Brian Sheng Yep Yeo, Harris Jun Jie Muhammad Danial Song, Benjamin Kye Jyn Tan, Adithya Suresh, Owen Tsung Wen Ho, Jun He Chan, Esther Yanxin Gao, Claire Jing-Wen Tan, Chong Boon Teo, Christopher Li-Hsian Chen, Laura Tay, Ecosse L Lamoureux, Thomas Hummel, Anna See, Shuhui Xu, Song Tar Toh, Tze Choong Charn, Neville Wei Yang Teo
{"title":"嗅觉障碍与偶发性认知衰退：系统回顾与元分析。","authors":"Brian Sheng Yep Yeo, Harris Jun Jie Muhammad Danial Song, Benjamin Kye Jyn Tan, Adithya Suresh, Owen Tsung Wen Ho, Jun He Chan, Esther Yanxin Gao, Claire Jing-Wen Tan, Chong Boon Teo, Christopher Li-Hsian Chen, Laura Tay, Ecosse L Lamoureux, Thomas Hummel, Anna See, Shuhui Xu, Song Tar Toh, Tze Choong Charn, Neville Wei Yang Teo","doi":"10.1002/alr.23635","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Olfactory impairment (OI) is associated with poor ageing outcomes. While cross-sectional studies found a high prevalence of OI among patients with neurodegenerative diseases, the temporal relationship remains unclear. This meta-analysis aims to synthesise the longitudinal association of OI with cognitive decline (CD).</p><p><strong>Methods: </strong>PubMed, Embase and Web of Science were searched through August 9, 2024 for longitudinal studies reporting on self-reported and objectively measured OI in adults, in association with CD, measured using validated methods. The outcome of interest was incident CD. Independent authors extracted data, assessed for bias and graded the strength of evidence. A mixed-effects meta-analysis with subgroup, sensitivity and bias analyses was conducted. The population-attributable fraction (PAF) of OI-associated CD was calculated.</p><p><strong>Results: </strong>This study included 48 articles and 37,783 participants. OI patients had a 2.06-fold greater risk of any CD (risk ratio [RR] = 2.06; 95% CI = 1.87‒2.26, I<sup>2</sup> = 0%), compared to individuals with normal olfaction. Patients with severe OI had a higher risk of any CD (RR = 2.60; 95% CI = 2.12‒3.20, I<sup>2</sup> = 0%) than patients with moderate OI (RR = 1.51; 95% CI = 1.23‒1.85, I<sup>2</sup> = 0%). The risk of any CD increased by 18% per 10% decrease in olfactory score (RR = 1.18; 95% CI = 1.14‒1.22, I<sup>2</sup> = 24%) and by 15% per point decrement on the Sniffin' Sticks Odor Identification Test (RR = 1.15; 95% CI = 1.11‒1.18, I<sup>2</sup> = 0%). These results remained robust to supplementary analyses. The PAF of OI-associated incident CD was 18%.</p><p><strong>Conclusion: </strong>OI may increase the risk of CD, with poorer olfaction linked to greater risks. 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OI patients had a 2.06-fold greater risk of any CD (risk ratio [RR] = 2.06; 95% CI = 1.87‒2.26, I<sup>2</sup> = 0%), compared to individuals with normal olfaction. Patients with severe OI had a higher risk of any CD (RR = 2.60; 95% CI = 2.12‒3.20, I<sup>2</sup> = 0%) than patients with moderate OI (RR = 1.51; 95% CI = 1.23‒1.85, I<sup>2</sup> = 0%). The risk of any CD increased by 18% per 10% decrease in olfactory score (RR = 1.18; 95% CI = 1.14‒1.22, I<sup>2</sup> = 24%) and by 15% per point decrement on the Sniffin' Sticks Odor Identification Test (RR = 1.15; 95% CI = 1.11‒1.18, I<sup>2</sup> = 0%). These results remained robust to supplementary analyses. The PAF of OI-associated incident CD was 18%.</p><p><strong>Conclusion: </strong>OI may increase the risk of CD, with poorer olfaction linked to greater risks. 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引用次数: 0
