Olfactory Biopsies

Group 1: Alzheimer's study

Inclusion Criteria:

* Between the ages of 18 and 80
* Pre-clinical AD (this cohort consists of subjects who have normal cognitive testing and function, but have positive AD biomarkers);
* Symptomatic AD (a confirmed diagnosis of Alzheimer's or dementia who are capable of understanding and signing the consent document)

Exclusion Criteria:

* Advanced Alzheimer's/dementia
* Self-reported or known allergy to Afrin or Tetracain HCL (or related class of drugs)
* Active Rhinosinusitis symptoms
* Other known sinonasal disease history that would preclude biopsy (i.e prior sinus or skull base surgery directly impacting this anatomic region, sinonasal neoplasm in this anatomic region, olfactory cleft polyps)
* Parkinson's disease
* Unable or willing to complete the nasal endoscopy procedure.
* Unable to read or speak English
* Unable to provide legally effective consent

Group 2: Act-seq study or Non-AD controls

Inclusion Criteria:

* Age 18 years or older
* Patients being seen for rhinology or olfactory disorders
* Patients having unrelated endoscopic nasal surgery

Exclusion Criteria:

* Self-reported or known allergy to Afrin or Tetracain HCL (or related class of drugs)
* Unable or willing to complete the nasal endoscopy procedure
* Unable to read or speak English
* Unable to provide legally effective consent