Olfactory impairment and the risk of cognitive decline and dementia in older adults: a meta-analysis

Introduction: The prediction of the impact of olfactory impairment on cognitive decline in older adults has been different among different age groups. Objective: This meta-analysis sought to estimate the predictive power of olfactory impairment on cognitive decline during follow-up in older adults of different ages. Material and methods: A medical literature search was carried out using these databases for eligible studies: MEDLINE, COCHRANE and EMBASE. Studies recording olfaction and cognition detection at the beginning and end of the follow-up were included in the preliminary screening. The medical records of older adults without cognitive impairment at the beginning of the follow-up were taken into account in this analysis. Raw data was extracted in order to estimate the relative risk and the corresponding 95% confidence interval (95% CI). Subgroup analysis of age was performed to eliminate the effect of age on the results. Statistical heterogeneity was measured using the l(2) index and Cochran's Q test. Results: Eight studies were enrolled in this analysis (3237 events and 13165 participants), and the pooled relative risk for the 70-80 years old subgroup was 2.00 (95% CI = 1.79-2.23). Conclusion: Relatively, there is a higher risk of cognitive impairment at the end of follow-up in younger adults with olfactory impairment at the beginning of follow-up. The length of follow-up has a little effect on the relative risk. (C) 2020 Associacao Brasileira de Otorrinolaringologia e Cirurgia Cervico-Facial. Published by Elsevier Editora Ltda.