{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,18]],"date-time":"2026-07-18T09:28:41Z","timestamp":1784366921354,"version":"3.55.0"},"reference-count":44,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2023,8,1]],"date-time":"2023-08-01T00:00:00Z","timestamp":1690848000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAD"],"published-print":{"date-parts":[[2023,8,1]]},"abstract":"<jats:p>Background: Olfactory dysfunction is an early symptom of Alzheimer\u2019s disease (AD). However, olfactory tests are rarely performed in clinical practice because their diagnostic efficacy in detecting early AD is unclear. Objective: To investigate odor discrimination in patients with early AD and the efficacy of olfactory discrimination tests in differentiating these patients from subjects with normal cognition (CN). Methods: Thirty patients each with mild dementia due to AD (MD-AD) and mild cognitive impairment due to AD (MCI-AD) and 30 older subjects with CN were enrolled. All participants underwent cognitive examinations (CDR, MMSE, ADAS-Cog 13, and verbal fluency) and odor discrimination tests (Sniffin\u2019 Sticks test, Burghart\u00ae, Germany). Results: The MD-AD group achieved significantly worse scores on the olfactory discrimination test than the MCI-AD group, and the MCI-AD group achieved significantly worse results than the CN group (p\u200a&lt;\u200a0.05). A cut-off score of\u226410 had a diagnostic accuracy of 94.44% (95% CI, 87.51\u201398.17%) in differentiating patients with MCI-AD\/MD-AD from subjects with CN and of 91.67% (95% CI, 81.61\u201397.24%) in differentiating those with MCI-AD from subjects with CN. Our multinomial logistic regression model with demographic data and ADAS-Cog 13 scores as predictor variables correctly classified 82.2% of the cases (CN, 93.3%; MC-AD, 70%; MD-AD, 83.3%); on adding the olfactory discrimination score to the model, the percentage increased to 92.2% (CN, 96.7%; MCI-AD, 86.7%; MD-AD, 93.3%). Conclusion: Odor discrimination is impaired in cases of early AD and continues to deteriorate as the disease progresses. The olfactory discrimination test showed good diagnostic efficacy in detecting early AD.<\/jats:p>","DOI":"10.3233\/jad-230077","type":"journal-article","created":{"date-parts":[[2023,6,24]],"date-time":"2023-06-24T06:44:53Z","timestamp":1687589093000},"page":"1169-1178","source":"Crossref","is-referenced-by-count":23,"title":["Odor Discrimination as a Marker of Early Alzheimer\u2019s Disease"],"prefix":"10.1177","volume":"94","author":[{"given":"Egle","family":"Audronyte","sequence":"first","affiliation":[{"name":"Clinic of Neurology and Neurosurgery, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius, Lithuania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gyte","family":"Pakulaite-Kazliene","sequence":"additional","affiliation":[{"name":"Clinic of Neurology and Neurosurgery, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius, Lithuania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vaiva","family":"Sutnikiene","sequence":"additional","affiliation":[{"name":"Clinic of Neurology and Neurosurgery, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius, Lithuania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gintaras","family":"Kaubrys","sequence":"additional","affiliation":[{"name":"Clinic of Neurology and Neurosurgery, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius, Lithuania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","reference":[{"key":"10.3233\/JAD-230077_ref1","unstructured":"World Health Organization (2021) Global Status Report on thePublic Health Response to Dementia. World Health Organization, Geneva. License: CC, BY-NC-SA3.0 IGO."