title: Olfactory identification deficits and increased mortality in the community.
abstract: OBJECTIVE
  To examine the association between odor identification deficits and future mortality in a multiethnic community cohort of older adults.
  
  
  METHODS
  Participants were evaluated with the 40-item University of Pennsylvania Smell Identification Test (UPSIT). Follow-up occurred at 2-year intervals with information on death obtained from informant interviews and the National Death Index.
  
  
  RESULTS
  During follow-up (mean = 4.1 years, standard deviation = 2.6), 349 of 1,169 (29.9%) participants died. Participants who died were more likely to be older (p < 0.001), be male (p < 0.001), have lower UPSIT scores (p < 0.001), and have a diagnosis of dementia (p < 0.001). In a Cox model, the association between lower UPSIT score and mortality (hazard ratio [HR] = 1.07 per point interval, 95% confidence interval [CI] = 1.05-1.08, p < 0.001) persisted after controlling for age, gender, education, ethnicity, language, modified Charlson medical comorbidity index, dementia, depression, alcohol abuse, head injury, smoking, body mass index, and vision and hearing impairment (HR = 1.05, 95% CI = 1.03-1.07, p < 0.001). Compared to the fourth quartile with the highest UPSIT scores, HRs for mortality for the first, second, and third quartiles of UPSIT scores were 3.81 (95% CI = 2.71-5.34), 1.75 (95% CI = 1.23-2.50), and 1.58 (95% CI = 1.09-2.30), respectively. Participant mortality rate was 45% in the lowest quartile of UPSIT scores (anosmia) and 18% in the highest quartile of UPSIT scores.
  
  
  CONCLUSIONS
  Impaired odor identification, particularly in the anosmic range, is associated with increased mortality in older adults even after controlling for dementia and medical comorbidity.
authors.affiliation: Division of Geriatric Psychiatry, Department of Psychiatry, Columbia University, New York, NY.
authors.forename: Davangere P
authors.initials: DP
authors.lastname: Devanand
authors.affiliation: Division of Biostatistics, New York State Psychiatric Institute and Columbia University, New York, NY.
authors.forename: Seonjoo
authors.initials: S
authors.lastname: Lee
authors.affiliation: Department of Neurology, Gertrude H. Sergievsky Center, and Taub Institute for Research on Alzheimer's Disease and the Aging Brain, College of Physicians and Surgeons, Columbia University, New York, NY.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Manly
authors.affiliation: Department of Neurology, Gertrude H. Sergievsky Center, and Taub Institute for Research on Alzheimer's Disease and the Aging Brain, College of Physicians and Surgeons, Columbia University, New York, NY.
authors.forename: Howard
authors.initials: H
authors.lastname: Andrews
authors.affiliation: Department of Neurology, Gertrude H. Sergievsky Center, and Taub Institute for Research on Alzheimer's Disease and the Aging Brain, College of Physicians and Surgeons, Columbia University, New York, NY.
authors.forename: Nicole
authors.initials: N
authors.lastname: Schupf
authors.affiliation: Department of Neurology, Gertrude H. Sergievsky Center, and Taub Institute for Research on Alzheimer's Disease and the Aging Brain, College of Physicians and Surgeons, Columbia University, New York, NY.
authors.forename: Arjun
authors.initials: A
authors.lastname: Masurkar
authors.affiliation: Department of Neurology, Gertrude H. Sergievsky Center, and Taub Institute for Research on Alzheimer's Disease and the Aging Brain, College of Physicians and Surgeons, Columbia University, New York, NY.
authors.forename: Yaakov
authors.initials: Y
authors.lastname: Stern
authors.affiliation: Department of Neurology, Gertrude H. Sergievsky Center, and Taub Institute for Research on Alzheimer's Disease and the Aging Brain, College of Physicians and Surgeons, Columbia University, New York, NY.
authors.forename: Richard
authors.initials: R
authors.lastname: Mayeux
authors.affiliation: Smell and Taste Center, University of Pennsylvania, Philadelphia, PA.
authors.forename: Richard L
authors.initials: RL
authors.lastname: Doty
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D009026:Mortality / Q000639:trends; D000857:Olfaction Disorders / Q000175:diagnosis* / Q000401:mortality*; D012111:Residence Characteristics