摘要
背景：嗅觉损伤（OI）与不良的衰老结果相关。虽然横断面研究发现神经退行性疾病患者成骨不全发生率高，但其时间关系尚不清楚。本荟萃分析旨在综合成骨不全与认知能力下降（CD）的纵向关联。方法：通过PubMed、Embase和Web of Science检索到2024年8月9日之前的纵向研究报告，这些研究报告是自我报告和客观测量的成人OI，与CD相关，使用经过验证的方法进行测量。值得关注的结果是偶发性CD。独立作者提取数据，评估偏倚并对证据强度进行分级。进行混合效应荟萃分析，包括亚组分析、敏感性分析和偏倚分析。计算oi相关CD的人群归因分数（PAF）。结果：本研究纳入48篇文献，37,783名受试者。成骨不全患者发生任何CD的风险高出2.06倍(风险比[RR] = 2.06；95% CI = 1.87-2.26, I2 = 0%)，与嗅觉正常的个体相比。严重成骨不全患者发生任何CD的风险更高(RR = 2.60；95% CI = 2.12-3.20, I2 = 0%)高于中度成骨不全患者(RR = 1.51；95% ci = 1.23-1.85, i2 = 0%)。嗅觉评分每降低10%，任何CD的风险增加18% (RR = 1.18；95% CI = 1.14-1.22, I2 = 24%)，嗅探棒气味识别测试每减少一个点，减少15% (RR = 1.15；95% ci = 1.11-1.18, i2 = 0%)。这些结果在补充分析中仍然是可靠的。oi相关事件CD的PAF为18%。结论：成骨不全可能增加患CD的风险，嗅觉差的风险更大。应将成骨不全作为一种潜在的认知筛查工具进行评估，在长期成骨不全患者中应考虑认知筛查。
Olfactory Impairment and Incident Cognitive Decline: A Systematic Review and Meta-Analysis.
Background: Olfactory impairment (OI) is associated with poor ageing outcomes. While cross-sectional studies found a high prevalence of OI among patients with neurodegenerative diseases, the temporal relationship remains unclear. This meta-analysis aims to synthesise the longitudinal association of OI with cognitive decline (CD).
Methods: PubMed, Embase and Web of Science were searched through August 9, 2024 for longitudinal studies reporting on self-reported and objectively measured OI in adults, in association with CD, measured using validated methods. The outcome of interest was incident CD. Independent authors extracted data, assessed for bias and graded the strength of evidence. A mixed-effects meta-analysis with subgroup, sensitivity and bias analyses was conducted. The population-attributable fraction (PAF) of OI-associated CD was calculated.
Results: This study included 48 articles and 37,783 participants. OI patients had a 2.06-fold greater risk of any CD (risk ratio [RR] = 2.06; 95% CI = 1.87‒2.26, I2 = 0%), compared to individuals with normal olfaction. Patients with severe OI had a higher risk of any CD (RR = 2.60; 95% CI = 2.12‒3.20, I2 = 0%) than patients with moderate OI (RR = 1.51; 95% CI = 1.23‒1.85, I2 = 0%). The risk of any CD increased by 18% per 10% decrease in olfactory score (RR = 1.18; 95% CI = 1.14‒1.22, I2 = 24%) and by 15% per point decrement on the Sniffin' Sticks Odor Identification Test (RR = 1.15; 95% CI = 1.11‒1.18, I2 = 0%). These results remained robust to supplementary analyses. The PAF of OI-associated incident CD was 18%.
Conclusion: OI may increase the risk of CD, with poorer olfaction linked to greater risks. OI should be assessed as a potential cognitive screening tool, and cognitive screening should be considered in patients with long-standing OI.
期刊介绍：
International Forum of Allergy & Rhinologyis a peer-reviewed scientific journal, and the Official Journal of the American Rhinologic Society and the American Academy of Otolaryngic Allergy.
International Forum of Allergy Rhinology provides a forum for clinical researchers, basic scientists, clinicians, and others to publish original research and explore controversies in the medical and surgical treatment of patients with otolaryngic allergy, rhinologic, and skull base conditions. The application of current research to the management of otolaryngic allergy, rhinologic, and skull base diseases and the need for further investigation will be highlighted.
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