},{"key":"10.3233\/JAD-230077_ref2","unstructured":"Gauthier S , Rosa-Neto P , Morais JA , Webster C (2021) World Alzheimer Report 2021: Journey through the Diagnosis of Dementia, Alzheimer\u2019s Disease International, London, England."},{"key":"10.3233\/JAD-230077_ref3","unstructured":"World Health Organization (2017) Global Action Plan on the Public Health Response to Dementia 2017\u20132025. World Health Organization, Geneva. License: CC BY-NC-SA 3.0 IGO."},{"key":"10.3233\/JAD-230077_ref4","doi-asserted-by":"crossref","first-page":"270","DOI":"10.1016\/j.jalz.2011.03.008","article-title":"The diagnosis of mild cognitive impairment due to Alzheimer\u2019s disease: Recommendations from the National Institute on Aging-Alzheimer\u2019s Association workgroups on diagnostic guidelines for Alzheimer\u2019s disease","volume":"7","author":"Albert","year":"2011","journal-title":"Alzheimers Dement"},{"key":"10.3233\/JAD-230077_ref5","doi-asserted-by":"crossref","first-page":"263","DOI":"10.1016\/j.jalz.2011.03.005","article-title":"The diagnosis of dementia due to Alzheimer\u2019s disease: Recommendations from the National Institute on Aging-Alzheimer\u2019s Association workgroups on diagnostic guidelines for Alzheimer\u2019s disease","volume":"7","author":"McKhann","year":"2011","journal-title":"Alzheimers Dement"},{"key":"10.3233\/JAD-230077_ref6","doi-asserted-by":"crossref","first-page":"e12295","DOI":"10.1002\/trc2.12295","article-title":"Alzheimer\u2019s disease drug development pipeline: 2022","volume":"8","author":"Cummings","year":"2022","journal-title":"Alzheimers Dement"},{"key":"10.3233\/JAD-230077_ref7","doi-asserted-by":"crossref","first-page":"539","DOI":"10.1111\/j.1600-0447.1974.tb09714.x","article-title":"Clinical observations of impaired cranial nerve function in senile dementia","volume":"50","author":"Waldton","year":"1974","journal-title":"cta Psychiatr Scand"},{"key":"10.3233\/JAD-230077_ref8","doi-asserted-by":"crossref","first-page":"597","DOI":"10.1016\/0361-9230(87)90129-8","article-title":"Presence of both odor identification and detection deficits in Alzheimer\u2019s disease","volume":"18","author":"Doty","year":"1987","journal-title":"Brain Res Bull"},{"key":"10.3233\/JAD-230077_ref9","doi-asserted-by":"crossref","first-page":"262","DOI":"10.1016\/j.neubiorev.2014.06.016","article-title":"Olfactory markers of depression and Alzheimer\u2019s disease","volume":"45","author":"Marine","year":"2014","journal-title":"Neurosci Biobehav Rev"},{"key":"10.3233\/JAD-230077_ref10","doi-asserted-by":"crossref","first-page":"362","DOI":"10.1002\/lary.27399","article-title":"Olfactory function in mild cognitive impairment and Alzheimer\u2019s disease: A meta-analysis","volume":"129","author":"Jung","year":"2019","journal-title":"Laryngoscope"},{"key":"10.3233\/JAD-230077_ref11","doi-asserted-by":"crossref","first-page":"226","DOI":"10.1136\/jnnp-2016-314638","article-title":"A quantitative meta-analysis of olfactory dysfunction in mild cognitive impairment","volume":"88","author":"Roalf","year":"2017","journal-title":"J Neurol Neurosurg Psychiatry"},{"key":"10.3233\/JAD-230077_ref12","doi-asserted-by":"crossref","first-page":"693","DOI":"10.1016\/j.neurobiolaging.2006.11.014","article-title":"Olfaction in patients with mild cognitive impairment and Alzheimer\u2019s disease","volume":"29","author":"Djordjevic","year":"2008","journal-title":"Neurobiol Aging"},{"key":"10.3233\/JAD-230077_ref13","doi-asserted-by":"crossref","first-page":"1497","DOI":"10.3233\/JAD-201022","article-title":"Olfactory