Episodic memory of odors stratifies Alzheimer biomarkers in normal elderly
Alefiya Dhilla Albers, Josephine Asafu-Adjei, Mary K Delaney, Kathleen E Kelly, Teresa Gomez-Isla, Deborah Blacker, Keith A Johnson, Reisa A Sperling, Bradley T Hyman, Rebecca A Betensky, Lloyd Hastings, Mark W Albers, Alefiya Dhilla Albers, Josephine Asafu-Adjei, Mary K Delaney, Kathleen E Kelly, Teresa Gomez-Isla, Deborah Blacker, Keith A Johnson, Reisa A Sperling, Bradley T Hyman, Rebecca A Betensky, Lloyd Hastings, Mark W Albers
Abstract
Objective: The objective of this study was to relate a novel test of identifying and recalling odor percepts to biomarkers of Alzheimer's disease (AD) in well-characterized elderly individuals, ranging from cognitively normal to demented.
Methods: One hundred eighty-three participants (cognitively normal: n = 70; subjective cognitive concerns: n = 74; mild cognitive impairment [MCI]: n = 29, AD dementia: n = 10) were administered novel olfactory tests: the Odor Percept IDentification (OPID) and the Percepts of Odor Episodic Memory (POEM) tests. Univariate cross-sectional analyses of performance across diagnoses; logistic regression modeling, including covariates of age, sex, education, APOE genotype, and neuropsychological test scores; and linear mixed modeling of longitudinal cognitive scores were performed. Amyloid deposition and MRI volumetrics were analyzed in a subset of participants.
Results: Accuracy of identification and episodic memory of odor percepts differed significantly across diagnosis and age, with progressively worse performance across degrees of impairment. Among the participants who were cognitively normal or had subjective cognitive concerns, poorer than expected performance on the POEM test (based on the same individual's performance on the OPID and odor discrimination tests) was associated with higher frequencies of the APOE ε4 allele, thinner entorhinal cortices, and worse longitudinal trajectory of Logical Memory scores.
Interpretation: Selective impairment of episodic memory of odor percepts, relative to identification and discrimination of odor percepts revealed by this novel POEM battery, is associated with biomarkers of AD in a well-characterized pre-MCI population. These affordable, noninvasive olfactory tests offer potential to identify clinically normal individuals who have greater likelihood of future cognitive decline. Ann Neurol 2016;80:846-857.
Conflict of interest statement
Potential Conflicts of Interest: Dr. Hastings is the founder, owns stock, and receives a salary for serving as President of Osmic Enterprises, Inc., which markets the OPID and POEM tests. Dr. M. Albers receives consulting fees from International Flavors and Fragrances. All other authors do not have relationships with commercial enterprises that are of direct relevance to the current research.
© 2016 American Neurological Association.
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Source: PubMed