{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T10:01:12Z","timestamp":1779271272261,"version":"3.51.4"},"reference-count":50,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2024,2,5]],"date-time":"2024-02-05T00:00:00Z","timestamp":1707091200000},"content-version":"vor","delay-in-days":4,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000065","name":"National Institute of Neurological Disorders and Stroke","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000065","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000050","name":"National Heart, Lung, and Blood Institute","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000049","name":"National Institute on Aging","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000049","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000968","name":"American Heart Association","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000968","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Int J Geriat Psychiatry"],"published-print":{"date-parts":[[2024,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>Post\u2010operative delirium (POD) affects up to 50% of cardiac surgery patients, with higher incidence in older adults. There is increasing need for screening tools that identify individuals most vulnerable to POD. Here, we examined the relationship between pre\u2010operative olfaction and both incident POD and POD severity in patients undergoing cardiac surgery. We also examined cross\u2010sectional relationships between baseline olfaction, cognition, and plasma neurofilament light (NfL).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Individuals undergoing cardiac surgery (n\u00a0=\u00a0189; mean age\u00a0=\u00a070\u00a0years; 75% men) were enrolled in a clinical trial of cerebral autoregulation monitoring. At baseline, odor identification performance (Brief Smell Identification Test), cognitive performance, and plasma concentrations of NfL levels (Simoa\u2122 NF\u2010Light Assay) were measured. Delirium was assessed with the Confusion Assessment Method (CAM) or CAM\u2010ICU, and delirium severity was assessed using the Delirium Rating Scale\u2010Revised\u201098. The association of baseline olfaction, delirium incidence, and delirium severity was examined in regression models adjusting for age, duration of cardiopulmonary bypass, logistic European System for Cardiac Operative Risk Evaluation (EuroSCORE), and baseline cognition.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Olfactory dysfunction was present in 30% of patients, and POD incidence was 44%. Pre\u2010operative olfactory dysfunction was associated with both incident POD (OR\u00a0=\u00a03.17, <jats:italic>p<\/jats:italic>\u00a0=\u00a00.001) and greater severity of POD after cardiac surgery (OR\u00a0=\u00a03.94 <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.001) in models adjusted for age, duration of bypass, and a surgical risk score. The addition of baseline cognition attenuated the strength of the association, but it remained significant for incident POD (OR\u00a0=\u00a02.25, <jats:italic>p<\/jats:italic>\u00a0=\u00a00.04) and POD severity (OR 2.10, <jats:italic>p<\/jats:italic>\u00a0=\u00a00.04). Poor baseline olfaction was associated with greater baseline cognitive dysfunction (<jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.001) and increased baseline plasma NfL concentrations (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.04). Neither age, cognition, nor baseline NFL concentration modified the association of impaired olfaction and delirium outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Olfactory assessment may be a useful pre\u2010surgical screening tool for the identification of patients undergoing cardiac surgery at increased risk of POD. Identifying those at highest risk for severe delirium and poor cognitive outcomes following surgery would allow for earlier intervention and pre\u2010operative rehabilitation strategies, which could ultimately impact the functional disability and morbidity associated with POD.<\/jats:p><\/jats:sec>","DOI":"10.1002\/gps.6066","type":"journal-article","created":{"date-parts":[[2024,2,7]],"date-time":"2024-02-07T08:29:41Z","timestamp":1707294581000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Poor olfaction prior to cardiac surgery: Association with cognition, plasma neurofilament light, and post\u2010operative delirium"],"prefix":"10.1002","volume":"39","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7711-3597","authenticated-orcid":false,"given":"Vidyulata","family":"Kamath","sequence":"first","affiliation":[{"name":"Department of Psychiatry and Behavioral Sciences Johns Hopkins University School of Medicine  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