Dementia: The simple smell test that could indicate your risk of developing the condition

Dementia is a cluster of symptoms associated with brain damage, a common symptom being memory loss. Dementia is one of the most devastating afflictions because it greatly diminishes one’s quality of life and those that care for them. Most devastating of all is the knowledge that there is no cure for dementia.


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The lack of cure should not belie the great strides that have been made in understanding the condition.

Research has found tantalising links to various lifestyle factors, links that may indicate your risk of one day developing dementia.

These breakthroughs are crucial because evidence suggests you can reduce your risk by preserving and enhancing your cognitive abilities throughout your life.

A study published in the Journal of the American Geriatrics Society made a decisive contribution to this field.

In the study that followed almost 3,000 older people with normal cognition, researchers found that a simple smell test was able to identify those at higher risk of dementia.

They found that participants who could not identify at least four out of five odours in the simple smell test were twice as likely to have dementia five years later.

“These results show that the sense of smell is closely connected with brain function and health,” said Professor Pinto, who is also an ear, nose, and throat specialist.

He explained that losing one’s sense of smell is a strong indicator of “significant damage,” and that this “simple smell test could provide a quick and inexpensive way to identify those who are already at high risk”.

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What the smell test entails

In the study, a “nationally representative sample” of 2,906 men and women aged between 57 and 85 underwent home interviews and completed a simple smell test.

For the “validated five-item test,” they had to identify five odours, one at a time, by sniffing a device similar to a felt-tip pen.

Each time, they were given four choices, from which they had to pick out the correct one.

The five different odours were: peppermint, fish, orange, rose, and leather, with peppermint being the easiest, and leather the hardest, to identify.


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The researchers found that the vast majority of participants were able to correctly identify at least four out of five odours.

Of the rest, seven percent identified two or three out of five smells, 2.2 percent identified just one, and one percent could not identify any of them.

After five years, the participants were interviewed again to find out if they had been diagnosed with dementia.

A proxy stood in if the participant was too sick to be interviewed or had died during the follow-up.

After analysing the results, the team found that the participants who had not been able to identify at least four out of the five odours at baseline (the starting point of the comparison) were more than twice as likely to be among those who had developed dementia during the five-year follow-up.

They also found that the lower the number of odours correctly detected at baseline, the higher the chances of dementia being diagnosed during the follow-up period.

No definitive conclusion

In a linked editorial, Dr. Stephen Thielke – from the Psychiatry and Behavioral Sciences Faculty at the University of Washington in Seattle – notes that this does not mean that “smell testing would be a useful tool for predicting the onset of dementia”.

Prof. Pinto accepted this limitation, noting: “Our test simply marks someone for closer attention.”

What underpins the link?

The reason poor sense of smell is linked to higher rates of death, Parkinson’s disease, and Alzheimer’s disease is unclear, but one possibility is that loss of smell might be an early indication that the condition is present, says Harvard Health.

“Or, perhaps other conditions that affect smell increase the risk of these diseases,” notes the health body.

It adds: “It could also be due to medications taken to treat symptoms of these conditions.”

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