Detecting signs of concern

Regarding the early identification of cognitive decline, a recent study indicates that the nose has a significant role.

Investigators from Mass General Brigham, affiliated with Harvard, designed olfactory assessments — where participants inhale scent labels attached to a card — to evaluate individuals’ capacity to distinguish, identify, and recall odors. They observed that participants could effectively conduct the test in their homes, with older adults experiencing cognitive decline achieving lower scores than their cognitively healthy counterparts. The outcomes are documented in Scientific Reports.

“Detecting cognitive impairment at an early stage could assist in recognizing individuals vulnerable to Alzheimer’s disease and allowing for interventions years prior to the onset of memory symptoms,” stated senior author Mark Albers from the Laboratory of Olfactory Neurotranslation at the McCance Center for Brain Health in the Department of Neurology at Massachusetts General Hospital, also an assistant professor of neurology at Harvard Medical School. “We aimed to create and validate an affordable, noninvasive test that can be utilized at home, establishing the foundation for enhancing research and treatment for Alzheimer’s.”

Albers and his team are exploring whether olfactory impairment — the often subtle decline in the sense of smell — may act as an early indicator for neurodegenerative conditions like Alzheimer’s, Parkinson’s, chronic traumatic encephalopathy, and traumatic brain injuries. Albers co-founded a company that produces the Aromha Brain Health Test, which the research group employed in their current investigation.

To assess the olfactory examination, the team enlisted English- and Spanish-speaking participants with subjective cognitive concerns (individuals expressing self-reported memory worries) and those with mild cognitive impairment. They compared the test findings from these participants to those who were anosmic and individuals with normal cognitive function.

The research group discovered that the ability to identify odors, memory performance, and discrimination capabilities diminished with age. Additionally, they found that elderly individuals with mild cognitive impairment exhibited lower scores for odor identification and discrimination compared to older adults with intact cognition. Overall, the researchers noted similar test results between English- and Spanish-speaking participants, and performance remained consistent whether or not a research assistant was present during the test.

The authors emphasize that subsequent studies could involve neuropsychological assessments and track patients over time to determine if the tool can forecast cognitive deterioration.

“Our findings imply that olfactory assessments could be implemented in clinical research environments in multiple languages and among older populations to predict neurodegenerative diseases and the emergence of clinical symptoms,” asserted Albers.

The research received funding from the National Institutes of Health.