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.

项目概要/摘要 多达四分之一的美国老年人嗅觉较差，这是一种大多数人都没有意识到的感觉障碍 我们和其他人发现嗅觉不良是痴呆症和帕金森病的重要早期症状。 （PD），并有力地预测了死亡率的加速。其他人也推测嗅觉不良会产生不利影响。 营养、安全和生活质量，但我们最近的分析很大程度上缺乏严格的实证数据。 研究表明，痴呆、帕金森病和体重减轻仅能解释约 30% 的与不良嗅觉相关的过度行为 老年人的死亡率，导致死亡率增加的很大一部分潜在原因仍然未知。 因此，拟议的项目旨在利用廉价的、可利用的预测和信息能力。 通过回答两个新颖且具有临床意义的问题来实现简便、无创的嗅觉测试：1）什么 老年人的嗅觉差可能预示着不良的健康结果，此外 神经退行性疾病？ 2）嗅觉不良是加速衰老的标志吗？ 来自 Health ABC 和 ARIC 神经认知研究的前瞻性数据 – 完善的基于社区的研究 据我们所知，具有可比人群、研究设计和数据收集的混血儿群体。 这项研究将是迄今为止最大规模的，结合了客观测试的嗅觉和纵向评估 8,630 名 65 岁以上美国成年人（包括 56.6% 的女性和 27.6% 的非裔美国人）的健康结果 我们评估了性别和种族的影响，作为早期的标志和/或贡献者，嗅觉不佳。 老年人意味着多种主要疾病的风险升高，包括但不限于痴呆症和帕金森病（目标 1)、身体、肺和认知/心理功能下降以及虚弱（目标 2），并且与 根据我们的初步发现，我们进一步研究了年龄加速的表观遗传标记。 性别和种族可能会改变痴呆症、帕金森病和其他与痴呆相关的不良健康结果的关系 这些目标得到了我们严格的已发表和未发表的初步数据的支持，以及 由流行病学家、生物统计学家和临床研究人员组成的多学科团队，拥有良好的记录 大样本量、精心收集的健康数据保证了科学严谨性， 精心策划的统计分析、研究结果的交叉验证、策略性的汇总分析以及非常 我们经验丰富的多机构研究团队将提出创新的分析和预测结果。 显着促进人们对嗅觉不良对老年人健康（除了痴呆症）意味着什么的理解 和 PD，因此可能有助于将老年临床范式转向评估老年人的嗅觉 临床访问，监测和更好地预测即将发生的情况的风险，为识别高危人群提供信息 人群进行新颖的干预试验，并最终改善老年人的健康和生存。