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Olfactory Impairment and Subjective Olfactory Complaints Independently Predict Conversion to Dementia: A Longitudinal, Population-Based Study

Published online by Cambridge University Press:  22 January 2014

Ingrid Stanciu
Gösta Ekman Laboratory, Stockholm University, Stockholm, Sweden Psychology Department, Stockholm University, Stockholm, Sweden
Maria Larsson
Gösta Ekman Laboratory, Stockholm University, Stockholm, Sweden Psychology Department, Stockholm University, Stockholm, Sweden
Steven Nordin
Department of Psychology, Umeå University, Umeå, Sweden
Rolf Adolfsson
Department of Clinical Sciences, Psychiatry, Umeå University, Umeå, Sweden
Lars-Göran Nilsson
Psychology Department, Stockholm University, Stockholm, Sweden
Jonas K. Olofsson
Gösta Ekman Laboratory, Stockholm University, Stockholm, Sweden Psychology Department, Stockholm University, Stockholm, Sweden Swedish Collegium for Advanced Study, Uppsala, Sweden


We examined whether conversion to dementia can be predicted by self-reported olfactory impairment and/or by an inability to identify odors. Common forms of dementia involve an impaired sense of smell, and poor olfactory performance predicts cognitive decline among the elderly. We followed a sample of 1529 participants, who were within a normal range of overall cognitive function at baseline, over a 10-year period during which 159 were classified as having a dementia disorder. Dementia conversion was predicted from demographic variables, Mini-Mental State Examination score, and olfactory assessments. Self-reported olfactory impairment emerged as an independent predictor of dementia. After adjusting for effects of other predictors, individuals who rated their olfactory sensitivity as “worse than normal” were more likely to convert to dementia than those who reported normal olfactory sensitivity (odds ratio [OR] = 2.17; 95% confidence interval [CI] [1.40, 3.37]). Additionally, low scores on an odor identification test also predicted conversion to dementia (OR per 1 point increase = 0.89; 95% CI [0.81, 0.98]), but these two effects were additive. We suggest that assessing subjective olfactory complaints might supplement other assessments when evaluating the risk of conversion to dementia. Future studies should investigate which combination of olfactory assessments is most useful in predicting dementia conversion. (JINS, 2014, 20, 1–9)

Research Articles
Copyright © The International Neuropsychological Society 2014 

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