Abstract Background Olfactory identification decline is a known early marker of Alzheimer's disease and is already present at the mild cognitive impairment (MCI) stage. While being linked with episodic memory, its predictive value for cognitive performance and distinguishing between clinical stages remains unclear. Objective This study examined (1) the predictive value of olfactory identification for episodic memory performance and (2) its utility for discriminating individuals with MCI from those with subjective cognitive decline (SCD). Methods Participants included 45 individuals with MCI (mean age = 80.08, SD = 5.86) and 48 with SCD (mean age = 75.82, SD = 5.64) from the Consortium for the Early Identification of Alzheimer's Disease–Quebec cohort. We evaluated olfactory identification with the University of Pennsylvania Smell Identification Test (UPSIT), and episodic memory with the Rey Auditory Verbal Learning Test (RAVLT). LASSO regression models were used to predict RAVLT total and delayed recall scores, using 80% of data for training and 20% for testing. Results UPSIT significantly predicted both RAVLT total (β = 0.45, p = 0.03) and delayed recall (β = 0.18, p = 0.02), independent of diagnostic group. Including UPSIT in the models increased explained variance from 9% to 19% for total recall, and from 8% to 20% for delayed recall. The MCI group had significantly lower UPSIT performance than the SCD group (p = 0.01). Linear discriminant analysis yielded 69% classification accuracy, with higher specificity (79%) than sensitivity (58%). Conclusions Olfactory identification enhances prediction of episodic memory performance and may be used as a cost-effective, non-invasive early screening tool for MCI.
Jobin et al. (2025) studied this question.