title: Adapting the Sniffin' Sticks olfactory test to diagnose Parkinson's disease in Estonia.
abstract: The aim of the study was to develop a culturally adapted translation of the 12-item smell identification test from Sniffin' Sticks (SS-12) for the Estonian population in order to help diagnose Parkinson's disease (PD).
  
  
  METHODS
  A standard translation of the SS-12 was created and 150 healthy Estonians were questioned about the smells used as response options in the test. Unfamiliar smells were replaced by culturally familiar options. The adapted SS-12 was applied to 70 controls in all age groups, and thereafter to 50 PD patients and 50 age- and sex-matched controls.
  
  
  RESULTS
  14 response options from 48 used in the SS-12 were replaced with familiar smells in an adapted version, in which the mean rate of correct response was 87% (range 73-99) compared to 83% with the literal translation (range 50-98). In PD patients, the average adapted SS-12 score (5.4/12) was significantly lower than in controls (average score 8.9/12), p < 0.0001. A multiple linear regression using the score in the SS-12 as the outcome measure showed that diagnosis and age independently influenced the result of the SS-12. A logistic regression using the SS-12 and age as covariates showed that the SS-12 (but not age) correctly classified 79.0% of subjects into the PD and control category, using a cut-off of <7 gave a sensitivity of 76% and specificity of 86% for the diagnosis of PD.
  
  
  CONCLUSIONS
  The developed SS-12 cultural adaption is appropriate for testing olfaction in Estonia for the purpose of PD diagnosis.
authors.affiliation: Department of Neurology and Neurosurgery, University of Tartu, Tartu, Estonia.
authors.forename: Eva
authors.initials: E
authors.lastname: Antsov
authors.affiliation: Reta Lila Weston Institute of Neurological Studies, Institute of Neurology, University College London, London, UK; University of Campinas, UNICAMP, Campinas, Brazil; PPGMI, Universidade Federal do Paraná, UFPR, Brazil.
authors.forename: Laura
authors.initials: L
authors.lastname: Silveira-Moriyama
authors.affiliation: Department of Neurology and Neurosurgery, University of Tartu, Tartu, Estonia.
authors.forename: Stela
authors.initials: S
authors.lastname: Kilk
authors.affiliation: Department of Neurology and Neurosurgery, University of Tartu, Tartu, Estonia.
authors.forename: Liis
authors.initials: L
authors.lastname: Kadastik-Eerme
authors.affiliation: East Tallinn Central Hospital, Tallinn, Estonia.
authors.forename: Toomas
authors.initials: T
authors.lastname: Toomsoo
authors.affiliation: Reta Lila Weston Institute of Neurological Studies, Institute of Neurology, University College London, London, UK.
authors.forename: Andrew
authors.initials: A
authors.lastname: Lees
authors.affiliation: Department of Neurology and Neurosurgery, University of Tartu, Tartu, Estonia. Electronic address: Pille.Taba@kliinikum.ee.
authors.forename: Pille
authors.initials: P
authors.lastname: Taba
mesh_terms: D003948:Diagnostic Techniques, Respiratory System; D004957:Estonia; D005260:Female; D006801:Humans; D007802:Language; D008297:Male; D000857:Olfaction Disorders / Q000175:diagnosis* / Q000209:etiology; D010300:Parkinson Disease / Q000150:complications / Q000175:diagnosis*; D012903:Smell / Q000502:physiology*
keywords: Cultural adaption; Olfactory dysfunction; Parkinson's disease; Smell test; Sniffin' Sticks