The Role Of Olfactory-Visual-Auditory Cognitive Test In Identifying The Impairment Of Episodic Memory

Objective: To study the role of Olfactory-Visual-Auditory cognitive test in identifying the impairment of episodic memory and to explore the sensitivity and specificity of Olfactory-Visual-Auditory cognitive test in the screening of cognitive dysfunction.Methods: We collected 20 patients with normal cognitive function(NCI)?18 patients with mild cognitive impairment(MCI)and 19 patients with Alzheimer's disease(AD)were enrolled in this study.Mini-mental State examination(MMSE)?Montreal Cognitive Assessment(Mo CA)?Addenbrooke's Cognitive Examination-III(ACE-III)?Activity of Daily Living Scale(ADL)?Global Deterioration Scale(GDS)?Clinical Dementia Reporting(CDR)to assess subjects' global cognitive function,and Rey-Osterrieth Complex Figure(ROCF)?Rey Auditory Verbal Learning Test(RAVLT)?Olfactory Memory? Olfactory Discrimination?Olfactory Identification evaluation of OlfactoryVisual-Auditory cognitive tests in subjects.The Logistic regression model was used to analyze the different factors in univariate comparison,and to explore the role of Olfactory-Visual-Auditory cognitive test in screening patients with cognitive impairment.To explore the correlation between Olfactory-Visual-Auditory cognitive test and situational memory by Pearson correlation test.In addition,the receiver operating characteristic curve was used to analyze the sensitivity and specificity of Olfactory-Visual-Auditory cognitive tests in the recognition of cognitive dysfunction.Results: 1.The MCI group of MMSE?Mo CA?ACE-III?Olfactory Memory?Olfactory Discrimination?Olfactory Identification?ROCF Delay Recall?RAVLT Immediate Memory?RAVLT Delay Recall was lower than that of NCI group(P<0.05),but there was no significant difference between the two groups in ROCF Replication score(P>0.05),And in the NCI group,there were 60 percent(12/20)subjects who got full scores,and 38.89 percent(7/18)of the participants in the MCI group got full scores,and in the AD group,26.32 percent(5/19)of the participants got full scores.MMSE?Mo CA?ACE-III,Olfactory Memory?Olfactory Discrimination?Olfactory Identification?RAVLT Immediate Memory?RAVLT Delay Recall?ROCF Replication?ROCF Delay Recall in AD group were significantly lower than those in NCI group(P < 0.05).2.To compare the detection methods of Olfactory-Visual-Auditory test between MCI group and NCI group,There was a significant difference between including Olfactory Memory?Olfactory Discrimination?Olfactory Identification?ROCF Delay Recall?RAVLT Immediate Memory?RAVLT Delay Recall and MCI group(P<0.05).After adjusting the possible confounding factors,there was a correlation between MCI diagnosis and Olfactory Identification and RAVLT Delayed Recall,the ORs(95%CI)were 0.530(0.325~0.866)and 0.436(0.229~0.830)respectively.Similarly,To compare the detection methods of Olfactory-Visual-Auditory test between AD group and NCI group,There was a significant difference between including Olfactory Memory?Olfactory Discrimination?Olfactory Identification?ROCF Replication?ROCF Delay Recall?RAVLT Immediate Memory?RAVLT Delay Recall and MCI group(P < 0.05).After adjusting the effect of possible confounding factors,AD diagnosis was associated with Olfactory Identification and RAVLT Delayed Recall,the ORs(95%CI)were 0.520(0.284~0.953)and 0.401(0.206~0.778)respectively.3.The Olfactory-Visual-Auditory cognitive tests were used to screen patients with cognitive impairment.Analyzed of Olfactory Memory?Olfactory Discrimination?Olfactory Identification?ROCF Replication?ROCF Delay Recall?RAVLT Immediate Memory ? RAVLT Delay Recall ROC curves:(1).The area under the curve for distinguishing MCI group from NCI group was(0.700?0.735?0.839,0.585,0.753,4.0.907,0.868),The maximum Yorden index was(0.306?0.422?0.499?0.211?0.467?0.733?0.583),The sensitivity was(75.0%?70.0%?60.0%?60.0%?80.0%?90.0%?75.0%)the specificity was(55.6%?72.2%?89.9%?61.1%?66.7%?83.3%?83.3%)?(2).The area under the curve for distinguishing AD group from NCI group was(0.729?0.812?0.825,0.716,0.866,0.882,0.911),The maximum Yorden index was(0.329?0.522?0.499?0.337?0.649?0.795?0.645),The sensitivity was(75.0%?70.0%?70.0%?60.0%?85.0%?90.0%?75.0%),the specificity was(57.9%?84.2%?79.9%?73.7%?79.9%?89.5%?89.5%)?Conclusions: 1.The patients with cognitive dysfunction(MCI / ADD)had early situational memory impairment,while Olfactory-Visual-Auditory cognitive test might be an effective test method for the impairment of situational memory.2.The ROCF Replication test may have "ceiling effect" in Chinese characters population.3.The Olfactory Recognition and RAVLT Delayed Recall may be used as an independent method for the detection of MCI patients.Its sensitivity and specificity were 60.0% and 89.9%,75.0% and 83.3%,respectively.Similarly,The Olfactory Recognition and RAVLT Delayed Recall may also be used as an independent method for the detection of AD patients.Its sensitivity and specificity were 70.0% and 75.9% respectively.4.The RAVLT may be superior to Olfactory Test and ROCF in the diagnosis of cognitive dysfunction in patients(MCI?AD).