Why your nose sometimes knows when it comes to Alzheimer's
COLUMBIA, SC (WIS) - For Alzheimer's Awareness Month, we want to focus on your nose and the possibility of using a smell test to diagnose the disease.
This story may have you pulling out your jar of peanut butter and a ruler. Some medical experts speculate Alzheimer's disease may begin - in the nose. It's estimated 86,000 South Carolinians have Alzheimer's.
That is 11 percent of our state's seniors.
Dr. Donald Schmechel of Southeastern Neurology & Memory Clinic says while patients don't really come in complaining about not being able to smell, sometimes the nose does know.
"The validity is this: smell IS affected by Alzheimer's," Schmechel said.
One smell test done at the University of Florida was with peanut butter. Shut your eyes. Close off one nostril. Hold a ruler under the other nostril. At the end of that ruler, open a jar of peanut butter.
With each exhale, the peanut butter is moved by 1 centimeter until the odor is detected. People without Alzheimer's will smell the peanut butter much sooner than those with the disease. But be careful before you try to conduct your own test.
"The Germans and the Europeans have done this work for a long time. It is not easy to test smell. And to do it properly you need a whole gizmo where you isolate one nostril and only test the other," Schmechel said. "It's very easy to cross-contaminate. And I think in that particular review that you showed me another group tried to replicate the results and couldn't do it."
It is widely believed though that a change in smell is one of the first clinical signs of Alzheimer's - happening before there's noticeable cognitive decline. The nose is more fragile, so it is affected more by aging changes.
"You have all these little fibers there that detect all kinds of different odors," Schmechel said. "And they can regenerate, but then right after that is a pathway that goes up into the base of the brain. And the smell system is hooked up with emotions, it is hooked up with memory."
Despite the pathology of Alzheimer's appearing to start in the part of the brain that handles the smell, the data on a smell test for prediction and diagnosis is just too mixed.
"This research is interesting, but no one yet is going to use the smell test to test for Alzheimer's. What does your husband or wife say about what's up? How is your memory working? What's the brain scan like? And above all, are you now unable to do something you used to be able to do?"
Rather than focus on the possible loss of smell, doctors encourage patients to focus on the pillars of prevention - regular exercise, social engagement, a healthy diet, mental stimulation, quality sleep, and stress management.
According to the Alzheimer's Association, by the year 2025, the number of South Carolinians with Alzheimer's is projected to grow to 120,000 from the current 86,000.
Our state has the eighth highest Alzheimer's death rate in the United States. Remember - early detection and treatment are very key. So, if you have concerns about a family member, make that doctor appointment for your loved one.
Here are resources related to Alzheimer's disease:
- Alzheimer’s Association in South Carolina: https://www.alz.org/sc/in_my_community_105019.asp
- University of Florida smell test: https://www.youtube.com/watch?v=z1mcAAgrCnw
- Dr. Michael Greger’s peanut butter smell test: https://www.youtube.com/watch?v=gY0Sk_zgrMw
- Pillars of prevention: https://www.helpguide.org/articles/alzheimers-dementia-aging/preventing-alzheimers-disease.htm
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