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October 03, 2017; 89 (14) Article

Olfaction and incident Parkinson disease in US white and black older adults

Honglei Chen, Srishti Shrestha, Xuemei Huang, Samay Jain, Xuguang Guo, Gregory J. Tranah, Melissa E. Garcia, Suzanne Satterfield, Caroline Phillips, Tamara B. Harris, For the Health ABC Study
First published September 6, 2017, DOI: https://doi.org/10.1212/WNL.0000000000004382
Honglei Chen
From the Epidemiology Branch (H.C., S. Shrestha), National Institute of Environmental Health Sciences, Research Triangle Park, NC; Department of Epidemiology and Biostatistics (H.C.), College of Human Medicine, Michigan State University, East Lansing; Department of Neurology (X.H.), Pennsylvania State University College of Medicine, Hershey; Department of Neurology (S.J.), University of Pittsburgh School of Medicine, PA; Westat Inc. (X.G.), Durham, NC; California Pacific Medical Center Research Institute (G.J.T.), San Francisco; Laboratory of Epidemiology, Demography, and Biometry (M.E.G., C.P., T.B.H.), National Institute on Aging, Bethesda, MD; and Department of Preventive Medicine (S. Satterfield), University of Tennessee Health Science Center, Memphis. M.E.G. is currently affiliated with the National Heart, Lung, and Blood Institute, Bethesda, MD.
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Srishti Shrestha
From the Epidemiology Branch (H.C., S. Shrestha), National Institute of Environmental Health Sciences, Research Triangle Park, NC; Department of Epidemiology and Biostatistics (H.C.), College of Human Medicine, Michigan State University, East Lansing; Department of Neurology (X.H.), Pennsylvania State University College of Medicine, Hershey; Department of Neurology (S.J.), University of Pittsburgh School of Medicine, PA; Westat Inc. (X.G.), Durham, NC; California Pacific Medical Center Research Institute (G.J.T.), San Francisco; Laboratory of Epidemiology, Demography, and Biometry (M.E.G., C.P., T.B.H.), National Institute on Aging, Bethesda, MD; and Department of Preventive Medicine (S. Satterfield), University of Tennessee Health Science Center, Memphis. M.E.G. is currently affiliated with the National Heart, Lung, and Blood Institute, Bethesda, MD.
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Xuemei Huang
From the Epidemiology Branch (H.C., S. Shrestha), National Institute of Environmental Health Sciences, Research Triangle Park, NC; Department of Epidemiology and Biostatistics (H.C.), College of Human Medicine, Michigan State University, East Lansing; Department of Neurology (X.H.), Pennsylvania State University College of Medicine, Hershey; Department of Neurology (S.J.), University of Pittsburgh School of Medicine, PA; Westat Inc. (X.G.), Durham, NC; California Pacific Medical Center Research Institute (G.J.T.), San Francisco; Laboratory of Epidemiology, Demography, and Biometry (M.E.G., C.P., T.B.H.), National Institute on Aging, Bethesda, MD; and Department of Preventive Medicine (S. Satterfield), University of Tennessee Health Science Center, Memphis. M.E.G. is currently affiliated with the National Heart, Lung, and Blood Institute, Bethesda, MD.
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Samay Jain
From the Epidemiology Branch (H.C., S. Shrestha), National Institute of Environmental Health Sciences, Research Triangle Park, NC; Department of Epidemiology and Biostatistics (H.C.), College of Human Medicine, Michigan State University, East Lansing; Department of Neurology (X.H.), Pennsylvania State University College of Medicine, Hershey; Department of Neurology (S.J.), University of Pittsburgh School of Medicine, PA; Westat Inc. (X.G.), Durham, NC; California Pacific Medical Center Research Institute (G.J.T.), San Francisco; Laboratory of Epidemiology, Demography, and Biometry (M.E.G., C.P., T.B.H.), National Institute on Aging, Bethesda, MD; and Department of Preventive Medicine (S. Satterfield), University of Tennessee Health Science Center, Memphis. M.E.G. is currently affiliated with the National Heart, Lung, and Blood Institute, Bethesda, MD.
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Xuguang Guo
From the Epidemiology Branch (H.C., S. Shrestha), National Institute of Environmental Health Sciences, Research Triangle Park, NC; Department of Epidemiology and Biostatistics (H.C.), College of Human Medicine, Michigan State University, East Lansing; Department of Neurology (X.H.), Pennsylvania State University College of Medicine, Hershey; Department of Neurology (S.J.), University of Pittsburgh School of Medicine, PA; Westat Inc. (X.G.), Durham, NC; California Pacific Medical Center Research Institute (G.J.T.), San Francisco; Laboratory of Epidemiology, Demography, and Biometry (M.E.G., C.P., T.B.H.), National Institute on Aging, Bethesda, MD; and Department of Preventive Medicine (S. Satterfield), University of Tennessee Health Science Center, Memphis. M.E.G. is currently affiliated with the National Heart, Lung, and Blood Institute, Bethesda, MD.
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Gregory J. Tranah
