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Characterizing the olfaction and dementia association in the community‐based ARIC study
Srishti Shrestha, Xiaoqian Zhu, Anna Kucharska‐Newton, Yaqun Yuan, Vidyulata J. Kamath, Priya Palta, Jennifer A. Deal, Thomas H. Mosley et al.. Alzheimer s & Dementia, 2025-02-01
Topic: Risk, prevention and care in population studies
Compared to good olfaction, moderate olfaction (hazard ratio [HR]: 1.53, 95% confidence interval [CI]: 1.26 to 1.86), hyposmia (HR: 2.24, 95% CI: 1.81 to 2.78), and anosmia (HR: 3.47, 95% CI: 2.77 to 4.34) were all associated with higher dementia hazard; these associations were consistent across age, race, sex, and APOE ε4 groups. The absolute risk difference between anosmia and good olfaction was higher in APOE ε4 carriers than in non-carriers. Those with stable anosmia and converting from normal olfaction to anosmia over time showed particularly strong associations. Olfactory impairment was robustly associated with incident dementia, with strongest associations in those with persistent impairment and greater olfactory decline over ∼5 years. HIGHLIGHTS: We examined olfactory status and olfactory change in relation to incident dementia. Poor olfactory status was robustly associated with higher dementia rate. Associations were robust across subgroups of age, sex, race, and APOE ε4 status. Persistent poor olfaction or decline over time showed the strongest associations.
Key findings
- Compared to good olfaction, moderate olfaction (hazard ratio [HR]: 1.53, 95% confidence interval [CI]: 1.26 to 1.86), hyposmia (HR: 2.24, 95% CI: 1.81 to 2.78), and anosmia (HR: 3.47, 95% CI: 2.77 to 4.34) were all associated with higher dementia hazard; these associations were consistent across age, race, sex, and APOE ε4 groups.
- The absolute risk difference between anosmia and good olfaction was higher in APOE ε4 carriers than in non-carriers.
- Those with stable anosmia and converting from normal olfaction to anosmia over time showed particularly strong associations.
- Olfactory impairment was robustly associated with incident dementia, with strongest associations in those with persistent impairment and greater olfactory decline over ∼5 years.
- HIGHLIGHTS: We examined olfactory status and olfactory change in relation to incident dementia.
Why it matters
In the community-based ARIC study, poorer sense of smell was strongly associated with higher dementia risk, with the strongest links in those with persistent impairment or decline over about 5 years. This supports olfactory testing as a possible risk marker, not a treatment or cure.
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Study details
- Participants4,470
- Effect sizeHR: 2.24; HR: 3.47
- Evidence strengthLow
How this study scored 52/100
Published in a peer-reviewed journal. Scored zero for study design and randomised / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (Alzheimer s & Dementia) |
| Journal's citation record | 2 / 4 | Alzheimer s & Dementia: journal h-index 228 (OpenAlex, 2026-10-29) |
| Study design | 0 / 12 | No study design recorded — scores zero, not guessed (not stated in the record — scored 0) |
| Strength of evidence | 1 / 5 | Rated “low” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 4 / 5 | 2025 — within 3 year(s) of the newest study here |
| Sample size | 3 / 4 | 4,470 participants |
| Effect reported | 3 / 3 | Effect reported with a statistic (interval, p-value, ratio or similar) |
| Studied in people | 3 / 3 | Studied in people (participant count stated) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 2 / 7 | Cited 6 times (OpenAlex, 2026-10-10) |
| Citations per year | 1 / 5 | 2.0 citations a year over 3 year(s) since 2025 |
| Impact for its field and year | 3 / 6 | Cited 3.5× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 1 / 6 | Cited by 1 other studies in this library |
| Still being cited | 1 / 4 | Cited 6 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 3 / 4 | Last-listed author Honglei Chen: h-index 97 (OpenAlex, whole career) |
| Institution's track record | 2 / 3 | Johns Hopkins University: institution h-index 2,306 (OpenAlex) |
| Multi-centre collaboration | 2 / 3 | OpenAlex lists 4 institution(s) in 1 country |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 39988999) |
| Free to read | 2 / 2 | Free to read |
| Total | 52 / 100 | — |
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Read the original
Full text: free to read — OpenAlex lists this copy as free to read: the link above (checked 6 Feb 1020).
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. The record's author list ends in “et al.”, so not every author is named. Check the citation against the original before you use it.
APA 7th
Shrestha, S., Zhu, X., Kucharska‐Newton, A., Yuan, Y., Kamath, V. J., Palta, P., et al. (2025). Characterizing the olfaction and dementia association in the community‐based ARIC study. Alzheimer s & Dementia. https://doi.org/10.1002/alz.14613
Vancouver
Shrestha S, Zhu X, Kucharska‐Newton A, Yuan Y, Kamath VJ, Palta P, et al. Characterizing the olfaction and dementia association in the community‐based ARIC study. Alzheimer s & Dementia. 2025. doi:10.1002/alz.14613. PMID: 39988999.
BibTeX
@article{shrestha2025-39988999,
author = {Shrestha, Srishti and Zhu, Xiaoqian and Kucharska‐Newton, Anna and Yuan, Yaqun and Kamath, Vidyulata J. and Palta, Priya and Deal, Jennifer A. and Mosley, Thomas H. and others},
title = {{Characterizing the olfaction and dementia association in the community‐based ARIC study}},
journal = {Alzheimer s \& Dementia},
year = {2025},
doi = {10.1002/alz.14613},
pmid = {39988999},
url = {https://doi.org/10.1002/alz.14613}
}
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