Olfactory loss and nigrostriatal dopaminergic denervation in the elderly |
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Authors: | Ka Kit Wong Martijn LTM Muller Hiroto Kuwabara Stephanie A Studenski Nicolaas I Bohnen |
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Institution: | 1. VA Ann Arbor Healthcare System, GRECC, Ann Arbor, MI, USA;2. Functional Neuroimaging, Cognitive and Mobility Laboratory, Departments of Radiology and Neurology, University of Michigan, Ann Arbor, MI, USA;3. Department of Radiology, Johns Hopkins University, Baltimore, MD, USA;4. VA Pittsburgh Healthcare System, GRECC, Pittsburgh, PA, USA;5. Department of Medicine, Division of Geriatric Medicine, University of Pittsburgh Medical School, Pittsburgh, PA, USA |
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Abstract: | Olfactory dysfunction may precede common neurodegenerative disorders in the elderly, such as Alzheimer (AD) or Parkinson disease (PD). However, pathobiological mechanisms of olfactory loss in the elderly are poorly understood. Although nigrostriatal dopaminergic denervation is a key patholobiological feature of PD, age-associated nigrostriatal denervation (AASDD) occurs also with normal aging and can be more prominent in some elderly. We investigated the relationship between AASDD and olfactory performance in community-dwelling subjects. Community-dwelling subjects (n = 73, 44 F/29 M, mean age 64.0 ± 16.4, range 20–85) underwent brain dopamine transporter (DAT) 11C]2-β-carbomethoxy-3β-(4-fluorophenyl) tropane (β-CFT) positron emission tomography (PET) imaging and olfactory assessment using the 40-odor University of Pennsylvania Smell Identification Test (UPSIT). Subjects with clinical or DAT PET evidence of Parkinson disease (PD) were not eligible for the study. AASDD was defined based on normative data in young and middle-aged subjects. Compared to a mild and general linear decline in odor identification observed in most subjects (R2 = 0.18, P = 0.0002), there were 13 subjects who deviated below the 5% confidence interval level in age-predicted UPSIT scores. Analysis limited to elderly subjects 60 years and over demonstrated a significant association between poor smell (n = 10 out of 49, 20.4%) and AASDD (χ2 = 4.4, P < 0.05). There is a significant association between olfactory dysfunction and more prominent nigrostriatal denervation in the elderly. Olfactory assessment may have potential as a screening tool to detect age-accelerated neurodegeneration in the elderly. |
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Keywords: | AASDDa ge-associated striatal dopaminergic denervation DAT dopamine transporter MMSE Mini-Mental State Examination PD Parkinson disease AD Alzheimer disease PET positron emission tomography UPDRS Unified Parkinson's Disease Rating Scale UPSIT University of Pennsylvania Smell Identification Test VOI volume of interest |
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