Affiliations: Section of Neurology, Department of Internal Medicine, Taipei Hospital, Ministry of Health and Welfare, Taipei, Taiwan | Department of Neurology, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
Note:  Correspondence to: Dr. Ruey-Meei WU, Department of Neurology, National Taiwan University Hospital, No. 7, Chung-shan South Road, Taipei, Taiwan 10002. Tel.: +886 2 23123456; Ext. 65337; Fax: +886 2 23418395; E-mail: [email protected]
Abstract: Background: Olfactory dysfunction is a non-motor feature of Parkinson's disease (PD) that appears at an early stage. The University of Pennsylvania Smell Identification Test (UPSIT) is the most widely used test for olfactory dysfunction, with multiple language versions available, including one in Traditional Chinese (UPSIT-TC). However, the UPSIT-TC has rarely been applied to the elderly population or patients with PD in Taiwan. Objective: The present study aimed to establish normative data in a Taiwanese cohort and evaluate the efficacy of the UPSIT-TC for detecting olfactory deficits in early PD. Methods: The UPSIT-TC was administered to 161 healthy Taiwanese subjects divided into four age groups: 40–49, 50–59, 60–69, and 70–79 years. Furthermore, 30 patients with PD with less than 2 years disease duration were examined with the UPSIT-TC. Results: The normative data from this cohort were lower than expected, deviating from North American norms by 2.5 to 5 points. The deviation was more prominent with advanced age. The PD group had a significantly lower mean UPSIT-TC score than the age- and gender-matched control group (p < 0.0001). With a cutoff score of 29.5, the sensitivity and specificity of the UPSIT-TC for the diagnosis of olfactory dysfunction in early PD was 86% and 70%, respectively. The subjects with PD, advanced age, and shorter education had significantly lower UPSIT-TC scores (p < 0.0001). Conclusions: The UPSIT-TC effectively detected hyposmia in early PD in the Taiwanese cohort. Despite the modification of UPSIT-TC items, a discrepancy was found between the Taiwanese and North American norms.
Keywords: Parkinson's disease, olfactory test, UPSIT Traditional Chinese Version, hyposmia, non-motor symptoms, Taiwanese