FREQUENCY OF OLFACTORY SYMPTOMS IN PATIENTS OF PARKINSON DISEASE PRESENTING TO PEMH

Abstract

Background: Olfactory impairment is one of the most prevalent and the initial non-motor indications of Parkinson's disease (PD), often occurring years before motor symptoms. Despite its clinical importance, it remains under-recognized in routine neurological practice in Pakistan.

Objective: The purpose of this study was to determine, frequency of olfactory dysfunction in Parkinson’s disease patients presenting to Pak Emirates Military Hospital (PEMH), Rawalpindi and assess their associations with disease duration/severity and impaired cognitive function.

Methods: This cross sectional study was carried out in the Dept. of Neurology, PEMH, over six months (March–September 2025). A total of 210 patients with clinically confirmed Parkinson's disease who met the UK Brain Bank criteria were enrolled through consecutive sampling. Culturally validated Pakistani Smell Identification Test (PKSIT) was assign to assess olfactory function, and self-reported symptoms were also recorded. The data were analyzed with SPSS version 26. Descriptive statistics and chi square tests were used to assess the relationship between olfactory dysfunction and demographic or clinical variables with a significance level of p < 0.05.

Results: Olfactory dysfunction was identified in 141 patients (67.1%), including hyposmia in 36.7% and anosmia in 30.5%. Subjective self-reporting identified only 45.2% of cases, with a sensitivity of 70.2% and specificity of 82.5% when compared with PKSIT results. Olfactory dysfunction was significantly associated with longer disease duration (>5 years: 80.0% vs. ≤5 years: 57.5%, p = 0.01) and advanced Hoehn and Yahr stage (p = 0.03).

Conclusion: Olfactory dysfunction is common among Parkinson's disease patients in Pakistan, and it gets worse with disease duration and severity. Objective smell testing outperforms subjective reporting and should be considered as part of routine assessment in PD clinics for early detection and patient counseling.