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Cut-Off Scores of an Olfactory Function Test for Mild Cognitive Impairment and Dementia

Psychiatry Investigation 2020년 17권 10호 p.1021 ~ 1030
김혜리, 김선미, 성원식, 민현진, 김경수, 가혁, 한덕현,
소속 상세정보
김혜리 ( Kim Hye-Ri ) - Chung-Ang University College of Medicine Department of Psychiatry
김선미 ( Kim Sun-Mi ) - Chung-Ang University College of Medicine Department of Psychiatry
성원식 ( Seong Won-Shik ) - Chung-Ang University College of Medicine Department of Psychiatry
민현진 ( Min Hyun-Jin ) - Chung-Ang University College of Medicine Department of Otorhinolaryngology-Head and Neck Surgery
김경수 ( Kim Kyung-Soo ) - Chung-Ang University College of Medicine Department of Otorhinolaryngology-Head and Neck Surgery
가혁 ( Ga Hyuk ) - Incheon Eun-Hye Hospital Institute of Geriatric Medicine
한덕현 ( Han Doug-Hyun ) - Chung-Ang University College of Medicine Department of Psychiatry

Abstract


Objective: We aimed to find the optimal cut-off scores for screening of odor detection threshold, odor discrimination, and odor identification tests for detection of mild cognitive impairment (MCI) and dementia in Korean elderly.

Methods: A total of 195 elderly people were divided into three groups: the normal cognition (NC), MCI, and dementia groups. All participants underwent neurocognitive and olfactory function tests. We used k-means cluster analysis and receiver operating characteristic (ROC) analysis to identify the most appropriate cut-off value.

Results: To distinguish the MCI from NC groups, odor identification [area under the curve (AUC)=0.670, p<0.007] with a cut-off point of 7 showed greater validity for screening (sensitivity/specificity=0.462/0.837) than did other olfactory function tests. To distinguish the MCI and dementia from NC as well, odor identification (AUC=0.817, p=0.002) with a cut-off point of 7 showed the highest validity for screening (0.785/0.654). To distinguish MCI from AD, an odor detection threshold (AUC=0.722, p=0.001) with a cut-off point of 2 showed the highest validity for screening (0.785/0.654).

Conclusion: Olfactory function tests may be a useful screening tool for cognitive decline before clinical symptoms of dementia have completely developed. This tool can be used as a supplementary tool to enhance the sensitivity of traditional cognitive tests to screen for dementia.

키워드

Dementia; Alzheimer’s disease; Mild cognitive impairment; Olfaction; Clinical marker

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