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Bouhaben J, Delgado-Lima AH, Delgado-Losada ML. The role of olfactory dysfunction in mild cognitive impairment and Alzheimer's disease: A meta-analysis. Arch Gerontol Geriatr 2024; 123:105425. [PMID: 38615524 DOI: 10.1016/j.archger.2024.105425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2024] [Revised: 03/22/2024] [Accepted: 03/27/2024] [Indexed: 04/16/2024]
Abstract
PURPOSE This comprehensive meta-analysis investigates the association between olfactory deficits in mild cognitive impairment (MCI) and Alzheimer's disease (AD). METHODS A thorough search across databases identified articles analyzing olfactory status in MCI or AD patients. Methodological quality assessment followed PRISMA guidelines. Hedges' g effect size statistic computed standard mean differences and 95% confidence intervals. Moderator analysis was conducted. RESULTS Among the included studies (65 for MCI and 61 for AD), odor identification exhibited larger effect sizes compared to odor threshold and discrimination, in both MCI and AD samples. Moderate effect size is found in OI scores in MCI (k = 65, SE = 0.078, CI 95% = [-1.151, -0.844]). Furthermore, compared to MCI, AD had moderate to large heterogeneous effects in olfactory identification (k = 61, g = -2.062, SE = 0.125, CI 95% = [-2.308, -1.816]). Global cognitive status is positively related to olfactory identification impairment in both MCI (k = 57, Z = 2.74, p = 0.006) and AD (k = 53, Z = 5.03, p < 0.0001) samples. CONCLUSION Olfactory impairments exhibit a notable and substantial presence in MCI. Among these impairments, odor identification experiences the greatest decline in MCI, mirroring the primary sensory deficit observed in AD. Consequently, the incorporation of a straightforward odor identification test is advisable in the evaluation of individuals vulnerable to the onset of AD, offering a practical screening tool for early detection.
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Affiliation(s)
- Jaime Bouhaben
- Experimental Psychology, Cognitive Processes and Speech Therapy Department, Faculty of Psychology, Complutense University of Madrid, 28223 Pozuelo de Alarcon, Spain
| | - Alice Helena Delgado-Lima
- Experimental Psychology, Cognitive Processes and Speech Therapy Department, Faculty of Psychology, Complutense University of Madrid, 28223 Pozuelo de Alarcon, Spain
| | - María Luisa Delgado-Losada
- Experimental Psychology, Cognitive Processes and Speech Therapy Department, Faculty of Psychology, Complutense University of Madrid, 28223 Pozuelo de Alarcon, Spain.
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Mak HWF, Ho SY, Wong JCY, Chiang V, Lee E, Yim JSH, Wong BYH, Li PH. Clinical utility of and correlation between Sniffin' Sticks and TIB smell identification test (TIBSIT) among Hong Kong Chinese with or without chronic rhinosinusitis. Front Allergy 2024; 5:1292342. [PMID: 38332895 PMCID: PMC10847303 DOI: 10.3389/falgy.2024.1292342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Accepted: 01/15/2024] [Indexed: 02/10/2024] Open
Abstract
Introduction Olfactory dysfunction (OD) is common among patients with chronic rhinosinusitis (CRS). Validated and culturally specific tests, such as the "Sniffin' Sticks" test (SST) and the TIB Smell Identification Test (TIBSIT), are crucial for the diagnosis and monitoring of OD. However, they have not been utilised in Hong Kong Chinese and their correlations are unknown. Methods Twelve CRS patients and twenty healthy volunteers were prospectively recruited from a joint allergy-otorhinolaryngology clinic in Hong Kong and performed both SST and TIBSIT. Demographics, baseline characteristics and all test results were compared and analysed. Results Patients with CRS demonstrated significantly lower test scores than healthy controls (all p < 0.001). Significant and strong correlations were observed between all composite and subtest scores, particularly between the composite SST and TIBSIT scores (ρ = 0.789, p < 0.001). Multivariate analysis demonstrated that the presence of CRS and increasing age were significantly associated with OD. Conclusion Both SST and TIBSIT are useful olfactory tests and are strongly correlated among Hong Kong Chinese. We advocate that either test can be used for measuring OD among CRS patients.
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Affiliation(s)
- Hugo W F Mak
- Division of Rheumatology and Clinical Immunology, Department of Medicine, Queen Mary Hospital, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Shi Yeung Ho
- Department of Ear, Nose and Throat, Queen Mary Hospital, Hong Kong, Hong Kong SAR, China
| | - Jane C Y Wong
- Division of Rheumatology and Clinical Immunology, Department of Medicine, Queen Mary Hospital, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Valerie Chiang
- Division of Clinical Immunology, Department of Pathology, Queen Mary Hospital, Hong Kong, Hong Kong SAR, China
| | - Elaine Lee
- Division of Rheumatology and Clinical Immunology, Department of Medicine, Queen Mary Hospital, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Jackie S H Yim
- Division of Rheumatology and Clinical Immunology, Department of Medicine, Queen Mary Hospital, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Birgitta Y H Wong
- Department of Ear, Nose and Throat, Queen Mary Hospital, Hong Kong, Hong Kong SAR, China
| | - Philip H Li
- Division of Rheumatology and Clinical Immunology, Department of Medicine, Queen Mary Hospital, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
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Zhang H, Wang M, Qian M, Wei H. Odor familiarity and improvement of olfactory identification test in Chinese population. Front Psychol 2023; 14:1278668. [PMID: 37908819 PMCID: PMC10613687 DOI: 10.3389/fpsyg.2023.1278668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2023] [Accepted: 09/21/2023] [Indexed: 11/02/2023] Open
Abstract
Aims This study aimed to design the Chinese Modified Olfactory Identification (CMOI) test based on the Sniffin' Sticks Olfactory Identification (SSOI) test by changing unfamiliar distractors and odors for more familiar ones for the Chinese population. Materials and methods We recruited 200 healthy volunteers (103 males and 97 females, aged 18-65 years, mean age 35.04 years, SD 10.96); in a survey, 100 volunteers rated their familiarity with 121 odors, including all the SSOI test odor descriptors and common odors in Chinese daily life. The SSOI test was modified according to the survey results. The other 100 volunteers were tested three times using the SSOI test, the Modified Distractors Olfactory Identification (MDOI) test established by modifying distractors in the SSOI test, and the CMOI test developed by using familiar unpleasant odors to displace the odors with low correct recognition rates in the MDOI test. We compared the test scores of the volunteers during the modification process. Results Volunteers were unfamiliar with 31 odor descriptors in the SSOI test; 23 distractors with low familiarity were displaced with more familiar distractors. The three odors with the lowest correct recognition rate in the MDOI test (apple, leather, and pineapple) were displaced with familiar unpleasant odors. The test scores were significantly higher in the CMOI test than in others (p < 0.0001); the correct recognition rate in the CMOI test was significantly higher than in the SSOI test (p < 0.01). Conclusion The test scores in the CMOI test were significantly improved; it prevented choosing wrongly due to unfamiliarity with an odor and its distractors.
