Poor sense of smell and the health of older adults

嗅觉差与老年人的健康

• 批准号: 10633069
• 负责人: HONGLEI CHEN
• 金额: $ 54.31万
• 依托单位: MICHIGAN STATE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-06-15 至 2027-02-28
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10633069
• 关键词: Acceleration; Adult; Affect; African American population; Age; Aging; Alzheimer' s Disease; Atherosclerosis Risk in Communities; Behavior; Black Populations; Body Composition; Body Weight decreased; Chronic; Chronic Disease; Chronology; Clinical; Clinical Management; Cognitive; Collaborations; Collection; Communities; Data; Data Collection; Dementia; Detection; Deterioration; Diabetes Mellitus; Diet; Disease; Elderly; Epidemiologist; Excess Mortality; Exhibits; Health; Impairment; Individual; Institution; Intervention Trial; Knowledge; Life; Link; Longevity; Lung; Monitor; Moods; Neurocognitive; Neurodegenerative Disorders; Olfactory dysfunction; Outcome; Parkinson Disease; Participant; Performance; Physiological; Pneumonia; Population; Populations at Risk; Predisposition; Prevalence; Productivity; Prospective Studies; Psyche structure; Public Health; Publishing; Quality of life; Race; Reproducibility; Research; Research Design; Research Personnel; Respiratory Disease; Risk; Safety; Sample Size; Sensory; Smell Perception; Solid; Source; Statistical Data Interpretation; Symptoms; System; Testing; Visit; Woman; biracial; cardiovascular disorder risk; clinically significant; cognitive function; cohort; comorbidity; epigenetic marker; experience; frailty; functional decline; health assessment; health data; human old age (65+); improved; innovation; men; mental function; mortality; multidisciplinary; novel; nutrition; poor health outcome; prospective; public health relevance; sex; stressor; validation studies

PROJECT SUMMARY/ABSTRACT Up to a quarter of older US adults have a poor sense of smell, a sensory impairment which most are unaware of. We and others found that poor olfaction is an important early symptom of dementia and Parkinson’s disease (PD), and robustly predicts accelerated mortality. Others also speculate that poor olfaction adversely affects nutrition, safety, and quality of life, but rigorous empirical data are largely lacking. Our most recent analysis revealed that dementia, PD, and weight loss combined explained only ~30% of poor olfaction-associated excess mortality in older adults, leaving a large portion of the potential causes of such increased mortality still unknown. The proposed project thus aims to leverage the predictive and informational power available via inexpensive, facile, and noninvasive olfaction testing, by answering two novel and clinically-significant questions: 1) What adverse health outcomes can a poor sense of smell in older adults potentially herald, in addition to neurodegenerative diseases? 2) Is poor olfaction a marker of accelerated aging? We will exploit extensive prospective data from the Health ABC and ARIC-Neurocognitive studies – well-established community-based biracial cohorts with comparable populations, study design, and data collection. To our knowledge, the proposed study will be the largest to date, combining the objectively-tested sense of smell and longitudinally assessed health outcomes in 8,630 US adults aged ≥65 years, including 56.6% women and 27.6% African Americans to assess sex and racial influences. We hypothesize that, as an early marker and/or contributor, poor olfaction in older adults signifies elevated risk of multiple major diseases, including but not limited to dementia and PD (Aim 1), declines in physical, pulmonary, and cognitive/mental functions, and frailty (Aim 2), and it is associated with epigenetic markers of age acceleration (Aim 3). Based on our preliminary findings, we further hypothesize that sex and race may modify the relationships of dementia, PD, and other adverse health outcomes associated with a poor sense of smell. The aims are supported by our rigorous published and unpublished preliminary data, and a multidisciplinary team of epidemiologists, biostatisticians, and clinical researchers with a proven track record of productive collaborations. Scientific rigor is assured by large sample sizes, meticulously collected health data, carefully planned statistical analyses, cross-validation of study findings, strategized pooled analyses, and a very experienced multi-institutional research team. Our innovative proposed analyses and predicted results will significantly advance understanding of what poor olfaction means for the health of older adults, besides dementia and PD, and may thus help shift the geriatric clinical paradigm toward assessing olfaction in the elderly during clinical visits, to monitor and better anticipate risks of impending conditions, to inform the identification of at-risk populations for novel interventional trials, and ultimately to improve the health and survival of older adults.

项目摘要/摘要 多达四分之一的美国成年人的嗅觉很差，这是大多数人不知道的感觉障碍 的。我们和其他人发现，嗅觉差是痴呆和帕金森氏病的重要早期症状 （PD），并坚固地预测死亡率加速。其他人还推测，嗅觉差会对不良影响 营养，安全性和生活质量，但严格的经验数据在很大程度上缺乏。我们最近的分析 揭示痴呆，PD和体重减轻的总和仅解释了约30％的不良嗅觉相关的超过 老年人的死亡率留下了这种增加死亡率的潜在原因的很大一部分仍然未知。 因此，拟议的项目旨在利用廉价的，廉价的预测和信息能力 通过回答两个小说和临床上重要的问题，便利和无创嗅觉测试：1）什么 不利的健康结果可能会在老年人中可能会有较香的嗅觉，除了 神经退行性疾病？ 2）不良的嗅觉是加速衰老的标志吗？我们将利用大量 来自健康ABC和ARIC神经认知研究的潜在数据 - 建立在社区的知名度 与人群，研究设计和数据收集的混血儿队列。据我们所知，提议 研究将是迄今为止最大的，结合了客观测试的嗅觉和纵向评估 8,630名年龄≥65岁的美国成年人的健康成果，包括56.6％的妇女和27.6％的非裔美国人 评估性别和种族影响。我们假设，作为早期标记和/或贡献者，嗅觉不佳 老年人表示多种主要疾病的风险升高，包括但不限于痴呆和PD（AIM 1），身体，肺部和认知/心理功能以及脆弱的衰落（AIM 2），与 年龄加速的表观遗传标记（AIM 3）。根据我们的初步发现，我们进一步假设 性和种族可能会改变痴呆症，PD和其他不良健康结果的关系 味道糟糕的感觉。我们严格发布和未发表的初步数据为目标提供了支持， 具有良好往绩记录的流行病学家，生物统计学家和临床研究人员的多学科团队 科学严谨是由大型样本量，精心收集的健康数据假定的， 仔细计划的统计分析，研究结果的交叉验证，战略性的合并分析以及非常 经验丰富的多机构研究团队。我们的创新提议的分析和预测的结果将 除了痴呆症之外 和PD，因此可能有助于将老年临床范式转移到较早的评估嗅觉中 临床访问，监测和更好地预测即将到来的条件的风险，以告知处于危险的识别 新型介入试验的人群，最终改善老年人的健康和生存。