The utility of olfactory function in distinguishing early stage Alzheimer's disease from HIV-associated neurocognitive disorder.

TitleThe utility of olfactory function in distinguishing early stage Alzheimer's disease from HIV-associated neurocognitive disorder.
Publication TypeJournal Article
Year of Publication2020
AuthorsSundermann, EE, Fields, A, Saloner, R, Gouaux, B, Bharti, A, Murphy, C, Moore, DJ
JournalAIDS
Date Published2020 Nov 26
ISSN1473-5571
KeywordsInternal
Abstract

OBJECTIVES: Given the rising number of older people with HIV (PWH) and the overlap in cognitive dysfunction profiles in HIV-associated Neurocognitive Disorders (HAND) and Alzheimer's disease (AD) and its precursor, amnestic mild cognitive impairment (aMCI), methods are needed to distinguish aMCI/AD from HAND. As an early indicator of AD, we examined whether olfactory dysfunction could help to distinguish between aMCI/AD and HAND among PWH.DESIGN: Observational cohort study METHODS:: Eighty-one older (≥50 years) PWH (83% male, 65% Caucasian) from the California NeuroAIDS Tissue Consortium completed the University of Pennsylvania Smell Identification Test (UPSIT; higher scores = better smell identification) and a comprehensive seven-domain neuropsychological test battery and neuromedical evaluation. HAND was classified via Frascati criteria. High aMCI risk was defined as impairment (>1.0 SD below normative mean) on two of four delayed recall or recognition outcomes (at-least one recognition impairment required) from the Hopkins Verbal Learning Test-Revised and the Brief Visuospatial Memory Test-Revised. We examined UPSIT scores in relation to: 1) aMCI risk and HAND status, and 2) continuous memory scores considering adjustments for demographics and relevant clinical or HIV disease characteristics.RESULTS: Fifty-seven participants were classified with HAND (70%) and 35 participants were classified as high aMCI risk (43%). UPSIT scores were lower (worse) in the high versus low aMCI risk group (F (1,76) = 10.04, p = .002), but did not differ by HAND status (F (1,76) = 0.62, p = .43). UPSIT scores positively correlated with all memory outcomes (ps < .05).CONCLUSIONS: Olfactory assessments may help in detecting early aMCI/AD among PWH and allow for appropriate and early disease intervention.

DOI10.1097/QAD.0000000000002761
Alternate JournalAIDS
PubMed ID33252483