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Affiliation(s)
| | | | | | - Hongquan Wei
- The First Affiliated Hospital of China Medical University, Shenyang, China
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Tuz‐Hrycyna N, Rzepakowska A, Niemczyk K. Reliability and validity of the Polish version of the Questionnaire of Olfactory Disorders. Laryngoscope Investig Otolaryngol 2023; 8:799-807. [PMID: 37621288 PMCID: PMC10446256 DOI: 10.1002/lio2.1087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 05/03/2023] [Accepted: 05/23/2023] [Indexed: 08/26/2023] Open
Abstract
Background The comprehensive counseling of patients with olfactory dysfunctions requires accurate diagnosis. The recommendations include subjective assessment. The Questionnaire of Olfactory Disorders (QOD) is a disease-specific questionnaire for the subjective evaluation of olfactory dysfunctions. Material The study included 54 patients with olfactory dysfunctions, who were recruited to the study group (SG). The other 47 patients without the history of olfactory dysfunction and nasal cavity pathology were voluntarily allocated to the control group (CG). The protocol of the study was introduced to each patient and included: olfactory testing with Sniffin' Stick test, fulfillment of the Polish version of World Health Organization Quality of Life brief questionnaire and completing of the Polish version of the QOD. All participants (101) were invited for refilling the QOD questionnaire after 2 weeks for the test-retest statistics. Results The Polish QOD statements were significantly correlated and met the requirement by having test-retest correlation larger than 0.7. We found that internal consistency of the test measured by Cronbach's alpha coefficient was very high. The mean scores of the QOD test in normosmic SG patients were compared with corresponding scores in normosmic CG patients using U Mann-Whitney test. The analysis revealed statistically significant differences on mean QOD scores for each domains except QOD-S between both groups. Conclusions The Polish version of the QOD demonstrated high rate of the validity and the reliability. This instrument may be widely used in research projects and clinical practice concerning olfactory disorders in Polish patients. Level of Evidence NA.
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Affiliation(s)
- Natalia Tuz‐Hrycyna
- Department of Otorhinolaryngology, Head and Neck SurgeryMedical University of WarsawWarsawPoland
| | - Anna Rzepakowska
- Department of Otorhinolaryngology, Head and Neck SurgeryMedical University of WarsawWarsawPoland
| | - Kazimierz Niemczyk
- Department of Otorhinolaryngology, Head and Neck SurgeryMedical University of WarsawWarsawPoland
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De Luca R, Bonanno M, Rifici C, Quartarone A, Calabrò RS. Post-traumatic olfactory dysfunction: a scoping review of assessment and rehabilitation approaches. Front Neurol 2023; 14:1193406. [PMID: 37521284 PMCID: PMC10374209 DOI: 10.3389/fneur.2023.1193406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Accepted: 06/27/2023] [Indexed: 08/01/2023] Open
Abstract
Post-traumatic Olfactory Dysfunction (PTOD) consists of a complete or partial loss of olfactory function that may occur after a traumatic brain injury (TBI). PTOD may be linked to some neuropsychiatric features, such as social, cognitive and executive dysfunction, as well as behavioral symptoms, especially when TBI involves the orbito-frontal cortex. The diagnosis of PTOD is based on medical history and clinical data and it is supported by psychometric tests (i.e., subjective tools) as well as electrophysiological and neuroimaging measures (i.e., objective methods). The assessment methods allow monitoring the changes in olfactory function over time and help to establish the right therapeutic and rehabilitative approach. In this context, the use of the olfactory training (OT), which is a non-pharmacological and non-invasive treatment option, could promote olfactory function through top-down (central) and bottom-up (peripheral) processes. To better manage patients with TBI, PTOD should be detected early and properly treated using the various therapeutic rehabilitative possibilities, both conventional and advanced, also taking into consideration the emerging neuromodulation approach.
