Predictors of Olfactory Impairment among Northern Iranian Population

Document Type: Original

Authors

1 Otorhinolaryngology Research Center, Department of Otolaryngology and Head and Neck Surgery, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran.

2 Guilan Legal Medicine Organization, Rasht, Iran.

10.22038/ijorl.2019.40358.2325

Abstract

Introduction:
The performance in most smell identification tests is subjected to cultural variations. This study aimed to evaluate age, gender, and smoking-related effects on the test performance in the North of Iran.
 
Materials and Methods:
The olfactory function of 1470 eligible subjects was assessed in this study. Moreover, this study evaluated the influence of age, gender, and education on the test scores.
 
Results:
According to the results, females obtained higher mean test scores, compared to males (18.4 vs. 17.6). In general, the elderly obtained lower scores, and about 30% of the subjects who were ≥65 years of age had severe hyposmia or anosmia. Furthermore, the olfactory impairment frequency in smoker subjects was significantly more than non-smokers (P<0.001). Test scores were generally higher in subjects with higher education levels. Logistic regression analysis revealed that the total number of cigarette doses in smokers and age had a significant association with olfactory dysfunction (P value <0.001 and 0.004, respectively). Cronbach’s α of Iran-SIT was obtained at 0.78 which was more than an acceptable value of 0.7.
 
Conclusion:
The findings of this study revealed that a low score in the Iran-SIT correlated with smoking, older age, low education level, and gender (male).

