Objective: To establish whether patients with PD who have mild/moderate microsmia, severe microsmia or anosmia (as measured by the University of Pennsylvania Smell Identification Test (UPSIT)), are clinically different when comparing their natural history of PD in terms of the non-motor domains and whether PD patients recognise their sense of smell loss.

Background: Non-motor symptoms (NMS) in Parkinson’s disease (PD) are important to investigate, not only because they increase the cost of care, but also because they substantially affect patients and carers quality of life. One non-motor symptom that appears to be significantly affected in PD is the sense of smell in comparison to the general population.

Methods: This is an open cross-sectional study involving 112 PD patients (of both genders).  Non-motor symptoms were assessed using the Non-Motor Symptoms Questionnaire (NMSQ). Self-reported sense of smell loss and whether it was mild, moderate or severe was documented on the screening questionnaire.

Results: A sense of urgency to pass urine (63%), getting up regularly at night to pass urine (61%) and constipation (54%) are the most prevalent top three non-motor symptoms experienced by PD patients in this study .Interestingly. the loss or change in ability to smell was only reported by 33% of the study group, despite on formal testing, none of the PD patients had a normal sense of smell.  When comparing the sense of smell to the individual non-motor symptoms the only symptom to reach statistical significance is dribbling of saliva during the day (p=0.003) However, through a multiple regression test unexplained pains (p=0.006) and falling (p=0.030) were predicted as being statistically significant

Conclusions: The findings of this study conclude that other non-motor symptoms may be linked to the degree of smell loss It also confirms PD patient sense of smell needs to be formally tested.  Therefore, determining a PD patient sense of smell with a simple bed side test at the outset may help to provide important information as to the range of clinical features that are likely to be encountered in this patient. It may also help to provide very important prognostic information in this person; this can only help in our understanding of PD.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/non-motor-symptoms-in-a-cross-section-of-pd-patients-with-varying-degrees-of-smell-loss/