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Tran TN, Thi Dang TH, Thai TT, Le HT, Nguyen TTT, Nguyen HT, Nguyen ANT, Le Ha UN, Vo KCN, Nguyen TV, van Nguyen T, Ly QX, Truong D. Development and validation of the Vietnamese smell identification test. Parkinsonism Relat Disord 2023; 113:105494. [PMID: 37413956 DOI: 10.1016/j.parkreldis.2023.105494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Revised: 06/13/2023] [Accepted: 06/17/2023] [Indexed: 07/08/2023]
Abstract
BACKGROUND Correct olfactory identification requires familiarity with the odor stimuli and is culturally dependent. Existing smell identification tests (SIT) are not culturally specific and may not be reliable in detecting hyposmia in all populations. This study aimed to develop a smell identification test suitable for Vietnamese patients (VSIT). METHODS The study included 4 phases: 1) survey-based evaluation of the familiarity of 68 odors to identify 18 odors for subsequent testing (N = 1050); 2) smell identification test of 18 odors in healthy patients (N = 50) to determine which 12 should be included in the VSIT; 3) comparison of VSIT scores on 12 odors in patients with hyposmia (N = 60; Brief smell identification test (BSIT) score <8 and those with normosmia (N = 120; BSIT score ≥8) to establish the validity of the newly developed test; and 4) retest of the VSIT in 60 normosmic patients from phase 3 (N = 60) to determine test-retest reliability. RESULTS As expected, the mean (SD) VSIT score was significantly higher in the healthy participants than in the hyposmic patients [10.28 (1.34) vs 4.57 (1.76); P < 0.001]. Using a cut-off score at 8, the sensitivity and specificity of the instrument in detecting hyposmia were 93.3% and 97.5% respectively. The test-retest reliability using the intra-class correlation coefficient was at 0.72 (P < 0.001). CONCLUSION The Vietnamese Smell Identification Test (VSIT) demonstrated favorable validity and reliability and will allow for assessment of olfactory function in Vietnamese patients.
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Affiliation(s)
- Tai Ngoc Tran
- Movement Disorder Unit, Neurology Department, University Medical Center, University of Medicine and Pharmacy at Ho Chi Minh City, Viet Nam.
| | - Thuong Huyen Thi Dang
- Movement Disorder Unit, Neurology Department, University Medical Center, University of Medicine and Pharmacy at Ho Chi Minh City, Viet Nam.
| | - Truc Thanh Thai
- Department of Medical Statistics and Informatics, Faculty of Public Health, University of Medicine and Pharmacy at Ho Chi Minh City, Viet Nam.
| | - Hien Thi Le
- Movement Disorder Unit, Neurology Department, University Medical Center, University of Medicine and Pharmacy at Ho Chi Minh City, Viet Nam.
| | - Thuy Thu Thi Nguyen
- Movement Disorder Unit, Neurology Department, University Medical Center, University of Medicine and Pharmacy at Ho Chi Minh City, Viet Nam.
| | - Hai Thi Nguyen
- Movement Disorder Unit, Neurology Department, University Medical Center, University of Medicine and Pharmacy at Ho Chi Minh City, Viet Nam.
| | - Anh Ngoc Thi Nguyen
- Movement Disorder Unit, Neurology Department, University Medical Center, University of Medicine and Pharmacy at Ho Chi Minh City, Viet Nam.
| | - Uyen Ngoc Le Ha
- Movement Disorder Unit, Neurology Department, University Medical Center, University of Medicine and Pharmacy at Ho Chi Minh City, Viet Nam.
| | - Khang Chung Ngoc Vo
- Movement Disorder Unit, Neurology Department, University Medical Center, University of Medicine and Pharmacy at Ho Chi Minh City, Viet Nam.
| | - Thanh Vinh Nguyen
- Movement Disorder Unit, Neurology Department, University Medical Center, University of Medicine and Pharmacy at Ho Chi Minh City, Viet Nam
| | - Thanh van Nguyen
- ENT Department, University Medical Center, University of Medicine and Pharmacy at Ho Chi Minh City, Viet Nam.
| | - Quang Xuan Ly
- ENT Department, University Medical Center, University of Medicine and Pharmacy at Ho Chi Minh City, Viet Nam.
| | - Daniel Truong
- The Parkinson and Movement Disorder Institute, Fountain Valley, CA, 92708, USA; Department of Psychiatry and Neuroscience, University of California Riverside, Riverside, CA, USA.
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Delgado-Lima AH, Bouhaben J, Martínez-Zujeros S, Pallardo-Rodil B, Gómez-Pavón J, Delgado-Losada ML. Could olfactory identification be a prognostic factor in detecting cognitive impairment risk in the elderly? GeroScience 2023:10.1007/s11357-023-00779-5. [PMID: 37084121 PMCID: PMC10119830 DOI: 10.1007/s11357-023-00779-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Accepted: 03/20/2023] [Indexed: 04/22/2023] Open
Abstract
Aging contributes to the deterioration of the olfactory system in humans. Several studies indicate that the olfactory identification test alone may function as a screening test for olfactory dysfunction and they are more feasible to apply in clinical practice. Olfactory identification may be a predictor for cognitive impairment. Multiple studies have considered the use of odor identification as a measure to identify the conversion from normality to mild cognitive impairment or dementia. The objectives were (i) to elucidate the associations between cognitive status and olfactory identification performance in aging; (ii) understand the predictive value of olfactory capacity in identifying subjects with cognitive impairment risk; and (iii) to study how cognitive status and olfactory identification relate with other variables of wellness in aging, such as functional capabilities and clinical measures. For this purpose, a group of 149 participants (77.15 ± 7.29 years; 73 women of 76.7 ± 8 years and 76 men of 77.6 ± 6.52 years) were recruited and were subjected to a sociodemographic questionnaire, a psychological screening tool of general cognitive status, an olfactory identification evaluation, and clinical measures. The participants were divided into groups based on their cutoff scores of previous scientific reports about the Spanish version of Montreal Cognitive Assessment. Our results indicate an age-associated decline in olfactory identification ability and intensity of odor perception. The predictive ability of olfactory identification scores for the risk of mild and severe impairment is around 80%. Olfactory identification decreases with cognitive function. Performance in odor identification is associated with impairment of episodic memory and executive functions. These findings further our current understanding of the association between cognition and olfaction, and support olfactory assessment in screening those at higher risk of dementia.