Keywords


  1. Bramerson A, Johansson L, Ek L, Nordin S, Bende M. Prevalence of olfactory dysfunction:
    the skovde population-based study. The Laryngoscope. 2004; 114(4): 733-7. DOI: 10.1097/00005537-200 404000-00026
  2. Croy I, Nordin S, Hummel T. Olfactory disorders and quality of life--an updated review. Chem Senses. 2014;39(3):185-94. DOI: 10.1093/chemse/bjt072
  3. Murphy C, Schubert CR, Cruickshanks KJ, Klein BE, Klein R, Nondahl DM. Prevalence of olfactory impairment in older adults. Jama. 2002; 288(18): 2307-12.
  4. Vennemann MM, Hummel T, Berger K. The association between smoking and smell and taste impairment in the general population. J Neurol. 2008;255(8):1121-6. DOI: 10.1007/s00415-008-0807-9
  5. Schubert CR, Cruickshanks KJ, Fischer ME, Huang G-H, Klein BE, Klein R, et al. Olfactory impairment in an adult population: the Beaver Dam Offspring Study.Chemical senses. 2011;37(4):
    325-34.
  6. Doty RL. Office procedures for quantitative assessment of olfactory function. American journal of rhinology. 2007;21(4):460-73.
  7. Doty RL, Shaman P, Dann M. Development of the University of Pennsylvania Smell Identification Test: a standardized microencapsulated test of olfactory function. Physiol Behav. 1984;32(3):
    489-502.
  8. Jiang RS, Su MC, Liang KL, Shiao JY, Wu SH, Hsin CH. A pilot study of a traditional Chinese version of the University of Pennsylvania Smell Identification Test for application in Taiwan. Am J Rhinol Allergy.2010;24(1):45-50.
  9. Jalali MM, Roudbary SA, Gerami H, Soleimani R, Ebrahimi SM. Olfactory Identification among Various Subtypes of Parkinson Disease. Eur Neurol. 2019 Jul 10:1-7.
  10. Shu CH, Yuan BC, Lin SH, Lin CZ. Cross-cultural application of the "Sniffin'' Sticks" odor identification test. American journal of rhinology. 2007;21(5):570-3. DOI: 10.2500/ajr.2007.21.3075
  11. Ogihara H, Kobayashi M, Nishida K, Kitano M, Takeuchi K. Applicability of the cross-culturally modified University of Pennsylvania Smell Identification Test in a Japanese population. American journal of rhinology & allergy. 2011; 25(6): 404-10. DOI: 10.2500/ajra.2011.25.3658
  12. Taherkhani S, Moztarzadeh F, Seraj JM, Nazari SSH, Taherkhani F, Gharehdaghi J, et al. Iran Smell Identification Test (Iran-SIT): a Modified Version of the University of Pennsylvania Smell Identification Test (UPSIT) for Iranian Population. Chemosensory perception. 2015;8(4):183-91.
  13. Fokkens W, Lund V, Mullol J. European position paper on rhinosinusitis and nasal polyps 2007. Rhinology Supplement. 2007;20:1-136.
  14. Doty RL, Marcus A, Lee WW. Development of the 12-item Cross-Cultural Smell Identification Test (CC-SIT). The Laryngoscope. 1996;106(3 Pt 1):
    353-6.
  15. Karpa MJ, Gopinath B, Rochtchina E, Jie Jin W, Cumming RG, Sue CM, et al. Prevalence and neurodegenerative or other associations with olfactory impairment in an older community. Journal of aging and health. 2010;22(2):154-68. DOI: 10.1177/0898264309353066
  16. Doty RL, Shaman P, Applebaum SL, Giberson R, Siksorski L, Rosenberg L. Smell identification ability: changes with age. Science. 1984; 226 (4681):1441-3.
  17. Doty RL, Kamath V. The influences of age on olfaction: a review. Frontiers in psychology. 2014; 5:20. DOI: 10.3389/fpsyg.2014.00020
  18. Doty RL, Applebaum S, Zusho H, Settle RG. Sex differences in odor identification ability: a cross-cultural analysis. Neuropsychologia. 1985;23(5):
    667-72.
  19. Doty RL, Cameron EL. Sex differences and reproductive hormone influences on human odor perception. Physiol Behav. 2009;97(2):213-28. DOI: 10.1016/j.physbeh.2009.02.032
  20. Platek SM, Burch RL, Gallup GG, Jr. Sex differences in olfactory self-recognition. Physiol Behav. 2001;73(4):635-40.
  21. Choudhury ES, Moberg P, Doty RL. Influences of age and sex on a microencapsulated odor memory test. Chem Senses. 2003;28(9):799-805.
  22. Silveira-Moriyama L, Azevedo AM, Ranvaud R, Barbosa ER, Doty RL, Lees AJ. Applying a new version of the Brazilian-Portuguese UPSIT smell test in Brazil. Arq Neuropsiquiatr. 2010;68(5):700-5.
  23. Schlaepfer TE, Harris GJ, Tien AY, Peng L, Lee S, Pearlson GD. Structural differences in the cerebral cortex of healthy female and male subjects: a magnetic resonance imaging study. Psychiatry research. 1995;61(3):129-35.
  24. Larsson M, Lovden M, Nilsson LG. Sex differences in recollective experience for olfactory and verbal information. Acta psychologica. 2003; 112(1):89-103.
  25. Sorokowski P, Karwowski M, Misiak M, Marczak MK, Dziekan M, Hummel T, et al. Sex differences in human olfaction: a meta-analysis. Frontiers in psychology. 2019;10:242.
  26. Hedner M, Larsson M, Arnold N, Zucco GM, Hummel T. Cognitive factors in odor detection, odor discrimination, and odor identification tasks. J Clin Exp Neuropsychol. 2010;32(10):1062-7. DOI: 10.1080/13803391003683070
  27. Razani J, Murphy C, Davidson TM, Grant I, McCutchan A. Odor sensitivity is impaired in HIV-positive cognitively impaired patients. Physiol Behav. 1996;59(4-5):877-81.
  28. Katotomichelakis M, Balatsouras D, Tripsianis G, Davris S, Maroudias N, Danielides V, et al. The effect of smoking on the olfactory function. Rhinology. 2007;45(4):273-80.
  29. Ishimaru T, Fujii M. Effects of smoking on odour identification in Japanese subjects. Rhinology. 2007;45(3):224-8.
  30. Frye RE, Schwartz BS, Doty RL. Dose-related effects of cigarette smoking on olfactory function. Jama. 1990;263(9):1233-6.
  31. Doty RL, Frye R. Influence of nasal obstruction on smell function. Otolaryngologic clinics of North America. 1989;22(2):397-411.
  32. Vent J, Robinson AM, Gentry-Nielsen MJ, Conley DB, Hallworth R, Leopold DA, et al. Pathology of the olfactory epithelium: smoking and ethanol exposure. The Laryngoscope. 2004; 114(8): 1383-8.DOI:10.1097/00005537-200408000-00012
  33. Swan GE, Lessov-Schlaggar CN. The effects of tobacco smoke and nicotine on cognition and the brain. Neuropsychol Rev. 2007;17(3):259-73. DOI: 10.1007/s11065-007-9035-9
  34. Larsson M, Backman L. Age-related differences in episodic odour recognition: the role of access to specific odour names. Memory (Hove, England). 1997;5(3):361-78. DOI: 10.1080/741941391
  35. Matulionis DH. Ultrastructure of olfactory epithelia in mice after smoke exposure. The Annals of otology, rhinology, and laryngology. 1974; 83(2):192-201.DOI:10.1177/000348947408300207
  36. Jiang XZ, Buckley LA, Morgan KT. Pathology of toxic responses to the RD50 concentration of chlorine gas in the nasal passages of rats and mice. Toxicol Appl Pharmacol. 1983;71(2):225-36.
  37. Miller RR, Young JT, Kociba RJ, Keyes DG, Bodner KM, Calhoun LL, et al. Chronic toxicity and oncogenicity bioassay of inhaled ethyl acrylate in Fischer 344 rats and B6C3F1 mice. Drug and chemical toxicology. 1985;8(1-2):1-42.