This study aimed to investigate the causes of olfactory dysfunction (OD) and to discuss the benefits of understanding the characteristics of OD in elderly patients.
A total of 4300 patients with OD who were treated at our hospital between January 1996 and December 2020 were retrospectively analyzed. There were 1833 men and 2467 women, with ages ranging from 4 to 95 years. The patients were divided into two groups: younger (less than 65 years old, n = 2947) and elderly (65 years old or more, n = 1353) groups. Causative diseases were chronic rhinosinusitis (CRS), post-viral (PV), post-traumatic (PT), central nervous system dysfunction (CNS), peripheral nervous system dysfunction (PNS), congenital, psychogenic, and unknown. Visual analogue scale (VAS) and olfactory detection and recognition thresholds using the T&T olfaction test were used to evaluate olfaction. The mean detection and recognition thresholds, as well as the deviation difference (the difference between the mean detection and recognition thresholds) were compared by causative disease.
The causative diseases in elderly group were CRS (32%), PV (28%), PT (3%), CNS (2%), and PNS (4%). OD of unknown cause was significantly more in elderly (30%) than in younger patients (12%). Olfactory detection and recognition thresholds in elderly group were significantly worse than in younger group (p < 0.05). The olfactory detection and recognition thresholds were not any significant differences between patients with OD of unknown cause and those with CNS.
OD of unknown cause was predominantly observed in elderly group. The olfactory acuity of OD of unknown cause was similar to CNS OD. These findings suggest the importance of continuous follow-up due to the potential of neurodegenerative diseases in elderly OD patients.
To read this article in full you will need to make a payment
Purchase one-time access:Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
One-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:Subscribe to Auris Nasus Larynx
Already a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
- Olfactory disorders and quality of life – an updated review.Chem Senses. 2014; 39: 185-194
- The prevalence of olfactory and gustatory dysfunction in COVID-19 patients: A systematic review and meta-analysis.Otolaryngol Head Neck Surg. 2020; 163: 3-11
- Clinical practice guidelines for the management of olfactory dysfunction - secondary publication.Auris Nasus Larynx. 2019; 46: 653-662
- Position paper on olfactory dysfunction.Rhinol Suppl. 2017; 54: 1-30
- Age-related changes in the prevalence of smell/taste problems among the United States adult population. Results of the 1994 disability supplement to the National Health Interview Survey (NHIS).Ann N Y Acad Sci. 1998; 855: 716-722
- Olfactory impairment in an adult population: the Beaver Dam offspring Study.Chem Senses. 2012; 37: 325-334
- Furthering the understanding of olfaction, prevalence of loss of smell and risk factors: a population-based survey (OLFACAT study).BMJ Open. 2012; 2e001256
- Prevalence of olfactory dysfunction: the Skovde population-based study.Laryngoscope. 2004; 114: 733-737
- Prevalence of subjective olfactory dysfunction and its risk factors: korean national health and nutrition examination survey.PLoS One. 2013; 8: e62725
- Smell identification ability: changes with age.Science. 1984; 226: 1441-1443
- Development of a smell identification test using a novel stick-type odor presentation kit.Chem Senses. 2006; 31: 379-391
- European position paper on rhinosinusitis and nasal polyps 2020.Rhinology. 2020; 58 (Suppl S29): 1-464
- Impact of olfactory impairment on quality of life and disability.Arch Otolaryngol Head Neck Surg. 2001; 127: 497-503
- MR evaluation of patients with congenital hyposmia or anosmia.AJR Am J Roentgenol. 1996; 166: 439-443
- Quantitative magnetic resonance imaging evaluation of the olfactory system in Kallmann syndrome : correlation with a clinical smell test.Neuroendocrinology. 2011; 94: 209-217
- Anatomic olfactory structural abnormalities in congenital smell loss : magnetic resonance imaging evaluation of olfactory bulb, groove, sulcal, and hippocampal morphology.J Comput Assist Tomogr. 2013; 37 (650-7)
- Clinical availability of a self-administered odor questionnaire for patients with olfactory disorders.Auris Nasus Larynx. 2011; 38: 65-72
- Olfactory dysfunction in patients with head trauma.Auris Nasus Larynx. 2002; 29: 35-40
- Olfactory changes after endoscopic sinus surgery in patients with chronic rhinosinusitis.Auris Nasus Larynx. 2013; 40: 452-457
- Characteristics of olfactory disorders in relation to major causes of olfactory loss.Arch Otolaryngol Head Neck Surg. 2002; 128: 635-641
- MDS research criteria for prodromal Parkinson's disease.Mov Disord. 2015; 30: 1600-1611
- Effect of aromatherapy on patients with Alzheimer's disease.Psychogeriatrics. 2009; 9: 173-179
- The diagnosis of dementia due to Alzheimer's disease; recommendations from the National Institute on Aging-Alzheimer's association workgroups on diagnostic guidelines for Alzheimer's disease. Alzheimer's.Dement. 2011; 7: 263-269
- Validation of olfactory deficit as a biomarker of Alzheimer disease.Neurol Clin Pract. 2017; 7: 5-14
- Pattern of smell identification function as a severity and progression marker in Alzheimer's Disease.Int Psychogeriatr. 2013; 25: 1157-1166
- The human olfactory system in two proteinopathies: Alzheimer's and Parkinson's diseases.Transl Neurodegener. 2020; 9: 22
- Olfaction deterioration in cognitive disorders in the elderly.Aging Clin Exp Res. 2016; 28: 37-45
- Association of olfactory impairment with indexes of sarcopenia and frailty in community-dwelling older adults.Geriatr Gerontol Int. 2019; 19: 384-391
- Olfactory identification and cognitive performance in community-dwelling older adults with mild cognitive impairment.Chem Sense. 2014; 39: 39-46
- Development of the University of Pennsylvania smell identification test; A standardized microencapsulated test of olfactory function.Physiol Behav. 1984; 32: 489-502
- Olfactory dysfunction predicts 5-year mortality in older adults.PLoS One. 2014; 9e107541
Published online: June 18, 2022
Accepted: June 6, 2022
Received: November 17, 2021
© 2022 Japanese Society of Otorhinolaryngology-Head and Neck Surgery, Inc. Published by Elsevier B.V. All rights reserved.