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Lewy bodies and olfactory dysfunction in old age.

Robert S Wilson1, Lei Yu, Julie A Schneider

  • 1Rush Alzheimer's Disease Center, Rush University Medical Center, 600 South Paulina Avenue, Chicago, IL 60612, USA. rwilson@rush.edu

Chemical Senses
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Summary

Impaired sense of smell in older adults may indicate Lewy body disease, even without other symptoms. This neuropathology affects olfactory function, highlighting a potential early detection marker.

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Area of Science:

  • Neuropathology
  • Neuroscience
  • Gerontology

Background:

  • Olfactory dysfunction is common in aging and neurodegenerative diseases.
  • Lewy body disease (LBD) is characterized by alpha-synuclein aggregates in the brain.
  • The relationship between LBD distribution and olfactory function requires further elucidation.

Purpose of the Study:

  • To investigate the association between Lewy body distribution and olfactory identification performance in older adults.
  • To determine if olfactory impairment can serve as an early indicator of underlying Lewy body disease.

Main Methods:

  • A cohort of older adults underwent odor identification testing.
  • Following death, brain autopsies were performed to identify and classify Lewy bodies.
  • Neuropathologic examination assessed Lewy body distribution (nigral, limbic, neocortical), plaques, tangles, and neuronal loss.

Main Results:

  • Limbic and neocortical Lewy body presence was significantly associated with impaired odor identification.
  • These associations remained significant after adjusting for age, sex, education, and time to death.
  • Results were consistent even when controlling for dementia, parkinsonism, or other neuropathologic markers.

Conclusions:

  • Lewy body disease, particularly limbic and neocortical forms, impairs olfactory function in late life.
  • Impaired olfaction may be a detectable sign of Lewy body disease in asymptomatic individuals.
  • Olfactory testing could potentially aid in the early detection of Lewy body disease.