Nasal citology for the selection of patients submitted to radiofrequency turbinate volume reduction

OBJECTIVES: Patients with amnesic Mild Cognitive Impairment (aMCI) have a higher risk to develop Alzheimer disease (AD) than general elderly population. The aim of this study is to evaluate the olfactory performance in patients with aMCI at baseline (T0) and at 18 months follow-up (T1) its correlation with neurocognitive decline and the accuracy of olfactory test to discriminate patients that will progress in AD. METHODS: 29 aMCI patients, were enrolled in the study and examined at T0 and at T1. Neurocognitive functions were assessed by the Mini Mental State Examination (MMSE) and the Mental Deterioration Battery (MDB). Olfactory function was evaluated by the Sniffin' Sticks Screening Test (SSST) and the Sniffin‘ Sticks Extended Test (SSET). RESULTS: The mean olfactory score of the 29 aMCI patients at SSST (T0:8.3±2.1; T1:7.3±2.5) and SSET(T0:26.8±5.5; T1:25.3±5.1) showed a significant impairment of olfactory identification and discrimination. At T1 9 of the 29 patients developed AD and these patients at T0 showed a lower olfactory performance and a higher olfactory decline at T1. Our results showed a good diagnostic accuracy of the SSST for AD in aMCI patients using a cut-off of 10 for the SSST score between normosmic and hypo-anosmic subjects. An high statistically significant relationship was found between olfactory discrimination and visuo-spatial ability (0.52; p=0.004), language skill (0.46; p=0.01) and Rey Immediate test (0.41; p=0.03) of MDB and between olfactory identification and Rey Delayed test (0.40; p=0.03) of MDB. CONCLUSIONS: These results demonstrate that the olfactory test should be part of the clinical testing for aMCI diagnosis.