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Olfactory Dysfunction Discriminates Probable Alzheimer's Dementia From Major Depression

A Cross-Validation and Extension

Received February 26, 1999; revised May 10, 1999; accepted July 20, 1999. From the University at Albany–State University of New York and Psychiatric Consultants, P.C. Address correspondence to Dr. Solomon, Psychiatric Consultants, P.C., 310 25th Avenue North, Suite 309, Nashville, TN 37203.

The present study was conducted to cross-validate and extend the hypothesis that olfactory dysfunction could discriminate between groups of patients with Alzheimer's disease and major depression. Forty patients meeting the DSM-IV criteria for either Alzheimer's disease or major depression (20 per group) underwent assessment with the Pocket Smell Test (PST), a three-item screening measure of odor identification, and the Mini-Mental State Examination (MMSE). A PST score of 1 (1 or 0 correct) discriminated between the groups with a hit rate of 97.5% (sensitivity=95%, specificity=100%). The optimal hit rate for the MMSE (24) was less effective (hit rate=90%, sensitivity=80%, specificity=100%). Age, gender, and education had minimal impact on the PST for both groups. Olfactory assessment continues to add to the diagnostic utility in the differential diagnosis of Alzheimer's disease versus major depression in elderly patients.

Key Words: Alzheimer's Disease • Depression • Olfactory Dysfunction

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