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The absolute risk difference between anosmia and good olfaction was higher in\n                      <jats:italic>APOE \u03b54<\/jats:italic>\n                      carriers than in non\u2010carriers. Those with stable anosmia and converting from normal olfaction to anosmia over time showed particularly strong associations.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>DISCUSSION<\/jats:title>\n                    <jats:p>Olfactory impairment was robustly associated with incident dementia, with strongest associations in those with persistent impairment and greater olfactory decline over \u223c5 years.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Highlights<\/jats:title>\n                    <jats:p>\n                      <jats:list list-type=\"bullet\">\n                        <jats:list-item>\n                          <jats:p>We examined olfactory status and olfactory change in relation to incident dementia.<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>Poor olfactory status was robustly associated with higher dementia rate.<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>\n                            Associations were robust across subgroups of age, sex, race, and\n                            <jats:italic>APOE \u03b54<\/jats:italic>\n                            status.\n                          <\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>Persistent poor olfaction or decline over time showed the strongest associations.<\/jats:p>\n                        <\/jats:list-item>\n                      <\/jats:list>\n                    <\/jats:p>\n                  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