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Affiliation(s)
- Alice Helena Delgado-Lima
- Experimental Psychology, Cognitive Processes and Speech Therapy Department, Faculty of Psychology, Complutense University of Madrid, 28223, Pozuelo de Alarcón, Spain
| | - Jaime Bouhaben
- Experimental Psychology, Cognitive Processes and Speech Therapy Department, Faculty of Psychology, Complutense University of Madrid, 28223, Pozuelo de Alarcón, Spain
| | - Sergio Martínez-Zujeros
- Geriatric Department, Hospital Central de La Cruz Roja "San José Y Santa Adela", 28003, Madrid, Spain
| | - Beatriz Pallardo-Rodil
- Geriatric Department, Hospital Central de La Cruz Roja "San José Y Santa Adela", 28003, Madrid, Spain
| | - Javier Gómez-Pavón
- Geriatric Department, Hospital Central de La Cruz Roja "San José Y Santa Adela", 28003, Madrid, Spain
| | - María Luisa Delgado-Losada
- Experimental Psychology, Cognitive Processes and Speech Therapy Department, Faculty of Psychology, Complutense University of Madrid, 28223, Pozuelo de Alarcón, Spain.
- Group of Neurosciences: Psychoneuroendocrinology, Neuroimaging and Molecular Genetics in Neuropsychiatric Diseases, Instituto de Investigación Sanitaria San Carlos (IdISSC), Hospital Clínico de Madrid, 28040, Madrid, Spain.
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Abstract
OBJECTIVE To investigate the prevalence and recovery of olfactory dysfunction (OD) in COVID-19 patients 24 months after the infection. METHODS From 22 March 2020 to 5 June 2022, 251 COVID-19 patients were followed in three European medical centres. Olfactory function was assessed with subjective patient-reported outcome questionnaires and odour identification tests at baseline, 6, 12, 18 and 24 months postinfection. The predictive values of epidemiological and clinical data were investigated with multivariate analysis. RESULTS One hundred and seventy-one patients completed the evaluations. The odour identification test revealed that 123 patients (50.8%) had OD at baseline. The prevalence of persistent psychophysical abnormalities at 6, 12, 18 and 24 months post-COVID-19 was 24.2%, 17.9%, 5.8% and 2.9%, respectively (p = 0.001). Parosmia occurred in 40 patients (23.4%) and lasted 60 ± 119 days. At 2 years, 51 patients (29.8%) self reported that their olfaction was unnormalised. Older patients had better odour identification evaluations at baseline (p < 0.001) but those with OD reported lower odour identification test scores at the end of the follow-up. Parosmia occurred more frequently in young patients. The olfactory training was significantly associated with higher values of Sniffin' Sticks tests at 18 months postinfection (rs = 0.678; p < 0.001). CONCLUSION Two years post-COVID-19, 29.8% of patients reported persistent OD, but only 2.9% had abnormal identification psychophysical evaluations.
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Affiliation(s)
- Jerome R Lechien
- Department of Otolaryngology, Polyclinic of Poitiers-Elsan, Poitiers, France.,Department of Human Anatomy and Experimental Oncology, Faculty of Medicine, UMONS Research Institute for Health Sciences and Technology, University of Mons (UMons), Mons, Belgium.,Department of Otolaryngology-Head and Neck Surgery, Foch Hospital, School of Medicine, UFR Simone Veil, Université Versailles Saint-Quentin-en-Yvelines (Paris Saclay University), Paris, France.,Department of Otorhinolaryngology and Head and Neck Surgery, EpiCURA Hospital, Baudour, Belgium
| | - Luigi A Vaira
- Maxillofacial Surgery Operative Unit, Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy.,Biomedical Science Department, PhD School of Biomedical Science, University of Sassari, Sassari, Italy
| | - Sven Saussez
- Department of Human Anatomy and Experimental Oncology, Faculty of Medicine, UMONS Research Institute for Health Sciences and Technology, University of Mons (UMons), Mons, Belgium.,Department of Otorhinolaryngology and Head and Neck Surgery, EpiCURA Hospital, Baudour, Belgium
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Abstract
Purpose of Review To provide an overview of psychophysical testing in olfaction and gustation. Recent Findings Subjective patient report correlates poorly with objective assessment of olfaction and gustation. It is therefore important that clinicians and researchers perform psychophysical testing during chemosensory assessment. There are several validated psychophysical tests of olfaction and gustation, with ongoing developments accelerated by the COVID-19 pandemic. These tests have been culturally and linguistically adapted globally. Screening tests have been developed with careful consideration to distinguish normosmics from those with olfactory dysfunction. Summary Validated chemosensory tools are available for use by the clinician to support screening, diagnosis, or monitoring. There are promising advances in self-assessment and screening that provide avenues for the development of a standardised pathway for identification and formal assessment of patients with smell and taste disorders.
