Neuropsychiatric Symptoms Mediated the Relationship Between Odor Identification and Cognition in Alzheimer's Disease Spectrum: A Structural Equation Model Analysis

Research output: Contribution to journalResearch articleContributedpeer-review

Contributors

  • Qiang Wang - , Guangzhou Medical University (Author)
  • Ben Chen - , Guangzhou Medical University (Author)
  • Xiaomei Zhong - , Guangzhou Medical University (Author)
  • Huarong Zhou - , Guangzhou Medical University (Author)
  • Min Zhang - , Guangzhou Medical University (Author)
  • Naikeng Mai - , Guangzhou Medical University (Author)
  • Zhangying Wu - , Guangzhou Medical University (Author)
  • Xinru Chen - , Guangzhou Medical University (Author)
  • Mingfeng Yang - , Guangzhou Medical University (Author)
  • Si Zhang - , Guangzhou Medical University (Author)
  • Gaohong Lin - , Guangzhou Medical University (Author)
  • Thomas Hummel - , Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Carl Gustav Carus Dresden (Author)
  • Yuping Ning - , Guangzhou Medical University (Author)

Abstract

Background: Odor identification dysfunction is an early predictor of the development of Alzheimer's disease (AD), but neuropsychiatric symptoms (NPS), which are common in AD and mild cognitive impairment (MCI), are also associated with odor identification dysfunction. Whether NPS affect the specificity of using odor identification dysfunction to predict cognitive decline in AD and MCI remains unclear. Methods: Patients (233 with MCI and 45 with AD) and 45 healthy controls (HCs) underwent assessments of odor identification (Sniffin' Sticks), NPS (Neuropsychiatric Inventory-12), and cognitive function (global cognition, memory, language, executive function, visual-spatial skill, and attention). Structural equation modeling (SEM) with bootstrapping estimation was conducted to explore the relationships between odor identification, NPS, and cognition. Results: Patients with NPS showed significantly worse performance in odor identification and cognition than patients without NPS and HCs. The SEM showed odor identification to be positively associated with cognition, and cognition had special indirect effects on odor identification through affective and psychosis symptoms (two factors extracted from Neuropsychiatric Inventory-12). Additionally, affective and psychosis symptoms partially mediated the effect of cognition on odor identification. Conclusion: Neuropsychiatric symptoms are associated with odor identification dysfunction in patients with AD and MCI. Studies exploring the relationship between odor identification dysfunction and cognitive decline in patients with AD and MCI should include an assessment of affective and psychosis symptoms, and adjust their confounding effects.

Details

Original languageEnglish
Article number732840
Number of pages11
JournalFrontiers in aging neuroscience
Volume13
Publication statusPublished - 12 Jan 2022
Peer-reviewedYes

External IDs

PubMedCentral PMC8789652
Scopus 85123427361
ORCID /0000-0001-9713-0183/work/146645256

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Library keywords