ArticleNeuropsychiatrie : Klinik, Diagnostik, Therapie und Rehabilitation : Organ der Gesellschaft Osterreichischer Nervenarzte und Psychiater2026
Subjective and objective olfactory dysfunction and its screening value in patients with subjective cognitive decline, mild cognitive impairment, and Alzheimer's dementia.
Article in Neuropsychiatrie : Klinik, Diagnostik, Therapie und Rehabilitation : Organ der Gesellschaft Osterreichischer Nervenarzte und Psychiater, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundDue to an ageing population and increased life expectancy, Alzheimer's dementia (AD) is becoming increasingly important. Since AD is characteristically preceded by subjective cognitive decline (SCD) and mild cognitive impairment (MCI), innovative diagnostic tools and therapeutics are essential for diagnosis at an early stage. Olfactory dysfunction is commonly associated with cognitive decline, indicating its potential as a diagnostic marker.
objectiveThis study examined the association between olfactory function, evaluated with the Sniffin' Sticks Odor Identification Test (SS-OIT), and Assessment of Self-Reported Olfactory Functioning (ASOF) inventory across five cognitive subgroups (healthy controls [HC], SCD, non-amnestic MCI, amnestic MCI, and AD). Furthermore, this study investigated the utility of olfactory testing in screening for AD.
methodsThis retrospective, single-center cross-sectional study was conducted at the Neurology Department of the Medical University of Vienna. The study included 958 participants during the period 2000-2023. Cognitive and olfactory functions were assessed using standardized neuropsychological and olfactory tools. Statistical analyses included descriptive measures, analysis of variance (ANOVA), model testing, and the receiver operating characteristic (ROC) methodology.
resultsOlfactory performance declined with increasing cognitive impairment, with the strongest contrast showing an effect size of r = 0.51 between HC and AD. The SS-OIT (area under the ROC curve [AUC]: 75.3%) and Olfactory-Related Quality of Life subscale (ORQ; AUC: 64.8%) were identified as the most effective in distinguishing AD, with the following recommended cut-offs: SS-OIT ≤ 9; Subjective Olfactory Capability (SOC) ≤ 6; Self-Reported Capability of Perceiving Specific Odors (SRP) ≤ 4.10; and ORQ ≤ 3.67.
conclusionOlfactory functioning shows moderate reliability in distinguishing subgroups; nevertheless, the proposed cut-off values may be suitable for AD screening. Further studies are recommended to confirm our findings.
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