From the Epidemiology Branch (H.C., S. Shrestha), National Institute of Environmental Health Sciences, Research Triangle Park, NC; Department of Epidemiology and Biostatistics (H.C.), College of Human Medicine, Michigan State University, East Lansing; Department of Neurology (X.H.), Pennsylvania State University College of Medicine, Hershey; Department of Neurology (S.J.), University of Pittsburgh School of Medicine, PA; Westat Inc. (X.G.), Durham, NC; California Pacific Medical Center Research Institute (G.J.T.), San Francisco; Laboratory of Epidemiology, Demography, and Biometry (M.E.G., C.P., T.B.H.), National Institute on Aging, Bethesda, MD; and Department of Preventive Medicine (S. Satterfield), University of Tennessee Health Science Center, Memphis. M.E.G. is currently affiliated with the National Heart, Lung, and Blood Institute, Bethesda, MD.
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Melissa E. Garcia
From the Epidemiology Branch (H.C., S. Shrestha), National Institute of Environmental Health Sciences, Research Triangle Park, NC; Department of Epidemiology and Biostatistics (H.C.), College of Human Medicine, Michigan State University, East Lansing; Department of Neurology (X.H.), Pennsylvania State University College of Medicine, Hershey; Department of Neurology (S.J.), University of Pittsburgh School of Medicine, PA; Westat Inc. (X.G.), Durham, NC; California Pacific Medical Center Research Institute (G.J.T.), San Francisco; Laboratory of Epidemiology, Demography, and Biometry (M.E.G., C.P., T.B.H.), National Institute on Aging, Bethesda, MD; and Department of Preventive Medicine (S. Satterfield), University of Tennessee Health Science Center, Memphis. M.E.G. is currently affiliated with the National Heart, Lung, and Blood Institute, Bethesda, MD.
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Suzanne Satterfield
From the Epidemiology Branch (H.C., S. Shrestha), National Institute of Environmental Health Sciences, Research Triangle Park, NC; Department of Epidemiology and Biostatistics (H.C.), College of Human Medicine, Michigan State University, East Lansing; Department of Neurology (X.H.), Pennsylvania State University College of Medicine, Hershey; Department of Neurology (S.J.), University of Pittsburgh School of Medicine, PA; Westat Inc. (X.G.), Durham, NC; California Pacific Medical Center Research Institute (G.J.T.), San Francisco; Laboratory of Epidemiology, Demography, and Biometry (M.E.G., C.P., T.B.H.), National Institute on Aging, Bethesda, MD; and Department of Preventive Medicine (S. Satterfield), University of Tennessee Health Science Center, Memphis. M.E.G. is currently affiliated with the National Heart, Lung, and Blood Institute, Bethesda, MD.
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Caroline Phillips
From the Epidemiology Branch (H.C., S. Shrestha), National Institute of Environmental Health Sciences, Research Triangle Park, NC; Department of Epidemiology and Biostatistics (H.C.), College of Human Medicine, Michigan State University, East Lansing; Department of Neurology (X.H.), Pennsylvania State University College of Medicine, Hershey; Department of Neurology (S.J.), University of Pittsburgh School of Medicine, PA; Westat Inc. (X.G.), Durham, NC; California Pacific Medical Center Research Institute (G.J.T.), San Francisco; Laboratory of Epidemiology, Demography, and Biometry (M.E.G., C.P., T.B.H.), National Institute on Aging, Bethesda, MD; and Department of Preventive Medicine (S. Satterfield), University of Tennessee Health Science Center, Memphis. M.E.G. is currently affiliated with the National Heart, Lung, and Blood Institute, Bethesda, MD.
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Tamara B. Harris
From the Epidemiology Branch (H.C., S. Shrestha), National Institute of Environmental Health Sciences, Research Triangle Park, NC; Department of Epidemiology and Biostatistics (H.C.), College of Human Medicine, Michigan State University, East Lansing; Department of Neurology (X.H.), Pennsylvania State University College of Medicine, Hershey; Department of Neurology (S.J.), University of Pittsburgh School of Medicine, PA; Westat Inc. (X.G.), Durham, NC; California Pacific Medical Center Research Institute (G.J.T.), San Francisco; Laboratory of Epidemiology, Demography, and Biometry (M.E.G., C.P., T.B.H.), National Institute on Aging, Bethesda, MD; and Department of Preventive Medicine (S. Satterfield), University of Tennessee Health Science Center, Memphis. M.E.G. is currently affiliated with the National Heart, Lung, and Blood Institute, Bethesda, MD.
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From the Epidemiology Branch (H.C., S. Shrestha), National Institute of Environmental Health Sciences, Research Triangle Park, NC; Department of Epidemiology and Biostatistics (H.C.), College of Human Medicine, Michigan State University, East Lansing; Department of Neurology (X.H.), Pennsylvania State University College of Medicine, Hershey; Department of Neurology (S.J.), University of Pittsburgh School of Medicine, PA; Westat Inc. (X.G.), Durham, NC; California Pacific Medical Center Research Institute (G.J.T.), San Francisco; Laboratory of Epidemiology, Demography, and Biometry (M.E.G., C.P., T.B.H.), National Institute on Aging, Bethesda, MD; and Department of Preventive Medicine (S. Satterfield), University of Tennessee Health Science Center, Memphis. M.E.G. is currently affiliated with the National Heart, Lung, and Blood Institute, Bethesda, MD.
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Olfaction and incident Parkinson disease in US white and black older adults
Honglei Chen, Srishti Shrestha, Xuemei Huang, Samay Jain, Xuguang Guo, Gregory J. Tranah, Melissa E. Garcia, Suzanne Satterfield, Caroline Phillips, Tamara B. Harris, For the Health ABC Study
Neurology Oct 2017, 89 (14) 1441-1447; DOI: 10.1212/WNL.0000000000004382