identification in subjective cognitive decline: A meta-analysis","volume":"79","author":"Jobin","year":"2021","journal-title":"J Alzheimers Dis"},{"key":"10.3233\/JAD-230077_ref14","doi-asserted-by":"crossref","first-page":"585","DOI":"10.3233\/JAD-201168","article-title":"Olfactory dysfunction is already present with subjective cognitive decline and deepens with disease severity in the Alzheimer\u2019s disease spectrum","volume":"79","author":"Wang","year":"2021","journal-title":"J Alzheimers Dis"},{"key":"10.3233\/JAD-230077_ref15","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1159\/000090250","article-title":"Odor identification and decline in different cognitive domains in old age","volume":"26","author":"Wilson","year":"2006","journal-title":"Neuroepidemiology"},{"key":"10.3233\/JAD-230077_ref16","doi-asserted-by":"crossref","first-page":"1517","DOI":"10.1111\/j.1532-5415.2008.01826.x","article-title":"Olfaction and the 5-year incidence of cognitive impairment in an epidemiological study of older adults","volume":"56","author":"Schubert","year":"2008","journal-title":"J Am Geriatr Soc"},{"key":"10.3233\/JAD-230077_ref17","doi-asserted-by":"crossref","first-page":"802","DOI":"10.1001\/archpsyc.64.7.802","article-title":"Olfactory identification and incidence of mild cognitive impairment in older age","volume":"64","author":"Wilson","year":"2007","journal-title":"Arch Gen Psychiatry"},{"key":"10.3233\/JAD-230077_ref18","doi-asserted-by":"crossref","first-page":"1391","DOI":"10.3390\/brainsci11111391","article-title":"Olfactory measures as predictors of conversion to mild cognitive impairment and Alzheimer\u2019s disease","volume":"11","author":"Wheeler","year":"2021","journal-title":"Brain Sci"},{"key":"10.3233\/JAD-230077_ref19","doi-asserted-by":"crossref","first-page":"1399","DOI":"10.1176\/appi.ajp.157.9.1399","article-title":"Olfactory deficits in patients with mild cognitive impairment predict Alzheimer\u2019s disease at follow-up","volume":"157","author":"Devanand","year":"2000","journal-title":"Am J Psychiatry"},{"key":"10.3233\/JAD-230077_ref20","doi-asserted-by":"crossref","first-page":"537","DOI":"10.1017\/S1041610218001114","article-title":"Identification of odors, faces, cities and naming of objects in patients with subjective cognitive decline, mild cognitive impairment and Alzheimer's disease: A longitudinal study","volume":"31","author":"Tahmasebi","year":"2019","journal-title":"Int Psychogeriatr"},{"key":"10.3233\/JAD-230077_ref21","doi-asserted-by":"crossref","first-page":"689","DOI":"10.2174\/156720511796717212","article-title":"Follow-up study of olfactory deficits, cognitive functions, and volume loss of medial temporal lobe structures in patients with mild cognitive impairment","volume":"8","author":"Lojkowska","year":"2011","journal-title":"Curr Alzheimer Res"},{"key":"10.3233\/JAD-230077_ref22","doi-asserted-by":"crossref","first-page":"30","DOI":"10.1186\/s40035-020-00210-5","article-title":"Increased prediction value of biomarker combinations for the conversion of mild cognitive impairment to Alzheimer\u2019s dementia","volume":"9","author":"Zhao","year":"2020","journal-title":"Transl Neurodegener"},{"key":"10.3233\/JAD-230077_ref23","doi-asserted-by":"crossref","first-page":"326","DOI":"10.1016\/j.jalz.2019.08.200","article-title":"Intact global cognitive and olfactory ability predicts lack of transition to dementia","volume":"16","author":"Devanand","year":"2020","journal-title":"Alzheimers Dement"},{"key":"10.3233\/JAD-230077_ref24","doi-asserted-by":"crossref","first-page":"S85","DOI":"10.1016\/S0197-4580(97)00062-6","article-title":"Diagnostic