Current work includes the development of a new approach in conducting sensory examinations via the Olfactory Response Baseline Identification Test (O.R.B.I.T). Based upon prior research (1), findings reveal olfactory testing to be an early detector of Alzheimer’s and Dementia (2), even aiding in differentiating the conditions based on identification distance per nostril. This sensory test device automates a crucial portion of the MCPT (Multisensory Cognition Proficiency Test). The O.R.B.I.T. will be the first of many mechanical designs supporting research in detecting and tracking sensory indicators of neurological performance and health throughout GAMMA treatment. Traditionally, when olfactory exams are conducted, they are performed manually, leading to a lack of consistent data across researchers and a higher error margin within same-patient testing.
TESTING BEFORE O.R.B.I.T
The ORBIT while still in prototype phases is set to become an intuitive, portable, automated testing system allowing a standardized protocol of olfactory testing. Factors such as the speed the olfactory stimulus approaches the nose, the angle it approaches, and the proximity measurement can vary when conducted manually skewing results. By implementing various sensors including a proximity sensor and accelerometer on a height adjustable, motorized unit, physicians will be able to ensure the same testing experience is replicated during patient visits and across larger patient pools. The implementation of this design could support the standardization of olfactory testing and more consistent data to inform the diagnostic process.
A three and a half year longitudinal olfactory study published in JAMA Neurology included the collective data of 1400 individuals. The average age group was 79. All participants were healthy and near cognitively normal exhibiting no measurable symptoms of memory dysfunction or deficit. All participants underwent smell tests with 12 items including food and non-food scents. Over the 3 1/2 years, 64 participants were diagnosed with early-stage dementia and 250 participants developed minor memory problems. Results revealed that as olfactory capabilities decreased, their likelihood of Alzheimer’s and memory loss increased. Researcher Rosebud Roberts stated that “the findings suggest that doing a smell test may help identify elderly, mentally normal people who are likely to progress to develop memory problems or, if they have these problems, to progress to Alzheimer’s or dementia” (Roberts, 2015).
In another study with over 90 participants conducted at the University of Florida, explored olfactory changes in Alzheimer’s using peanut butter as the olfactory stimulus. The study tested three subject groups. The only participants who struggled to smell the peanut butter were the participants with Alzheimer’s.
While both studies cited and others in this field are a promising a indicator for the implementation of olfactory testing, study photos (Fig. 2, 3) and testing documents reveal a need for standardization through sensors and atomization. It is the hope that the Olfactory Response Baseline Identification Test will support this.
1) Roberts RO, Christianson TJH, Kremers WK, et al. Association Between Olfactory Dysfunction and Amnestic Mild Cognitive Impairment and Alzheimer Disease Dementia. JAMA Neurol. 2016
2) Stamps, Jennifer J. et al. Journal of the Neurological Sciences, A brief olfactory test for Alzheimer's disease. 2013
O.R.B.I.T FUTURE STEPS
Throughout the prototyping process, the ORBIT will undergo critical user testing with strategic stakeholders including clinicians and patients to develop the most extensive, accurate and clinically relevant olfactory test available. Through data analysis, structural design changes will be implemented to include: further automation, increased tracking and broader proximity sensing in addition to accessible design and comfort-oriented modifications.
STANDARDISED MULTISENSORY TESTING
The ORBIT is just one of many automated testing apparatuses poised to undergo development in our lab. Sensory changes throughout pathologies, treatment spans and patient lifetimes, provide precise indicators of cognitive performance, degradation or restoration. Further devices will include a capacity for a wide array of testing including tactile and visual. These approaches are based on the MCPT (Multisensory Cognitive Proficiency Test) developed within the 2018 thesis: Gamma and the Senses.