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Thank you for your interest in the science behind the Early Alert™. In the following material, we bring together medical information about Alzheimer's disease (AD) and the correlation to the loss of olfactory sense. Additionally, the basis for the Early Alert™ and its functionality are discussed. If you would like more information, our website has a wide range of medical and scientific references and abstracts for your perusal.
Numerous medical research articles have documented the link between the sense of smell and Alzheimer's disease. A recent and notable article states that "A comprehensive review of the literature pertaining to olfaction in persons with Alzheimer's disease revealed that the olfactory identification ability of patients with memory disorders is impaired relative to controls" (Thompson et al., 1998. Neuropsych Review ). Furthermore, results demonstrate changes in olfactory threshold the year immediately preceding change in diagnosis from normal control to AD. Individuals with mild cognitive impairment, those with the ApoE epsilon 4 allele show poorer thresholds than those without the epsilon 4 allele." (Bacon et al.,1998. Ann New York Academy of Science.)
In a recent epidemiological study using the clinical version of the Early Alert™, 1604 senior citizens were studied. The authors concluded that "a simple test of olfaction may be more useful in clinical practice to predict cognitive decline than a test of global cognition." (Graves et al. 1999, Neurology)
Finally, Devanand et al. (2000, Am. J. Psychiatry) found that "olfaction scores were lower in patients with mild cognitive impairment than in healthy comparison subjects." Additionally, "patients with low olfaction scores, and patients with low olfaction scores who reported no subjective problems smelling, were more likely to develop AD than other patients."
Basically, the test consists of 12 microencapsulated smell strips that are scratched to release the odor. The individual sniffs the strip and chooses one of four possible answers. When the test is completed the Answer Key (last page of the test) is compared to the chosen answers by the individual. Those who complete the self-administered screening test and have 4 or more incorrect answers are asked to follow up with a physician. Those with less than 4 incorrect answers but demonstrate other signs and symptoms of Alzheimer's disease are also asked to follow up with a physician. Failing the test does not necessarily mean the person has Alzheimer's disease, and further testing is required.
It is our sincere hope that this self-administered screening test will increase social awareness of Alzheimer's disease and the possible early alert can improve a potential sufferer's quality of life.
EXAMPLE ARTICLES
Arnold SE, Smutzer GS, Trojanowski JQ, Moberg PJ, Annual New
York Academy of Science 1998 Nov 30; 855:762-75 Cellular and
molecular neuropathology of the olfactory epithelium and central
olfactory pathways in Alzheimer's disease and schizophrenia.
Bacon Moore AS, Paulsen JS, Murphy C, Journal Clinical Exp Neuropsychology 1999 June 21(3):341-51, A test of odor fluency in patients with Alzheimer's and Huntington's disease.
Bacon AW, Bondi MW, Salmon DP, Murphy C. Ann New York Academy of Science, Very early changes in olfactory functioning due to Alzheimer's disease and the role of apolipoprotein E in olfaction.1998 Nov 30;855:723-31.
Crino PB, Martin JA, Hill WD, Greenberg B, Lee VM, Trojanowski JQ, Annual Oto Rhinol Laryngol 1995 Aug;104(8):655-61 Beta-Amyloid peptide and amyloid precursor proteins in olfactory mucosa of patients with Alzheimer's disease, Parkinson's disease, and Down syndrome.
Devanand DP, Michaels-Marston KS, Liu X, Pelton GH, Padilla M, Marder K, Bell K, Stern Y, Mayeux R, American Journal of Psychiatry 2000 Sep;157(9):1399-405 Olfactory deficits in patients with mild cognitive impairment predict Alzheimer's disease at follow-up.
Graves AB, Bowen JD, Rajaram L, McCormick WC, McMurray SM et al. 1999. Impaired olfaction as a marker for cognitive decline: interaction with apoliprotein E epsilon4 status. Neurology 53: 1480-87.
Nores JM, Biacabe B, Bonfils P, Annual Medical Interne (Paris) 2000 Mar;151(2):97-106 Olfactory disorders in Alzheimer's disease and in Parkinson's disease. Review of the literature.
McCaffrey RJ, Duff K, Solomon GS, Journal of Neuropsychiatry and Clinical Neuroscience 2000 Winter;12(1):29-33 Olfactory dysfunction discriminates probable Alzheimer's dementia from major depression: a cross-validation and extension.
Murphy C, Physiology Behavior 1999 Apr;66(2):177-82 Loss of olfactory function in dementing disease.
Larsson M, Semb H, Winblad B, Amberla K, Wahlund LO, Backman L, Neuropsychology 1999 Jan;13(1):47-53 Odor identification in normal aging and early Alzheimer's disease: effects of retrieval support.
Nordin S, Murphy C, Annual New York Academy of Science 1998 Nov 30;855:686-93 Odor memory in normal aging and Alzheimer's disease.
Thompson MD, Knee K, Golden CJ. Olfaction in persons with Alzheimer's disease. Neuropsychology Review 1998 Mar;8(1):11-23.
Van Hoesen GW, Parvizi J, Chu CC, Cerebral Cortex 2000 Mar;10(3):243-51 Orbitofrontal cortex pathology in Alzheimer's disease.
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