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Affiliation(s)
- Miriam Fahmy
- ENT Department, Pinderfields Hospital, Mid Yorkshire Hospital NHS Trust, Wakefield, UK
- Wrexham, UK
| | - Katherine Whitcroft
- ENT Department, Pinderfields Hospital, Mid Yorkshire Hospital NHS Trust, Wakefield, UK
- UCL Ear Institute, London, UK
- Centre for Olfactory Research Applications, Institute of Philosophy, School of Advanced Study, London, UK
- Smell and Taste Clinic, Techniche Universität Dresden, Dresden, Germany
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Delgado-Losada ML, Bouhaben J, Ruiz-Huerta C, Canto MV, Delgado-Lima AH. Long-Lasting Olfactory Dysfunction in Hospital Workers Due to COVID-19: Prevalence, Clinical Characteristics, and Most Affected Odorants. Int J Environ Res Public Health 2022; 19:5777. [PMID: 35565169 DOI: 10.3390/ijerph19095777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Revised: 04/24/2022] [Accepted: 05/05/2022] [Indexed: 02/01/2023]
Abstract
Hospital workers have increased exposure risk of healthcare-associated infections due to the frontline nature of their work. Olfactory dysfunction is highly prevalent. The objectives for this investigation are to study the prevalence of long-lasting olfactory dysfunction associated with COVID-19 infection in hospital workers during the first pandemic wave, to identify clinical characteristics and associated symptomatology, and to analyze how many patients with COVID-19 infection had developed olfactory dysfunction during infection and maintained a reduced olfactory function for approximately 10 weeks after diagnosis. Between June and July of 2020, a cross-sectional study was carried out at the Hospital Central de la Cruz Roja San José and Santa Adela in Madrid, Spain. One hundred sixty-four participants were included, of which 110 were patient-facing healthcare staff and 54 were non-patient-facing healthcare staff. Participants were split into three groups, according to COVID-19 diagnosis and presence of COVID-19 related olfactory symptomatology. Participants were asked to complete a structured online questionnaire along with Sniffin' Stick Olfactory Test measurements. In this study, 88 participants were confirmed for COVID-19 infection, 59 of those participants also reported olfactory symptomatology. The prevalence of COVID-19 infection was 11.35%, and the prevalence for olfactory dysfunction was 67.05%. Olfactory dysfunction associated with COVID-19 infection leads to long-lasting olfactory loss. Objective assessment with Sniffin' Stick Olfactory Test points to odor identification as the most affected process. Lemon, liquorice, solvent, and rose are the odors that are worst recognized. Mint, banana, solvent, garlic, coffee, and pineapple, although they are identified, are perceived with less intensity. The findings of this study confirmed a high prevalence of SARS-CoV-2 infection among the hospital workers.
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Patel ZM, Holbrook EH, Turner JH, Adappa ND, Albers MW, Altundag A, Appenzeller S, Costanzo RM, Croy I, Davis GE, Dehgani-Mobaraki P, Doty RL, Duffy VB, Goldstein BJ, Gudis DA, Haehner A, Higgins TS, Hopkins C, Huart C, Hummel T, Jitaroon K, Kern RC, Khanwalkar AR, Kobayashi M, Kondo K, Lane AP, Lechner M, Leopold DA, Levy JM, Marmura MJ, Mclelland L, Miwa T, Moberg PJ, Mueller CA, Nigwekar SU, O'Brien EK, Paunescu TG, Pellegrino R, Philpott C, Pinto JM, Reiter ER, Roalf DR, Rowan NR, Schlosser RJ, Schwob J, Seiden AM, Smith TL, Soler ZM, Sowerby L, Tan BK, Thamboo A, Wrobel B, Yan CH. International consensus statement on allergy and rhinology: Olfaction. Int Forum Allergy Rhinol 2022; 12:327-680. [PMID: 35373533 DOI: 10.1002/alr.22929] [Citation(s) in RCA: 37] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Revised: 01/01/2021] [Accepted: 11/19/2021] [Indexed: 12/11/2022]
Abstract
BACKGROUND The literature regarding clinical olfaction, olfactory loss, and olfactory dysfunction has expanded rapidly over the past two decades, with an exponential rise in the past year. There is substantial variability in the quality of this literature and a need to consolidate and critically review the evidence. It is with that aim that we have gathered experts from around the world to produce this International Consensus on Allergy and Rhinology: Olfaction (ICAR:O). METHODS Using previously described methodology, specific topics were developed relating to olfaction. Each topic was assigned a literature review, evidence-based review, or evidence-based review with recommendations format as dictated by available evidence and scope within the ICAR:O document. Following iterative reviews of each topic, the ICAR:O document was integrated and reviewed by all authors for final consensus. RESULTS The ICAR:O document reviews nearly 100 separate topics within the realm of olfaction, including diagnosis, epidemiology, disease burden, diagnosis, testing, etiology, treatment, and associated pathologies. CONCLUSION This critical review of the existing clinical olfaction literature provides much needed insight and clarity into the evaluation, diagnosis, and treatment of patients with olfactory dysfunction, while also clearly delineating gaps in our knowledge and evidence base that we should investigate further.
