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Relationships Between Lower Olfaction and Brain White Matter Lesions in Elderly Subjects with Mild Cognitive

Juliette Heinrich1,2,3, Jean-Sébastien Vidal4,5, Axelle Simon1,2

  • 1Centre de Psychiatrie et Neurosciences UMR S894 Inserm Université Paris Descartes, Paris, France.

Journal of Alzheimer'S Disease : JAD
|January 15, 2018
PubMed
Abstract

Insights

Olfactory impairment in mild cognitive impairment (MCI) is linked to white matter lesions (WML) and hippocampal atrophy. Severe deep WML independently predicts poor smell identification in MCI patients.

Area of Science:

  • Neurology
  • Geriatrics
  • Radiology

Background:

  • Olfactory impairment is a known symptom in mild cognitive impairment (MCI) and Alzheimer's disease (AD), often linked to hippocampal atrophy.
  • In elderly individuals, dementia frequently involves AD neuropathology and white matter lesions (WML).
  • The relationship between olfactory function and WML in MCI requires further investigation.

Purpose of the Study:

  • To investigate the cross-sectional association between olfactory function and white matter lesions (WML) in elderly individuals diagnosed with mild cognitive impairment (MCI).

Main Methods:

  • Included 75 MCI subjects (age >65) assessed via comprehensive neuropsychological testing and brain MRI.
  • Olfactory function was measured using the Brief Smell Identification Test (BSIT).
  • Hippocampal atrophy and WML were evaluated by blinded neuroradiologists using Scheltens' and Fazekas criteria, respectively.

Main Results:

  • Lower olfactory performance (BSIT scores) in MCI subjects correlated with older age, lower BMI, lower MMSE, lower FCRST, hippocampal atrophy, and both periventricular and deep WML.
  • Multivariate analysis revealed that severe deep WML (OR 6.29) was independently associated with impaired olfaction, even after accounting for hippocampal atrophy.

Conclusions:

  • In elderly MCI patients, reduced olfactory function is associated with white matter lesions (WML).
  • Vascular treatments may potentially slow the progression of WML.
  • A longitudinal study is underway to determine if WML progression, hippocampal atrophy, and olfactory decline predict MCI conversion to dementia.
Keywords:
Brain white matter lesionsmagnetic resonance imagingmild cognitive impairmentolfaction

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