title: A Novel Application for Cognitive Evaluation in Mountain Ultramarathons: Olfactory Assessment.
abstract: OBJECTIVE
  Olfactory function, a cognitive impairment biomarker, was evaluated in mountain ultramarathon (MUM) runners during the Tor des Géants race (332.5 km with an overall altitude gain of 24,000 m; altitude range 330-3296 m above the sea).
  
  
  METHODS
  An Odor Identification Test was administered before (T0; n = 53), at 148.7 kms (T1; n = 32) and after the race (T2; n = 28). The effect of dehydration and sleep deprivation on olfactory function was assessed. Olfactory function was also assessed in non-MUM athletes and sedentary controls (C) at rest.
  
  
  RESULTS
  A majority of the athletes completed the olfactory test at all time intervals. Olfactory function decreased throughout the race (T0: 13.8 ± 1.9, T1: 13.7 ± 1.6, T2: 13.1 ± 1.8; T0 vs T2 P = .01). There was no relationship with race time or sleep deprivation on the sense of smell throughout the competition. However, there was a combined effect with decreased olfaction during the second half of the race, while a poor relationship was seen between olfaction and total body water at midterm (T1: rs = -0.427; P = .019), but not at baseline or after the race. MUM athletes had similar olfactory scores to C (13.8 ± 1.9 vs 13.7 ± 1.4) and non-MUM (13.8 ± 1.9 vs 13.9 ± 1.6) athletes.
  
  
  CONCLUSIONS
  This pilot study showed the feasibility of olfactory evaluation as a minimally invasive cognitive impairment assessment. The test can be used in logistically difficult environments, adding scientific value to this promising method. Although olfaction decreased after prolonged physical activity, further studies are warranted to make the relationship between cognition and external factors (eg, sleep deprivation, dehydration) more clear.
authors.affiliation: Institute of Clinical Physiology, National Research Council of Italy (IFC-CNR), Pisa, Italy (Drs Tonacci, Billeci, Mastorci, and Pratali; and Mr Borghini). Electronic address: atonacci@ifc.cnr.it.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Tonacci
authors.affiliation: Institute of Clinical Physiology, National Research Council of Italy (IFC-CNR), Pisa, Italy (Drs Tonacci, Billeci, Mastorci, and Pratali; and Mr Borghini).
authors.forename: Lucia
authors.initials: L
authors.lastname: Billeci
authors.affiliation: Institute of Clinical Physiology, National Research Council of Italy (IFC-CNR), Messina Unit, Messina, Italy (Drs Tartarisco and Pioggia).
authors.forename: Gennaro
authors.initials: G
authors.lastname: Tartarisco
authors.affiliation: Institute of Clinical Physiology, National Research Council of Italy (IFC-CNR), Pisa, Italy (Drs Tonacci, Billeci, Mastorci, and Pratali; and Mr Borghini).
authors.forename: Francesca
authors.initials: F
authors.lastname: Mastorci
authors.affiliation: Institute of Bioimaging and Molecular Physiology, National Research Council of Italy, Segrate (MI), Italy (Drs Mrakic-Sposta, Moretti, and Vezzoli).
authors.forename: Andrea
authors.initials: A
authors.lastname: Borghini
authors.affiliation: Institute of Bioimaging and Molecular Physiology, National Research Council of Italy, Segrate (MI), Italy (Drs Mrakic-Sposta, Moretti, and Vezzoli).
authors.forename: Simona
authors.initials: S
authors.lastname: Mrakic-Sposta
authors.affiliation: Institute of Bioimaging and Molecular Physiology, National Research Council of Italy, Segrate (MI), Italy (Drs Mrakic-Sposta, Moretti, and Vezzoli).
authors.forename: Sarah
authors.initials: S
authors.lastname: Moretti
authors.affiliation: Institute of Bioimaging and Molecular Physiology, National Research Council of Italy, Segrate (MI), Italy (Drs Mrakic-Sposta, Moretti, and Vezzoli).
authors.forename: Alessandra
authors.initials: A
authors.lastname: Vezzoli
authors.affiliation: Department of Translational Research on New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy (Dr Faraguna); IRCCS Stella Maris Scientific Institute, Calambrone, Pisa, Italy (Dr Faraguna).
authors.forename: Ugo
authors.initials: U
authors.lastname: Faraguna
authors.affiliation: Institute of Clinical Physiology, National Research Council of Italy (IFC-CNR), Messina Unit, Messina, Italy (Drs Tartarisco and Pioggia).
authors.forename: Giovanni
authors.initials: G
authors.lastname: Pioggia
authors.affiliation: Neurology and Neurophysiology Dept. Mountain Medicine Center Valle d'Aosta Regional Hospital, Aosta, Italy (Dr Giardini).
authors.forename: Giardini
authors.initials: G
authors.lastname: Guido
authors.affiliation: Institute of Clinical Physiology, National Research Council of Italy (IFC-CNR), Pisa, Italy (Drs Tonacci, Billeci, Mastorci, and Pratali; and Mr Borghini).
authors.forename: Lorenza
authors.initials: L
authors.lastname: Pratali
mesh_terms: D000328:Adult; D003072:Cognition Disorders / Q000175:diagnosis* / Q000209:etiology; D005260:Female; D005602:France; D006801:Humans; D007558:Italy; D008297:Male; D008875:Middle Aged; D009051:Mountaineering; D000857:Olfaction Disorders / Q000175:diagnosis* / Q000209:etiology; D014142:Track and Field; D055813:Wilderness Medicine / Q000379:methods*
keywords: altitude; dementia; nervous system diseases; psychophysiology; running