Percentile Scores for the Revised University of Pennsylvania Smell Identification Test for 16,972 Individuals 60 years of Age and Older

Background and Objectives The University of Pennsylvania Smell Identification Test (UPSIT) is a widely employed objective measure of smell function. A revised version of this test, termed the UPSIT-R, was developed in 2020 to update certain odorants and response options. The goal of this study was to establish normative age- and sex-specific data for the UPSIT-R in a large adult cohort and to compare the resultant percentiles to those of the original UPSIT. A second study was performed to compare the relative performance of these two tests in a small cohort of persons with and without Parkinson’s disease (PD). Methods UPSIT-R percentiles were derived separately by age (60-64, 65-69, 70-74, 75-59, and ≥80 years) and sex (male, female) categories in 16,972 volunteers who were predominantly white and non-Hispanic. Percentiles were derived statistically using an empirical distribution averaging procedure. A Bland-Altman plot was employed to visualize the level of agreement between percentiles for the UPSIT-R and UPSIT. For the second study, non-parametric statistics were employed to compare the results of those with and without PD. Results UPSIT-R performance declined with increasing age; deficits were more pronounced in men than in women. The magnitude of the difference between the original and revised test percentile scores differed by age and sex; women had up to a 3-point improvement with the UPSIT-R whereas the oldest male age had up to a 3-point decline in percentile scores. Olfactory deficits in PD were confirmed on the UPSIT-R. Discussion This study provides normative data clinically useful for assessing the relative degree of dysfunction in persons 60 years of age and older using the UPSIT-R. Like the traditional version of the UPSIT, this version demonstrates that smell function declines with age and is generally better in women than in men, providing a solid clinical basis for physicians to accurately determine the degree of smell dysfunction in their patients. Trial Registration Information ClinicalTrials.gov NCT05065060