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Background: Frailty is a syndrome characterized by reduced physiologic reserve and increased vulnerability to poor health outcomes. Disruption of sensorineural function appears to serve as a novel biomarker of frailty. Using population‐level data, we sought to characterize the association between otolaryngic sensory dysfunction and frailty. Methods: A cross‐sectional analysis of the 2011‐2012 US National Health and Nutrition Examination Survey was performed on adults ≥40 years of age (n = 2138). Participants were grouped by subjective gustatory dysfunction (sGD), olfactory dysfunction (sOD), hearing loss (sHL), and measured hearing loss (mHL) with pure tone averages (PTAs). Frailty was operationalized using a continuous 36‐item frailty index (FI) scored from 0 to 1, stratified in 4 categories ("non‐frail," "vulnerable," "frail," or "most frail"). Results: All sensory loss groups had significantly higher FI scores than those without sensory loss (sGD = 0.15; sOD = 0.14; sHL = 0.15; low‐frequency mHL = 0.16; high‐frequency mHL = 0.14 vs control = 0.11; p < 0.007 for all). "Vulnerable" individuals had increased odds of sOD (adjusted odds ratio [aOR], 1.45; 95% confidence interval [CI], 1.05‐2.00), whereas "frail" individuals had increased odds of sOD (aOR, 1.85; 95% CI, 1.26‐2.71) and low‐frequency mHL (aOR, 4.01; 95% CI, 1.27‐12.63). The "most frail" individuals had increased odds of sHL (aOR, 11.72; 95% CI, 2.88‐47.66) and high‐frequency mHL (aOR 5.10; 95% CI, 1.72‐15.12). PTAs were linearly associated with FI (low: β = 10.15; 95% CI, 1.78‐18.51; high: β = 19.85; 95% CI, 5.19‐34.53). Conclusion: Otolaryngic sensory loss is associated with increased frailty. Independent association of frailty with measures of olfaction and hearing suggests that olfactory and hearing assessments may help identify at‐risk individuals with modifiable risk factors. [ABSTRACT FROM AUTHOR]

Objectives: The underlying mechanism of the association between olfactory impairment and dementia may be explained by neurodegenerative changes detected on magnetic resonance imaging (MRI). The purpose of this systematic review is to describe neurodegenerative changes on MRI in patients with olfactory impairment and mild cognitive impairment (MCI) or dementia. Study design: Systematic review. Methods: A literature search encompassing PubMed, Embase, Cochrane Library, Web of Science, Scopus, and Google Scholar for studies with MRI and olfactory testing among participants diagnosed with MCI or dementia was performed. Sample size, study design, cognitive impairment type, olfactory testing, and MRI findings were abstracted. Two investigators independently reviewed all articles. Results: The search yielded 556 nonduplicate abstracts, from which 86 articles were reviewed and 24 were included. Seventeen (71%) of 24 studies reported hippocampal volume findings, with 14 studies reporting a relationship between hippocampal volume and olfactory performance. Two (50%) of four prospective studies reported the potential utility of baseline hippocampal volume as a marker of dementia conversion from MCI. Five (21%) of 24 studies reporting olfactory functional MRI (fMRI) findings highlighted the utility of olfactory fMRI to identify individuals in the early stages of cognitive decline. Conclusion: Current evidence suggests hippocampal volume correlates with olfactory performance in individuals with cognitive impairment, and that olfactory fMRI may improve early detection of AD. However, the predictive utility of these imaging markers is limited in prospective studies. MRI may be a useful modality for selecting patients at high risk of future cognitive decline for enrollment in early treatment trials. Laryngoscope, 132:177–187, 2022 [ABSTRACT FROM AUTHOR]

Objectives: Sublingual immunotherapy (SLIT) has emerged as an effective treatment alternative to subcutaneous immunotherapy (SCIT) given its improved safety profile and more convenient dosing. However, SLIT still relies on daily dosing for many years to optimize effectiveness. This study sought to investigate factors that influence patient completion of SLIT. Methods: We performed an institutional retrospective review of patients who received SLIT (2008–2020). Completion was defined as completing at least 36 months of SLIT. Patient demographics and characteristics, including the number of allergens treated, history of asthma and sinus surgery, number of clinic visits, and total time undergoing SLIT, were documented. Multivariate models were used to analyze predictors of SLIT completion. Subgroup analysis was performed among pediatric patients and patients who discontinued SLIT. Results: Of the 404 total patients, 249 (61.6%) discontinued, 47 (11.6%) completed, and 108 (26.7%) were currently undergoing SLIT. The mean duration of therapy was 11.2 months for those who discontinued and 49.4 months for patients who completed SLIT. The odds of SLIT completion were twice as high with each additional clinic visit (P <.001), and twice as high when the dosage was increased during therapy (P =.06). Pediatric patients younger than age 12 with a history of asthma were over five times more likely to complete therapy (P =.045). Patients with more clinic visits (P <.001) and higher associated costs (P =.003) were less likely to be lost to follow‐up. Conclusion: Increasing the frequency of clinic visits, improving therapy availability, and mitigating concerns about clinical efficacy may increase patient completion of SLIT. Level of Evidence: 4 Laryngoscope, 131:E2111–E2115, 2021 [ABSTRACT FROM AUTHOR]