highly significantP <0.0001
In discrete time survival analyses, lower baseline UPSIT scores were associated with transition to AD (hazard ratio 1.099 per point interval; 95% CI: 1.067, 1.131; P <0.0001) and remained highly significant (hazard ratio 1.072 per point interval; 95% CI: 1.036, 1.109; P <0.0001) after including demographic, cognitive, and functional covariates. 41 The study by Devanand et al 41 confirmed that impairment in olfactory recognition in a population with normal cognitive function more accurately predicted decline of cognitive function than assessment of verbal episodic memory and supported the cross-cultural application of inexpensive olfactory recognition tests as bio-markers for predicting decline in cognitive function and early stage AD.