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Affiliation(s)
- Zara M Patel
- Otolaryngology, Stanford University School of Medicine, Stanford, California, USA
| | - Eric H Holbrook
- Otolaryngology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, USA
| | - Justin H Turner
- Otolaryngology, Vanderbilt School of Medicine, Nashville, Tennessee, USA
| | - Nithin D Adappa
- Otolaryngology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Mark W Albers
- Neurology, Harvard Medical School, Boston, Massachusetts, USA
| | - Aytug Altundag
- Otolaryngology, Biruni University School of Medicine, İstanbul, Turkey
| | - Simone Appenzeller
- Rheumatology, School of Medical Sciences, University of Campinas, São Paulo, Brazil
| | - Richard M Costanzo
- Physiology and Biophysics and Otolaryngology, Virginia Commonwealth University School of Medicine, Richmond, Virginia, USA
| | - Ilona Croy
- Psychology and Psychosomatic Medicine, TU Dresden, Dresden, Germany
| | - Greg E Davis
- Otolaryngology, Proliance Surgeons, Seattle and Puyallup, Washington, USA
| | - Puya Dehgani-Mobaraki
- Associazione Naso Sano, Umbria Regional Registry of Volunteer Activities, Corciano, Italy
| | - Richard L Doty
- Smell and Taste Center, Otolaryngology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Valerie B Duffy
- Allied Health Sciences, University of Connecticut, Storrs, Connecticut, USA
| | | | - David A Gudis
- Otolaryngology, Columbia University Irving Medical Center, New York, USA
| | - Antje Haehner
- Smell and Taste, Otolaryngology, TU Dresden, Dresden, Germany
| | - Thomas S Higgins
- Otolaryngology, University of Louisville School of Medicine, Louisville, Kentucky, USA
| | - Claire Hopkins
- Otolaryngology, Guy's and St. Thomas' Hospitals, London Bridge Hospital, London, UK
| | - Caroline Huart
- Otorhinolaryngology, Cliniques universitaires Saint-Luc, Institute of Neuroscience, Université catholgique de Louvain, Brussels, Belgium
| | - Thomas Hummel
- Smell and Taste, Otolaryngology, TU Dresden, Dresden, Germany
| | | | - Robert C Kern
- Otolaryngology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Ashoke R Khanwalkar
- Otolaryngology, Stanford University School of Medicine, Stanford, California, USA
| | - Masayoshi Kobayashi
- Otorhinolaryngology-Head and Neck Surgery, Mie University Graduate School of Medicine, Mie, Japan
| | - Kenji Kondo
- Otolaryngology, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
| | - Andrew P Lane
- Otolaryngology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Matt Lechner
- Otolaryngology, Barts Health and University College London, London, UK
| | - Donald A Leopold
- Otolaryngology, University of Vermont Medical Center, Burlington, Vermont, USA
| | - Joshua M Levy
- Otolaryngology, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Michael J Marmura
- Neurology Thomas Jefferson University School of Medicine, Philadelphia, Pennsylvania, USA
| | - Lisha Mclelland
- Otolaryngology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Takaki Miwa
- Otolaryngology, Kanazawa Medical University, Ishikawa, Japan
| | - Paul J Moberg
- Psychiatry, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA
| | | | - Sagar U Nigwekar
- Division of Nephrology, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Erin K O'Brien
- Otolaryngology, Mayo Clinic Rochester, Rochester, Minnesota, USA
| | - Teodor G Paunescu
- Division of Nephrology, Massachusetts General Hospital, Boston, Massachusetts, USA
| | | | - Carl Philpott
- Otolaryngology, University of East Anglia, Norwich, UK
| | - Jayant M Pinto
- Otolaryngology, University of Chicago, Chicago, Illinois, USA
| | - Evan R Reiter
- Otolaryngology, Virginia Commonwealth University School of Medicine, Richmond, Virginia, USA
| | - David R Roalf
- Psychiatry, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA
| | - Nicholas R Rowan
- Otolaryngology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Rodney J Schlosser
- Otolaryngology, Medical University of South Carolina, Mt Pleasant, South Carolina, USA
| | - James Schwob
- Biomedical Sciences, Tufts University School of Medicine, Boston, Massachusetts, USA
| | - Allen M Seiden
- Otolaryngology, University of Cincinnati School of Medicine, Cincinnati, Ohio, USA
| | - Timothy L Smith
- Otolaryngology, Oregon Health and Sciences University, Portland, Oregon, USA
| | - Zachary M Soler
- Otolaryngology, Medical University of South Carolina, Mt Pleasant, South Carolina, USA
| | - Leigh Sowerby
- Otolaryngology, University of Western Ontario, London, Ontario, Canada
| | - Bruce K Tan
- Otolaryngology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Andrew Thamboo
- Otolaryngology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Bozena Wrobel
- Otolaryngology, Keck School of Medicine, USC, Los Angeles, California, USA
| | - Carol H Yan
- Otolaryngology, School of Medicine, UCSD, La Jolla, California, USA
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12
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Lim SXL, Höchenberger R, Busch NA, Bergmann M, Ohla K. Associations between Taste and Smell Sensitivity, Preference and Quality of Life in Healthy Aging-The NutriAct Family Study Examinations (NFSE) Cohort. Nutrients 2022; 14:nu14061141. [PMID: 35334798 PMCID: PMC8950182 DOI: 10.3390/nu14061141] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Revised: 02/28/2022] [Accepted: 03/02/2022] [Indexed: 12/12/2022] Open
Abstract
Taste and smell function decline with age, with robust impairment in the very old. Much less is known about taste and smell function in young and middle aged. We investigated taste and smell sensitivity via thresholds in a sub-sample of the NutriAct Family Study (NFS), the NFS Examinations cohort (NFSE; N = 251, age M = 62.5 years). We examined different aspects relating to taste and smell function: the degree to which taste and smell sensitivity relate to another and to taste and smell preferences, the role of gender and age, as well as effects on Quality of Life (QoL). Taste thresholds were highly correlated, but no correlation was observed between taste and smell thresholds and between thresholds and preference. Women were more sensitive for both taste and smell than men. We found no effect of age on sensitivity and no effect of sensitivity on QoL. All null findings were complemented by Bayesian statistics. Together our results indicate the independence of taste and smell despite their overlap during sensorial experiences. We found no evidence for age-related sensory decline, which could be due to our sample’s characteristics of non-clinical volunteers with good dental health and 93% non-smokers.
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Affiliation(s)
- Shirley X. L. Lim
- Cognitive Neuroscience (INM-3), Institute of Neuroscience and Medicine, Research Center Jülich, Wilhelm-Johnen-Straße, 52428 Jülich, Germany
- NutriAct-Competence Cluster Nutrition Research Berlin-Potsdam, 14558 Nuthetal, Germany; (M.B.); (K.O.)
- Correspondence:
| | - Richard Höchenberger
- CEA, Inria, Université Paris-Saclay, 1 Rue Honoré d’Estienne d’Orves, 91120 Palaiseau, France;
| | - Niko A. Busch
- Institute of Psychology, University of Münster, Fliednerstraße 21, 48149 Münster, Germany;
| | - Manuela Bergmann
- NutriAct-Competence Cluster Nutrition Research Berlin-Potsdam, 14558 Nuthetal, Germany; (M.B.); (K.O.)
