Objective: To investigate whether odor detection sensitivity for pyrid
ine, suggested by previous research not to be affected, is impaired in
Alzheimer disease (AD) and whether an association exists between odor
threshold and both degree of dementia and rate of dementia progressio
n in AD. Method: The method of constant stimuli was used to determine
odor thresholds for pyridine in 18 patients with AD (Diagnostic and St
atistical Manual of Mental Disorders, Third Edition, Revised and Natio
nal Institute of Neurological and Communicative Disorders and Stroke A
lzheimer's Disease and Related Disorders Association criteria) and 16
healthy elderly control subjects. All participants were carefully exam
ined with medical and neuropsychological tests. Results: Six patients
with AD but none of the controls were anosmic (total olfactory loss) t
o pyridine, and the 12 nonanosmic patients had significantly higher de
tection thresholds (50% probability for detection, 323 parts per billi
on [ppb]) than did the controls (50% probability for detection, 105 pp
b). In addition, an association was found between odor threshold and b
oth degree of dementia and rate of dementia progression in AD. Conclus
ions: In contrast to previous findings, our results provide evidence t
hat odor sensitivity in AD is impaired for pyridine. Odor sensitivity,
in addition to other suggested predictors of progression rate, may be
of interest for defining subgroups of AD or for clinical prognostic j
udgments of single patients.