A dollop of peanut butter and a ruler can be used to confirm a
diagnosis of early stage Alzheimer's disease, University of Florida
Health researchers have found.
Jennifer Stamps, a graduate student in the University of Florida (UF)
McKnight Brain Institute Center for Smell and Taste, and her colleagues
reported the findings of a small pilot study in the
Journal of the Neurological Sciences.
Stamps came up with the idea of using peanut butter to test for smell
sensitivity while she was working with Dr. Kenneth Heilman, one of the
world's best known behavioral neurologists, from the UF College of
Medicine's department of neurology.
While shadowing doctors in Heilman's clinic, she noticed that patients
were not tested for their sense of smell. The ability to smell is
associated with the first cranial nerve and is often one of the first
things to be affected in cognitive decline.
"Dr. Heilman said, 'If you can come up with something quick and inexpensive, we can do it,'" Stamps says.
She thought of peanut butter because, she said, it is a "pure odorant"
that is only detected by the olfactory nerve and is easy to access.
Widespread problem
According to the Alzheimer's Association, Alzheimer's disease affects 5.2 million people in the US and will cost the nation $203 billion in this year alone.
The Association estimates that one American develops Alzheimer's
every 68 seconds, and they expect to see this figure rise to one
American every 33 seconds by 2050.
In the study, patients who were coming to the clinic for testing also
sat down with a clinician, who was armed with 14 grams of peanut butter -
which equals about 1 tablespoon - and a metric ruler. The patient
closed his or her eyes and mouth and blocked one nostril.
The clinician opened the peanut butter container and held the ruler next
to the open nostril while the patient breathed normally. By moving the
peanut butter up the ruler 1 cm at a time during the patient's
exhalation, they were able to measure the distance at which the patient
could detect the odor.
The distance was recorded and the procedure repeated on the other nostril after a 90-second delay.
The clinicians running the test did not know the patients' diagnoses,
which were not usually confirmed until weeks after the initial clinical
testing.
Sense of smell loss
The scientists found that patients in the early stages of
Alzheimer's disease had a dramatic difference in detecting odor between
the left and right nostril - the left nostril was impaired and did not
detect the smell until it was an average of 10 cm closer to the nose
than the right nostril had made the detection in patients with
Alzheimer's disease.
This was not the case in patients with other kinds of dementia; instead,
these patients had either no differences in odor detection between
nostrils or the right nostril was worse at detecting odor than the left
one.
Of the 24 patients tested who had mild cognitive impairment, which
sometimes signals Alzheimer's disease and sometimes turns out to be
something else, about 10 patients showed a left nostril impairment and
14 patients did not.
The researchers said more studies must be conducted to fully understand the implications.
Stamps explains:
"At the moment, we can use this test to confirm diagnosis. But we plan
to study patients with mild cognitive impairment to see if this test
might be used to predict which patients are going to get Alzheimer's
disease."
Stamps and Dr. Heilman point out that this test could be used by clinics
that do not have access to the personnel or equipment to run other,
more elaborate tests required for a specific diagnosis, which can lead
to targeted treatment.
At UF Health, the peanut butter test will be one more tool to add to a
full suite of clinical tests for neurological function in patients with
memory disorders.
Non-invasive, early stage test
One of the first places in the brain to degenerate in people with
Alzheimer's disease is the front part of the temporal lobe that evolved
from the smell system, and this portion of the brain is involved in
forming new memories.
"We see people with all kinds of memory disorders," Heilman said. Many
tests to confirm a diagnosis of Alzheimer's disease or other dementias can be time-consuming, costly or invasive. "This can become an important part of the evaluation process."
The UF study could help by detecting a person's likelihood of
developing the disease at a much earlier stage, with a non-invasive
test.
The Alzheimer's Association acknowledge that at the moment, there is no
cure for the disease, nor can current Alzheimer's treatments stop
Alzheimer's from progressing. They can, however, temporarily slow the
worsening of dementia symptoms. This improves the quality of life for
both sufferers and their caregivers.
As Stamps says:
"If we can catch it at that early stage, we can start treatment more
aggressively at the early stage and you can possibly prevent a lot of
the progression."
including taking regular exercise and eating a balanced diet, could reduce your risk of developing Alzheimer's.