- German Institute of Human Nutrition Potsdam-Rehbrücke, Arthur-Scheunert-Allee 114-116, 14558 Nuthetal, Germany
| | - Kathrin Ohla
- NutriAct-Competence Cluster Nutrition Research Berlin-Potsdam, 14558 Nuthetal, Germany; (M.B.); (K.O.)
- Experimental Psychology Unit, Helmut Schmidt University/University of the Armed Forces Hamburg, Holstenhofweg 85, 22043 Hamburg, Germany
- Firmenich SA, Rue de la Bergère 7, 1242 Satigny, Switzerland
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13
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Zambom-Ferraresi F, Zambom-Ferraresi F, Fernández-Irigoyen J, Lachén-Montes M, Cartas-Cejudo P, Lasarte JJ, Casares N, Fernández S, Cedeño-Veloz BA, Maraví-Aznar E, Uzcanga-Lacabe MI, Galbete A, Santamaría E, Martínez-Velilla N. Olfactory Characterization and Training in Older Adults: Protocol Study. Front Aging Neurosci 2021; 13:757081. [PMID: 34867284 PMCID: PMC8637846 DOI: 10.3389/fnagi.2021.757081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Accepted: 10/19/2021] [Indexed: 11/19/2022] Open
Abstract
The aim of this article is to present the research protocol for a prospective cohort study that will assess the olfactory function and the effect of an intervention based on olfactory training in healthy very old adults (≥75 years old). A convenience sample of 180 older people (50% female) will be recruited in three different environments: hospitalized control group (CH) with stable acute illness (n = 60); ambulatory control group (CA) of community-based living (n = 60); and an experimental odor training group (EOT) from nursing homes (n = 60). The odor training (OT) intervention will last 12 weeks. All the volunteers will be assessed at baseline; CA and EOT groups will also be assessed after 12 weeks. The primary end point will be change in olfactory capacity from baseline to 12 weeks period of intervention or control. The intervention effects will be assessed with the overall score achieved in Sniffin Sticks Test (SST) – Threshold, Discrimination, and Identification (TDI) extended version. Secondary end points will be changes in cognitive tasks, quality of life, mood, immune status, and functional capacity. All these measurements will be complemented with an immune fitness characterization and a deep proteome profiling of the olfactory epithelium (OE) cultured ex vivo. The current study will provide additional evidence to support the implementation of olfactory precision medicine and the development of immunomodulatory nasal therapies based on non-invasive procedures. The proposed intervention will also intend to increase the knowledge about the olfactory function in very elderly people, improve function and quality of life, and promote the recovery of the health.
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Affiliation(s)
- Fabíola Zambom-Ferraresi
- Geriatric Unit, Navarrabiomed, Hospital Universitario de Navarra (HUN), Universidad Pública de Navarra (UPNA), Instituto de Investigación Sanitaria de Navarra (IdisNa), Pamplona, Spain
| | - Fabricio Zambom-Ferraresi
- Geriatric Unit, Navarrabiomed, Hospital Universitario de Navarra (HUN), Universidad Pública de Navarra (UPNA), Instituto de Investigación Sanitaria de Navarra (IdisNa), Pamplona, Spain
| | - Joaquín Fernández-Irigoyen
- Clinical Neuroproteomics Unit, Navarrabiomed, Hospital Universitario de Navarra (HUN), Universidad Pública de Navarra (UPNA), Instituto de Investigación Sanitaria de Navarra (IdisNa), Pamplona, Spain
| | - Mercedes Lachén-Montes
- Clinical Neuroproteomics Unit, Navarrabiomed, Hospital Universitario de Navarra (HUN), Universidad Pública de Navarra (UPNA), Instituto de Investigación Sanitaria de Navarra (IdisNa), Pamplona, Spain
| | - Paz Cartas-Cejudo
- Clinical Neuroproteomics Unit, Navarrabiomed, Hospital Universitario de Navarra (HUN), Universidad Pública de Navarra (UPNA), Instituto de Investigación Sanitaria de Navarra (IdisNa), Pamplona, Spain
| | - Juan José Lasarte
- Immunology and Immunotherapy Program, Centro de Investigación Médica Aplicada, Instituto de Investigación Sanitaria de Navarra (IdisNa), Universidad de Navarra, Pamplona, Spain
| | - Noelia Casares
- Immunology and Immunotherapy Program, Centro de Investigación Médica Aplicada, Instituto de Investigación Sanitaria de Navarra (IdisNa), Universidad de Navarra, Pamplona, Spain
| | - Secundino Fernández
- Department of Otolaryngology, Clínica Universidad de Navarra, Facultad de Medicina, Universidad de Navarra, Pamplona, Spain
| | | | - Enrique Maraví-Aznar
- Department of Otolaryngology, Hospital Universitario de Navarra (HUN), Pamplona, Spain
| | | | - Arkaitz Galbete
- Department of Statistics, Computer Science and Mathematics, Universidad Pública de Navarra (UPNA), Pamplona, Spain
| | - Enrique Santamaría
- Clinical Neuroproteomics Unit, Navarrabiomed, Hospital Universitario de Navarra (HUN), Universidad Pública de Navarra (UPNA), Instituto de Investigación Sanitaria de Navarra (IdisNa), Pamplona, Spain
| | - Nicolás Martínez-Velilla
- Geriatric Unit, Navarrabiomed, Hospital Universitario de Navarra (HUN), Universidad Pública de Navarra (UPNA), Instituto de Investigación Sanitaria de Navarra (IdisNa), Pamplona, Spain.,Department of Geriatrics, Hospital Universitario de Navarra (HUN), Pamplona, Spain
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14
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Zhang L, Fang F, Yao L, Sun H, Zhan X, Lu M, Wei Y. Decreased nasal nitric oxide levels: A potential marker of decreased olfactory discrimination in chronic rhinosinusitis. J Laryngol Otol 2021; 136:1-28. [PMID: 34702418 DOI: 10.1017/s0022215121003169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