criteria for neuropathologic assessment of Alzheimer\u2019s disease","volume":"18","author":"Braak","year":"1997","journal-title":"Neurobiol Aging"},{"key":"10.3233\/JAD-230077_ref25","doi-asserted-by":"crossref","first-page":"2814","DOI":"10.1093\/brain\/awv236","article-title":"The preclinical phase of the pathological process underlying sporadic Alzheimer\u2019s disease","volume":"138","author":"Braak","year":"2015","journal-title":"Brain"},{"key":"10.3233\/JAD-230077_ref26","doi-asserted-by":"crossref","first-page":"361","DOI":"10.1093\/ijnp\/pyab091","article-title":"Structural and functional abnormalities of olfactory-related regions in subjective cognitive decline, mild cognitive impairment, and Alzheimer\u2019s disease","volume":"25","author":"Chen","year":"2022","journal-title":"Int J Neuropsychopharmacol"},{"key":"10.3233\/JAD-230077_ref27","doi-asserted-by":"crossref","first-page":"184","DOI":"10.1016\/j.brainres.2010.08.018","article-title":"Olfactory deficit detected by fMRI in early Alzheimer\u2019s disease","volume":"1357","author":"Wang","year":"2010","journal-title":"Brain Res"},{"key":"10.3233\/JAD-230077_ref28","doi-asserted-by":"crossref","first-page":"947","DOI":"10.3233\/JAD-141947","article-title":"Olfactory cortex degeneration in Alzheimer\u2019s disease and mild cognitive impairment","volume":"45","author":"Vasavada","year":"2015","journal-title":"J Alzheimers Dis"},{"key":"10.3233\/JAD-230077_ref29","doi-asserted-by":"crossref","first-page":"581","DOI":"10.3233\/JAD-2010-091549","article-title":"Functional representation of olfactory impairment in early Alzheimer\u2019s disease","volume":"22","author":"F\u00f6rster","year":"2010","journal-title":"J Alzheimers Dis"},{"key":"10.3233\/JAD-230077_ref30","doi-asserted-by":"crossref","first-page":"1062","DOI":"10.1080\/13803391003683070","article-title":"Cognitive factors in odor detection, odor discrimination, and odor identification tasks","volume":"32","author":"Hedner","year":"2010","journal-title":"J Clin Exp Neuropsychol"},{"key":"10.3233\/JAD-230077_ref31","doi-asserted-by":"crossref","first-page":"11275","DOI":"10.1073\/pnas.1711415114","article-title":"SMELL-S and SMELL-R: Olfactory tests not influenced by odor-specific insensitivity or prior olfactory experience","volume":"114","author":"Hsieh","year":"2017","journal-title":"Proc Natl Acad Sci U S A"},{"key":"10.3233\/JAD-230077_ref32","doi-asserted-by":"crossref","first-page":"547","DOI":"10.1093\/chemse\/bjh059","article-title":"Demographic and cognitive predictors of cued odor identification: Evidence from a population-based study","volume":"29","author":"Larsson","year":"2004","journal-title":"Chem Senses"},{"key":"10.3233\/JAD-230077_ref33","doi-asserted-by":"crossref","first-page":"691","DOI":"10.1017\/S1355617702801424","article-title":"Differential sex effects in olfactory functioning: The role of verbal processing","volume":"8","author":"Oberg","year":"2002","journal-title":"J Int Neuropsychol Soc"},{"key":"10.3233\/JAD-230077_ref34","doi-asserted-by":"crossref","first-page":"114","DOI":"10.1097\/01.mlg.0000246518.79894.7e","article-title":"Normative values of olfactory function testing using the \u2018Sniffin\u2019 sticks\u2019","volume":"117","author":"Katotomichelakis","year":"2007","journal-title":"Laryngoscope"},{"key":"10.3233\/JAD-230077_ref35","doi-asserted-by":"crossref","first-page":"237","DOI":"10.1007\/s00405-006-0173-0","article-title":"Normative data for the \u201cSniffin\u2019 Sticks\u201d including tests of odor identification, odor discrimination, and olfactory thresholds: An upgrade based on a group of