Use of the Brief Smell Identification Test for olfactory deficit in a Norwegian population with Alzheimer's disease.

AIMS: Several studies have shown that Alzheimer's disease (AD) is associated with hyposmia. Olfactory identification may be a cheap and simple additional test in the assessment of early cognitive changes. The sense of smell is influenced by factors such as experience and culture and the aim of the present study was to assess the validity of the Brief Smell Identification Test (B-SIT) in distinguishing patients with AD from healthy gender and age-matched controls in a Norwegian population. METHODS: The study included 39 patients with a diagnosis of probable AD, and 52 gender and age-matched controls. Olfactory function was assessed with B-SIT, and a non-standardized olfactory identification task (freshly ground coffee). RESULTS: The difference in olfactory performance between patients and controls was highly significant, both for the whole AD patient group and the subgroup of patients with MMSE >or= 24. Receiver operating curve (ROC) analyses indicated that B-SIT distinguished patients from controls with high sensitivity and specificity. All the odours in B-SIT with the exception of turpentine showed highly significant differences between patients and controls. AD-associated memory impairment did not seem to affect the answers given for B-SIT in this population. CONCLUSIONS: For patients with AD, the Brief Smell Identification Test (B-SIT) appears to be well-suited for detecting a deficit in olfactory identification in a Norwegian population.

[Cholinesterase inhibitors in Norway--effectiveness and side effects in clinical practice]. / Bruk av kolinesterasehemmere.

BACKGROUND: Naturalistic trials are needed to evaluate whether the results obtained in randomised trials of cholinesterase inhibitors (CEI) can be generalised to clinical practice. We conducted two studies in Norway to address this issue. MATERIAL AND METHODS: We included patients with dementia from 16 centres in Norway who had received treatment with a CEI until November 2001 (study 1, n = 1,167, retrospective case review) or who came to the first evaluation after onset of treatment (study 2; n = 252; prospective enrollment). Adverse events, global effectiveness, and Mini-Mental State Exam scores were recorded. RESULTS: In study 1, 56% of the patients were rated as mildly or markedly improved two to four months after onset of treatment. Side effects were recorded in 23%; 8% discontinued treatment due to side effects. In study 2, 49% were rated as mildly or markedly improved on at least one of the items cognition, psychiatric symptoms, activities of daily living or behaviour. Treatment was discontinued due to lack of effectiveness in 12%. INTERPRETATION: CEI were found to be useful in clinical practice in Norway. The open and uncontrolled design of the study limits the generalisability of the study.