title: Smell test predicts performance on delayed recall memory test in elderly with depression.
abstract: BACKGROUND
  Elderly with depression are at increased risk for cognitive dysfunction and dementia. Smell tests are correlated with performance on cognitive tests in the elderly and therefore might serve as a screening test for cognitive impairment in depressed elderly.
  
  
  OBJECTIVE
  To assess the validity of the CC-SIT (Cross-Cultural Smell Identification Test) as a screening test for cognitive impairment in elderly with depression.
  
  
  METHODS
  Forty-one patients, aged 60 and over, were assessed with the CC-SIT and CVLT (California Verbal Learning Test) after 3 months treatment of a Major Depressive Episode (DSM-IV) at the Day Hospital for Depression, Baycrest. Patients already diagnosed with dementia, or other psychiatric and neurological disorders, were excluded. Receiver Operating Characteristics (ROC) analysis was applied to assess the CC-SIT's accuracy in identifying individuals with impairment (2 SD below the mean for age and education or less) on CVLT delayed recall trials.
  
  
  RESULTS
  Forty-one patients (33 women and eight men) were assessed. Mean age was 76.8 (SD: 6.5), mean HRSD scores before treatment was 22.0 (SD: 5.1). Nine patients had impairment on CVLT delayed recall measures. The area under the ROC curve was 0.776 (95% CI = 0.617-0.936).
  
  
  CONCLUSIONS
  Our results support the use of the CC-SIT as a screening tool for cognitive impairment among elderly with depression as an indicator for the need of a comprehensive neuropsychological evaluation. Replication with larger samples is necessary.
authors.affiliation: Department of Psychiatry, Baycrest, Toronto, Ontario, Canada. scalcom@wmhc.ca
authors.forename: Monica Z
authors.initials: MZ
authors.lastname: Scalco
authors.forename: David L
authors.initials: DL
authors.lastname: Streiner
authors.forename: Dmytro
authors.initials: D
authors.lastname: Rewilak
authors.forename: Saulo
authors.initials: S
authors.lastname: Castel
authors.forename: Robert
authors.initials: R
authors.lastname: Van Reekum
mesh_terms: D002170:Canada; D003072:Cognition Disorders / Q000175:diagnosis* / Q000523:psychology; D003704:Dementia / Q000175:diagnosis* / Q000523:psychology; D003866:Depressive Disorder / Q000175:diagnosis* / Q000523:psychology; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006801:Humans; D008297:Male; D011939:Mental Recall / Q000502:physiology*; D008875:Middle Aged; D009483:Neuropsychological Tests; D011237:Predictive Value of Tests; D012372:ROC Curve; D012307:Risk Factors; D012903:Smell