AbstractObjectiveThis study aimed to investigate the association of nasal nitric oxide and olfactory function.MethodA cross-sectional study was performed in 117 adults, including 91 patients with chronic rhinosinusitis and 26 healthy controls. Scores on the 22-item Sino-Nasal Outcomes Test, Lund-Mackay scale and Lund-Kennedy scale were recorded to assess severity of disease. All participants were screened for common inhaled and food allergens. Nasal nitric oxide and fractional exhaled nitric oxide testing, acoustic rhinometry and anterior rhinomanometry testing were performed to measure nasal function. The validated Sniffin’ Sticks test battery was used to assess olfactory function.ResultsHigher nasal nitric oxide was an independent protective factor for odour discrimination and odour threshold in participants with chronic rhinosinusitis after adjusting for age, gender, drinking, smoking, 22-item Sino-Nasal Outcomes Test, Lund-Mackay score, Lund-Kennedy score, immunoglobulin E and the second minimal cross-sectional area by acoustic rhinometry. Nasal nitric oxide also showed high discrimination in predicting impaired odour discrimination. In addition, nasal nitric oxide was lower in older participants, those with higher Lund-Mackay or Lund-Kennedy scores and higher with elevated total serum immunoglobulin E concentrations above a threshold of 0.35 kU/l.ConclusionHigher nasal nitric oxide is associated with better odour discrimination in chronic rhinosinusitis and is modulated by age, degree of allergy and severity of chronic rhinosinusitis.
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Affiliation(s)
- Lichuan Zhang
- Department of Otolaryngology-Head and Neck Surgery, Beijing An Zhen Hospital, Capital Medical University, Beijing100029, China
| | - Fang Fang
- Department of Otolaryngology-Head and Neck Surgery, Beijing An Zhen Hospital, Capital Medical University, Beijing100029, China
- Key Laboratory of Upper Airway Dysfunction-related Cardiovascular Diseases, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing Anzhen Hospital, Beijing100029, China
| | - Linyin Yao
- Department of Otolaryngology-Head and Neck Surgery, Beijing An Zhen Hospital, Capital Medical University, Beijing100029, China
| | - Haili Sun
- Department of Otolaryngology-Head and Neck Surgery, Beijing An Zhen Hospital, Capital Medical University, Beijing100029, China
- Key Laboratory of Upper Airway Dysfunction-related Cardiovascular Diseases, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing Anzhen Hospital, Beijing100029, China
| | - Xiaojun Zhan
- Department of Otolaryngology-Head and Neck Surgery, Beijing An Zhen Hospital, Capital Medical University, Beijing100029, China
| | - Mi Lu
- Department of Otolaryngology-Head and Neck Surgery, Beijing An Zhen Hospital, Capital Medical University, Beijing100029, China
| | - Yongxiang Wei
- Department of Otolaryngology-Head and Neck Surgery, Beijing An Zhen Hospital, Capital Medical University, Beijing100029, China
- Key Laboratory of Upper Airway Dysfunction-related Cardiovascular Diseases, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing Anzhen Hospital, Beijing100029, China
- Department of Otorhinolaryngology Head and Neck Surgery, Capital Institute of Pediatrics, Beijing, China
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15
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Delgado-Losada ML, Bouhaben J, Delgado-Lima AH. Development of the Spanish Version of Sniffin's Sticks Olfactory Identification Test: Normative Data and Validity of Parallel Measures. Brain Sci 2021; 11:216. [PMID: 33578970 PMCID: PMC7916642 DOI: 10.3390/brainsci11020216] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Revised: 02/04/2021] [Accepted: 02/06/2021] [Indexed: 12/22/2022] Open
Abstract
The Sniffin' Sticks Olfactory Identification Test is a tool for measurement of olfactory performance developed in Germany and validated in several countries. This research aims to develop the Spanish version of the Sniffin' Sticks Olfactory Identification Test and obtain normative values for the Spanish population. The parameters are free recall and subjective intensity of odorants are included. The influence of possible demographic covariates such as sex, age, smoking, or educational level are analyzed, and the items that best discriminate are studied. In addition, the internal structure validity of the blue and purple versions is studied as a parallel measure, and a cultural adaptation of the purple version is carried out. For this, three independent samples of normosmic healthy volunteers were studied. To obtain normative values, the sample was of 417 participants (18-89 years). For the internal structure validity study of both versions, the sample was 226 (18-70 years), and for familiarity of the purple version, the sample was 75 participants (21-79 years). Results indicated that men and women and smokers and non-smokers perform equally. However, differences were found as age progresses, being more pronounced after 60 years old in all three measurements of the identification test. This research also provides the items that best discriminate in the blue version and a cultural adaptation for the purple version. In conclusion, the Sniffin' Sticks Odor Identification Test is a suitable tool for olfactory assessment in the Spanish population. The instrument has been expanded with two new scores, and normative data as a function of age are provided. Its parallel version also seems appropriate for testing, as items have been culturally adapted and evidence of internal structure validity for both versions is reported.
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Affiliation(s)
- María Luisa Delgado-Losada
- Experimental Psychology, Cognitive Processes and Speech Therapy Department, Faculty of Psychology, Complutense University of Madrid, Campus de Somosaguas, 28223 Pozuelo de Alarcón, Spain; (J.B.); (A.H.D.-L.)
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