Odor Identification Screening Improves Diagnostic Classification in Incipient Alzheimer's Disease

J Alzheimers Dis. 2017;55(4):1497-1507. doi: 10.3233/JAD-160842.


Background: Measurements of olfaction may serve as useful biomarkers of incipient dementia. Here we examine the improvement in diagnostic accuracy of Alzheimer's disease (AD) and mild cognitive impairment (MCI) when assessing both cognitive functioning and odor identification.

Objective: To determine the utility of odor identification as a supplementary screening test in incipient AD.

Methods: Sniffin' Sticks Odor Identification Test (SS-OIT) and the Montreal Cognitive Assessment (MoCA) were administered in 262 AD, 174 MCI [150 amnestic (aMCI), and 24 non-amnestic (naMCI)], and 292 healthy older adults (HOA).

Results: Odor identification scores were higher in HOA relative to MCI or AD groups, and MCI outperformed AD. Odor identification scores were higher in aMCI single domain than aMCI multiple domain. Complementing MoCA scores with the SS-OIT significantly improved diagnostic accuracy of individuals with AD and MCI, including within MCI subgroups.

Discussion: Odor identification is a useful supplementary screening tool that provides additional information relevant for clinical categorization of AD and MCI, including those who are at highest risk to convert to AD.

Keywords: Alzheimer’s disease; Montreal Cognitive Assessment; Sniffin’ Sticks Olfactory Identification Test; mild cognitive impairment; odor identification; smell.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Alzheimer Disease* / classification
  • Alzheimer Disease* / complications
  • Alzheimer Disease* / diagnosis
  • Analysis of Variance
  • Cognition Disorders / diagnosis
  • Cognition Disorders / etiology
  • Female
  • Humans
  • Male
  • Middle Aged
  • Neuropsychological Tests
  • Odorants
  • Olfaction Disorders / etiology*
  • ROC Curve
  • Smell / physiology*