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Abstract

Objective: To investigate olfaction in relation to incident Parkinson disease (PD) in US white and black older adults.

Methods: The study included 1,510 white (mean age 75.6 years) and 952 black (75.4 years) participants of the Health, Aging, and Body Composition study. We evaluated the olfaction of study participants with the Brief Smell Identification Test (BSIT) in 1999–2000. We retrospectively adjudicated PD cases identified through August 31, 2012, using multiple data sources. We used multivariable Cox models to estimate hazard ratios (HRs) and 95% confidence intervals (CIs).

Results: During an average of 9.8 years of follow-up, we identified a total of 42 incident PD cases, including 30 white and 12 black participants. Overall, poor sense of smell, as indicated by a lower BSIT score, was associated with higher risk of PD. Compared with the highest tertile of BSIT (t3), the HR was 1.3 (95% CI 0.5–3.6) for the second tertile (t2) and 4.8 (95% CI 2.0–11.2) for the lowest tertile (t1) (ptrend < 0.00001). Further analyses revealed significant associations for incident PD in both the first 5 years of follow-up (HRt1/[t2+t3] 4.2, 95% CI 1.7–10.8) and thereafter (HRt1/[t2+t3] 4.1, 95% CI 1.7–9.8). This association appeared to be stronger in white (HRt1/[t2+t3] 4.9, 95% CI 2.3–10.5) than in black participants (HRt1/[t2+t3] 2.5, 95% CI 0.8–8.1), and in men (HRt1/[t2+t3] 5.4, 95% CI 2.3–12.9) than in women (HRt1/[t2+t3] 2.9, 95% CI 1.1–7.8).

Conclusions: Poor olfaction predicts PD in short and intermediate terms; the possibility of stronger associations among men and white participants warrants further investigation.

GLOSSARY

BSIT=
Brief Smell Identification Test;
CI=
confidence interval;
HAAS=
Honolulu-Asia Aging Study;
Health ABC=
Health, Aging, and Body Composition;
HR=
hazard ratio;
ICD-9-CM=
International Classification of Diseases–9–Clinical Modification;
PD=
Parkinson disease;
PRIPS=
Prospective Evaluation of Risk Factors for Idiopathic Parkinson's Syndrome

Footnotes

  • Coinvestigators are listed at Neurology.org.

  • Go to Neurology.org for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.

  • Supplemental data at Neurology.org

  • Editorial, page 1432

  • Received October 4, 2016.
  • Accepted in final form April 20, 2017.
  • © 2017 American Academy of Neurology
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Letters: Rapid online correspondence

  • Hyposmia as a prodromal marker for Parkinson disease
    • Honglei Chen, Professor, Michigan State Universitychenh@epi.msu.edu
    Submitted November 14, 2017
  • Hyposmia: A short and intermediate-term risk factor for incident Parkinson disease
    • Philipp Mahlknecht, Neurology Resident, Department of Neurology, Innsbruck Medical University, Innsbruck, AustriaPhilipp.Mahlknecht@i-med.ac.at
    • Stefan Kiechl, Johann Willeit, Werner Poewe, Klaus Seppi, Innsbruck, Austria
    Submitted November 03, 2017
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