Cross-cultural modification of the University of Pennsylvania smell identification test for the Saudi Arabian population: Validation and normative values

Saad Alsaleh; Ahmed Alhussien; Nawaf Alsubaie; Ziyad Alajlan; Sakhar Albader; Ibrahim Alarifi; Hussain Albaharna; Ibrahim Sumaily

doi:10.15537/smj.2024.45.1.20230422

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Figure 1
- The Saudi Arabian University of Pennsylvania smell identification test consists of 4 envelopes and a total of 40 odors.
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Figure 2
- Scattered plot showing the average Saudi Arabian University of Pennsylvania smell identification test (SA-UPSIT) score in female and male participants in different age groups. The linear pattern shows a decrease in the score with age advancement.
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Figure 3
- Box plot comparing the identification rate for each odor between the second and fourth versions of Saudi Arabian University of Pennsylvania smell identification test (SA-UPSIT) with a comparison to the previously proposed version by Albaharna et al.⁹

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Table 1

- Modifications carried out throughout versions of the Saudi Arabian University of Pennsylvania smell identification test.

SA-UPSIT	Modifications
Version 2	In question 16, the option (peach) was changed to fish
Version 3	- Odor 7 (coffee) was changed to walnut - In question 3, the option (strawberry) was changed to coffee - In number 39, the option (bubblegum) was changed to musk
Version 4	Odor 7 was changed back from walnut to coffee

SA-UPSIT: Saudi Arabian University of Pennsylvania smell identification test

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Table 2

- Comparison between the overall results and between the genders of the Saudi Arabian-University of Pennsylvania smell identification test throughout versions 1-4.

Variables	Albaharna et al⁹	SA-UPSIT V1	SA-UPSIT V2	SA-UPSIT V3	SA-UPSIT V4
Sample size	80	30	110	27	111
Total score	28.42±4.4	34.7±2.5	32.4±3.4	34.8±2.7	34.5±2.5
Female score	29.5±4.2 (n=38)	35.19±2.5 (n=16)	32.9±3.7 (n=55)	35.2±2.5 (n=14)	35±2.3 (n=58)
Male score	27.3±4.3 (n=42)	34.4±2.5 (n=14)	31.9±3.4 (n=55)	34.4±3.9 (n=13)	34.1±2.6 (n=53)

Values are presented as mean ± standard deviation (SD). SA-UPSIT: Saudi Arabian University of Pennsylvania smell identification test

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Table 3

- Percentage of correct answers for Saudi Arabian-University of Pennsylvania smell identification test between versions 1-4.

Odor number	Odors	SA-UPSIT V1 (n=30)	SA-UPSIT V2 (n=110)	SA-UPSIT V3 (n=27)	SA-UPSIT V4 (n=111)
1	Cinnamon	100	94.1	96.0	99.1
2	Rubber tire	90.0	94.1	100	100
3	Pineapple	80.0	34.9^{^†}	92.0	93.7
4	Banana	90.0	80.2	96.0	90.1
5	Leather	90.0	77.9	100	90.1
6	Bubblegum	76.6	80.2	60.0	85.6
7	Coffee-walnut	60.0 (coffee)	45.3 (coffee)	11.5 (walnut	21.4 (coffee)
8	Grass	83.3	74.4	80.0	93.7
9	Onion	100	94.2	100	97.3
10	Smoke	66.7	60.5	80.0	77.5
11	Natural gas	100	97.7	100	99.1
12	Baby powder	96.7	95.3	96.0	93.7
13	Soap	96.7	97.6	100	98.2
14	Garlic	93.3	94.2	100	94.6
15	Rose	100	72.1	95.8	91.0
16	Fruit punch	56.7^{^†}	60.5	79.2	83.8
17	Peppermint	93.3	95.4	96.3	99.1
18	Peanut	93.3	94.2	87.5	94.6
19	Grape	93.3	82.6	100	93.7
20	Clove	96.7	88.3	88.9	99.1
21	Watermelon	96.7	95.3	100	97.2
22	Cheddar cheese	93.3	81.0	87.5	90.9
23	Jasmine	100	96.5	100	93.7
24	Dill pickle	96.7	83.7	91.7	95.5
25	Peach	90.0	86.0	96.3	91.0
26	Coconut	93.3	84.4	91.7	71.2
27	Apple	76.7	56.9	70.8	86.5
28	Chocolate	90.0	87.2	87.5	95.5
29	Motor oil	63.3	54.7	75.0	75.7
30	Gasoline	93.3	69.7	91.7	76.6
31	Strawberry	73.3	77.9	87.5	85.6
32	Orange	100	76.7	70.8	55.9
33	Cumin	96.7	63.9	70.8	73.9
34	Menthol	100	90.7	100	89.9
35	Lilac	93.3	80.2	100	97.3
36	Cherry	96.7	91.8	87.5	93.7
37	Popcorn	90.0	73.2	79.2	69.7
38	Gingerbread	80.0	68.6	83.3	75.7
39	Cardamom	36.7^{^‡}	32.6^{^†}	62.5	61.3
40	Fish	53.3	54.6	70.8	83.5