Cut-Off Scores of an Olfactory Function Test for Mild Cognitive Impairment and Dementia

We aimed to find the optimal cut-off scores for screening of odor detection threshold, odor discrimination, and odor identification tests for detection of mild cognitive impairment (MCI) and dementia in Korean elderly.

A total of 195 elderly people were divided into three groups: the normal cognition (NC), MCI, and dementia groups. All participants underwent neurocognitive and olfactory function tests. We used k-means cluster analysis and receiver operating characteristic (ROC) analysis to identify the most appropriate cut-off value.

To distinguish the MCI from NC groups, odor identification [area under the curve (AUC)=0.670, p<0.007] with a cut-off point of 7 showed greater validity for screening (sensitivity/specificity=0.462/0.837) than did other olfactory function tests. To distinguish the MCI and dementia from NC as well, odor identification (AUC=0.817, p=0.002) with a cut-off point of 7 showed the highest validity for screening (0.785/0.654). To distinguish MCI from AD, an odor detection threshold (AUC=0.722, p=0.001) with a cut-off point of 2 showed the highest validity for screening (0.785/0.654).

Olfactory function tests may be a useful screening tool for cognitive decline before clinical symptoms of dementia have completely developed. This tool can be used as a supplementary tool to enhance the sensitivity of traditional cognitive tests to screen for dementia.