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Clinical Manifestations.

Berivan Ece1, Emily H Ho1, Sandra Weintraub2

  • 1Northwestern University Feinberg School of Medicine, Chicago, IL, USA.

Alzheimer'S & Dementia : the Journal of the Alzheimer'S Association
|December 25, 2025
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Summary
This summary is machine-generated.

Olfactory decline is linked to cognitive decline. The National Institutes of Health Toolbox Odor Identification Test (NIHTB-OIT) shows performance varies by age, sex, and cognitive status in Spanish-speaking elders.

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Area of Science:

  • Neuroscience
  • Gerontology
  • Psychometrics

Background:

  • Olfactory decline is associated with cognitive impairment in aging populations.
  • The National Institutes of Health Toolbox Odor Identification Test (NIHTB-OIT) is a validated measure of olfactory function.
  • Validation of the NIHTB-OIT in Spanish-speaking and LatinX populations, who have a higher risk of Alzheimer's disease, is crucial.

Purpose of the Study:

  • To evaluate the performance of the NIHTB-OIT in a cross-sectional sample of Spanish-speaking older adults.
  • To assess the relationship between olfactory ability, age, sex, and cognitive status (normal control, mild cognitive impairment, dementia of Alzheimer type).
  • To determine the test's utility in a diverse, at-risk population.

Main Methods:

  • A cross-sectional study of 239 Spanish-speaking adults (aged 53-89) including normal controls (NC), mild cognitive impairment (MCI), and dementia of Alzheimer type (DAT) groups.
  • Administration of the NIHTB-OIT by trained examiners using scratch-and-sniff cards.
  • Data analysis using ANOVA and Welch Two Sample t-tests to examine effects of age, diagnosis, sex, and their interactions.

Main Results:

  • Significant main effects of age, diagnosis, and sex were observed on NIHTB-OIT scores.
  • Older adults and individuals with cognitive impairment generally scored lower.
  • Sex differences were noted in healthy aging individuals, with females scoring higher; a three-way interaction between age, sex, and cognitive status was significant.

Conclusions:

  • The NIHTB-OIT demonstrates differential performance based on cognitive status and gender in Spanish-speaking older adults.
  • Findings suggest heterogeneous clinical presentations of olfactory decline with aging in this population.
  • The study highlights the importance of considering demographic factors in olfactory assessment for cognitive aging research.