Lewy bodies and olfactory dysfunction in old age.
As part of a clinical-pathologic project, older people completed a standard odor identification test at study entry. During a mean of 3.5 years of observation, 201 people died and underwent brain autopsy and neuropathologic examination (6 with a history of Parkinson's disease were excluded). Lewy bodies were identified with antibodies to alpha-synuclein and classified as nigral, limbic, or neocortical based on their distribution in 6 brain regions. Plaques and tangles in 5 regions were summarized with a previously established composite measure, and neuron loss in the substantia nigra was rated on 6-point scale. Odor identification scores ranged from 0 to 12 correct (mean = 8.0, standard deviation = 2.6). On neuropathologic examination, 26 persons had Lewy bodies (13 neocortical, 9 limbic, and 4 nigral). In an analysis adjusted for age, sex, education, and time from olfactory testing to death, limbic (estimate = -2.47, standard error [SE] = 0.73, P < 0.001) and neocortical (estimate = -4.36, SE = 0.63, P < 0.001) Lewy body subgroups were associated with impaired olfaction. Results were comparable in analyses that controlled for dementia or parkinsonism during the study or postmortem measures of plaques and tangles or nigral cell loss. A final set of analyses suggested that impaired olfactory performance may aid detection of underlying Lewy body disease. The findings indicate that Lewy body disease impairs late life olfactory function even in otherwise asymptomatic individuals.
Rush Alzheimer's Disease Center, Rush University Medical Center, 600 South Paulina Avenue, Chicago, IL 60612, USA. rwilson@rush.edu
Robert S
RS
Wilson
Lei
L
Yu
Julie A
JA
Schneider
Steven E
SE
Arnold
Aron S
AS
Buchman
David A
DA
Bennett
D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D000544:Alzheimer Disease / Q000150:complications / Q000473:pathology; D001921:Brain / Q000473:pathology; D005260:Female; D006801:Humans; D016631:Lewy Bodies / Q000473:pathology*; D020961:Lewy Body Disease / Q000150:complications / Q000473:pathology*; D008297:Male; D009474:Neurons / Q000473:pathology; D000857:Olfaction Disorders / Q000150:complications / Q000473:pathology*
Neurology. 1997 Dec;49(6):1580-7
9409350
Neurology. 2005 Mar 8;64(5):834-41
15753419
Percept Psychophys. 1989 May;45(5):381-4
2726398
J Neurol Neurosurg Psychiatry. 2011 Apr;82(4):369-72
20802026
Neurobiol Aging. 2011 May;32(5):857-63
19560232
Neurology. 2010 Sep 21;75(12):1070-8
20844243
J Neurol Neurosurg Psychiatry. 1992 Mar;55(3):181-4
1564476
Arch Neurol. 2011 Mar;68(3):351-6
21403020
Neuroepidemiology. 2005;25(4):163-75
16103727
Neurology. 2006 Jun 27;66(12):1837-44
16801647
Neuroepidemiology. 2006;27(3):169-76
17035694
Ann N Y Acad Sci. 2009 Jul;1170:730-5
19686220
Mov Disord. 2006 Dec;21(12):2062-7
16991138
Laryngoscope. 1996 Mar;106(3 Pt 1):353-6
8614203
Brain Cogn. 2005 Jul;58(2):178-82
15919549
J Neurol Neurosurg Psychiatry. 2009 Jun;80(6):667-70
19448090
Biol Psychiatry. 2008 Nov 15;64(10):871-9
18723162
Science. 1984 Dec 21;226(4681):1441-3
6505700
J Neurol Neurosurg Psychiatry. 2005 Oct;76(10):1342-7
16170073
J Neurol Neurosurg Psychiatry. 1992 Feb;55(2):138-42
1538221
J Gerontol. 1993 Mar;48(2):P49-53
8473697
J Neuropathol Exp Neurol. 2004 Jul;63(7):742-9
15290899
J Neural Transm (Vienna). 2004 Oct;111(10-11):1219-35
15480835
J Chronic Dis. 1975 Oct;28(9):493-7
1176578
Neurology. 2003 Jun 24;60(12):1909-15
12821732
Arch Neurol. 2008 Aug;65(8):1074-80
18695057
Ann Neurol. 2004 Aug;56(2):173-81
15293269
Neuroepidemiology. 2006;26(2):61-7
16352908
Neurobiol Aging. 2003 Mar-Apr;24(2):197-211
12498954
Arch Gen Psychiatry. 2007 Jul;64(7):802-8
17606814
J Gerontol B Psychol Sci Soc Sci. 2000 Sep;55(5):P304-10
10985295
Neurology. 2002 Jun 25;58(12):1815-9
12084882
Neurology. 2007 Dec 11;69(24):2197-204
17568013
J Neurol Neurosurg Psychiatry. 2001 Jun;70(6):739-43
11385006
J Gerontol A Biol Sci Med Sci. 1996 Mar;51(2):M86-91
8612109
Neurology. 1988 Aug;38(8):1237-44
3399075
Arch Neurol. 2003 Apr;60(4):539-44
12707067
Neurology. 2006 Aug 8;67(3):441-5
16894105
Neurology. 1996 Nov;47(5):1113-24
8909416
Neurology. 1984 Jul;34(7):939-44
6610841
Mov Disord. 2001 Jan;16(1):41-6
11215591
Ann Neurol. 2006 Jan;59(1):166-73
16374822
Acta Neuropathol. 2009 Jun;117(6):613-34
19399512
Ann Neurol. 2008 Feb;63(2):167-73
18067173
J Neurol Neurosurg Psychiatry. 2007 Jan;78(1):30-5
17012338