more than 3,000 subjects","volume":"264","author":"Hummel","year":"2007","journal-title":"Eur Arch Otorhinolaryngol"},{"key":"10.3233\/JAD-230077_ref36","doi-asserted-by":"crossref","first-page":"1995","DOI":"10.1176\/appi.ajp.160.11.1995","article-title":"Olfactory function in mild cognitive impairment and Alzheimer\u2019s disease: An investigation using psychophysical and electrophysiological techniques","volume":"160","author":"Peters","year":"2003","journal-title":"Am J Psychiatry"},{"key":"10.3233\/JAD-230077_ref37","doi-asserted-by":"crossref","first-page":"238","DOI":"10.1007\/s00415-009-5300-6","article-title":"Taste in mild cognitive impairment and Alzheimer\u2019s disease","volume":"257","author":"Steinbach","year":"2010","journal-title":"J Neurol"},{"key":"10.3233\/JAD-230077_ref38","doi-asserted-by":"crossref","first-page":"e118","DOI":"10.1038\/tp.2012.43","article-title":"Olfactory discrimination predicts cognitive decline among community-dwelling older adults","volume":"2","author":"Sohrabi","year":"2012","journal-title":"Transl Psychiatry"},{"key":"10.3233\/JAD-230077_ref39","doi-asserted-by":"crossref","first-page":"1021","DOI":"10.30773\/pi.2020.0203","article-title":"Cut-off scores of an olfactory function test for mild cognitive impairment and dementia","volume":"17","author":"Kim","year":"2020","journal-title":"Psychiatry Investig"},{"key":"10.3233\/JAD-230077_ref40","doi-asserted-by":"crossref","unstructured":"(2022) 2022 Alzheimer\u2019s disease facts and figures. Alzheimers Dement 18, 700\u2013789.","DOI":"10.1002\/alz.12638"},{"key":"10.3233\/JAD-230077_ref41","doi-asserted-by":"crossref","first-page":"641","DOI":"10.3233\/JAD-210175","article-title":"Olfactory phenotypes differentiate cognitively unimpaired seniors from Alzheimer\u2019s disease and mild cognitive impairment: A combined machine learning and traditional statistical approach","volume":"81","author":"Li","year":"2021","journal-title":"J Alzheimers Dis"},{"key":"10.3233\/JAD-230077_ref42","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1111\/ggi.14287","article-title":"Effect of intensive olfactory training for cognitive function in patients with dementia","volume":"22","author":"Cha","year":"2022","journal-title":"Geriatr Gerontol Int"},{"key":"10.3233\/JAD-230077_ref43","doi-asserted-by":"crossref","first-page":"745","DOI":"10.3233\/JAD-215257","article-title":"The effect of olfactory training on olfaction, cognition, and brain function in patients with mild cognitive impairment","volume":"85","author":"Chen","year":"2022","journal-title":"J Alzheimers Dis"},{"key":"10.3233\/JAD-230077_ref44","doi-asserted-by":"crossref","first-page":"743","DOI":"10.3233\/JAD-220248","article-title":"Training with odors impacts hippocampal thickness in patients with mild cognitive impairment","volume":"88","author":"Haehner","year":"2022","journal-title":"J Alzheimers Dis"}],"container-title":["Journal of Alzheimer's Disease"],"original-title":[],"link":[{"URL":"https:\/\/content.iospress.com\/download?id=10.3233\/JAD-230077","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T10:08:02Z","timestamp":1777370882000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/full\/10.3233\/JAD-230077"}},"subtitle":[],"editor":[{"given":"Martin","family":"Vyhnalek","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2023,8,1]]},"references-count":44,"journal-issue":{"issue":"3"},"URL":"https:\/\/doi.org\/10.3233\/jad-230077","relation":{},"ISSN":["1387-2877","1875-8908"],"issn-type":[{"value":"1387-2877","type":"print"},{"value":"1875-8908","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,8,1]]}}}