Caselli RJ,Adler CH,Nicholson LR,Arce R,Gerkin RC,Shprecher DR,Glass MJ,Shill HA,Davis KJ,Mehta Shayamal H.,Sabbagh MN.Severe Hyposmia Distinguishes Neuropathologically Confirmed Dementia with Lewy Bodies from Alzheimer’s Disease Dementia[EB/OL].(2025-03-28)[2025-08-02].https://www.biorxiv.org/content/10.1101/743856.点此复制
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