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Olfactory impairment is associated with functional disability and reduced independence among older adults

      Abstract

      Objectives

      Despite its relatively high prevalence, population-based data are lacking on whether olfactory impairment influences the functional status and independence of older adults. We assessed associations between olfactory impairment with activities of daily living (ADL) measures and the likelihood of using community support services and/or reliance on non-spouse family/friend support among older adults.

      Study design

      Olfaction was measured using the San Diego Odor Identification Test (SDOIT) among 1636 participants of the Blue Mountains Eye Study (2002–4). Functional status was determined by the Older Americans Resources and Services ADL scale. Use of services and non-spouse family/friend support was self-reported.

      Results

      Use of community support services was reported by 15.2% and 5.2% of persons with and without olfactory impairment, respectively. After multivariable adjustment including for cognitive function, participants with compared to those without olfactory impairment were more likely to use community support services and non-spouse family/friend support, odds ratio, OR, 1.82 (95% confidence intervals, CI 1.16–2.86) and OR 1.62 (95% CI 1.14–2.32), respectively. ADL difficulty was reported by 16.9% (n = 57) and 4.4% (n = 45) of participants with and without olfactory loss, respectively. Olfactory impairment was associated with increased likelihood of experiencing ADL difficulty, multivariable-adjusted OR 1.98 (95% CI 1.10–3.57). Olfactory loss was significantly associated with impaired basic ADL, OR 1.57 (95% CI 1.12–2.20).

      Conclusions

      The functional ability and independence of older adults is significantly impaired in the presence of olfactory impairment. Early diagnosis of olfactory loss by primary physicians and geriatricians could facilitate timely interventions assisting the maintenance of functional independence in later life.

      Keywords

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      References

        • Doty R.L.
        The olfactory system and its disorders.
        Semin Neurol. 2009; 29: 74-81
        • Murphy C.
        • Schubert C.R.
        • Cruickshanks K.J.
        • Klein B.E.
        • Klein R.
        • Nondahl D.M.
        Prevalence of olfactory impairment in older adults.
        JAMA. 2002; 288: 2307-2312
        • Kalmey J.K.
        • Thewissen J.G.
        • Dluzen D.E.
        Age-related size reduction of foramina in the cribriform plate.
        Anat Rec. 1998; 251: 326-329
        • Doty R.L.
        • Shaman P.
        • Applebaum S.L.
        • Giberson R.
        • Siksorski L.
        • Rosenberg L.
        Smell identification ability: changes with age.
        Science. 1984; 226: 1441-1443
        • Karpa M.J.
        • Gopinath B.
        • Rochtchina E.
        • et al.
        Prevalence and neurodegenerative or other associations with olfactory impairment in an older community.
        J Aging Health. 2010; 22: 154-168
        • Seo H.S.
        • Jeon K.J.
        • Hummel T.
        • Min B.C.
        Influences of olfactory impairment on depression, cognitive performance, and quality of life in Korean elderly.
        Eur Arch Otorhinolaryngol. 2009; 266: 1739-1745
        • Boyce J.M.
        • Shone G.R.
        Effects of ageing on smell and taste.
        Postgrad Med J. 2006; 82: 239-241
        • Miwa T.
        • Furukawa M.
        • Tsukatani T.
        • Costanzo R.M.
        • DiNardo L.J.
        • Reiter E.R.
        Impact of olfactory impairment on quality of life and disability.
        Arch Otolaryngol Head Neck Surg. 2001; 127: 497-503
        • Smeets M.A.
        • Veldhuizen M.G.
        • Galle S.
        • et al.
        Sense of smell disorder and health-related quality of life.
        Rehabil Psychol. 2009; 54: 404-412
        • Gopinath B.
        • Anstey K.J.
        • Sue C.M.
        • Kifley A.
        • Mitchell P.
        Olfactory impairment in older adults is associated with depressive symptoms and poorer quality of life scores.
        Am J Geriatr Psychiatry. 2011; 19: 830-834
        • Pollatos O.
        • Albrecht J.
        • Kopietz R.
        • et al.
        Reduced olfactory sensitivity in subjects with depressive symptoms.
        J Affect Disord. 2007; 102: 101-108
        • Nordin S.
        • Monsch A.U.
        • Murphy C.
        Unawareness of smell loss in normal aging and Alzheimer's disease: discrepancy between self-reported and diagnosed smell sensitivity.
        J Gerontol B Psychol Sci Soc Sci. 1995; 50: 187-192
        • Ross G.W.
        • Petrovitch H.
        • Abbott R.D.
        • et al.
        Association of olfactory dysfunction with risk for future Parkinson's disease.
        Ann Neurol. 2008; 63: 167-173
        • McCusker J.
        • Bellavance F.
        • Cardin S.
        • Belzile E.
        Validity of an activities of daily living questionnaire among older patients in the emergency department.
        J Clin Epidemiol. 1999; 52: 1023-1030
        • Kemper P.
        The use of formal and informal home care by the disabled elderly.
        Health Serv Res. 1992; 27: 421-451
        • Attebo K.
        • Mitchell P.
        • Smith W.
        Visual acuity and the causes of visual loss in Australia. The Blue Mountains Eye Study.
        Ophthalmology. 1996; 103: 357-364
        • Folstein M.F.
        • Folstein S.E.
        • McHugh P.R.
        “Mini-Mental State”: a practical method for grading the cognitive state of patients for the clinician.
        J Psychiat Res. 1975; 12: 189-198
        • Andresen E.M.
        • Malmgren J.A.
        • Carter W.B.
        • Patrick D.L.
        Screening for depression in well older adults: evaluation of a short form of the CES-D (Center for Epidemiologic Studies Depression Scale).
        Am J Prev Med. 1994; 10: 77-84
        • Irwin M.
        • Artin K.H.
        • Oxman M.N.
        Screening for depression in the older adult: criterion validity of the 10-item Center for Epidemiological Studies Depression Scale (CES-D) [see comments].
        Arch Intern Med. 1999; 159: 1701-1704
        • Morgan C.D.
        • Nordin S.
        • Murphy C.
        Odor identification as an early marker for Alzheimer's disease: impact of lexical functioning and detection sensitivity.
        J Clin Exp Neuropsychol. 1995; 17: 793-803
        • Doty R.L.
        Office procedures for quantitative assessment of olfactory function.
        Am J Rhinol. 2007; 21: 460-473
        • Ekman G.
        • Berglund B.
        • Berglund U.
        • Lindvall T.
        Perceived intensity of odor as a function of time of adaptation.
        Scand J Psychol. 1967; 8: 177-186
      1. Duke University Centre for the Study of Aging and Human Development. OARS Multidimensional Functional Assessment Questionnaire. 1975. 1988.

        • Bourdel-Marchasson I.
        • Joseph P.A.
        • Dehail P.
        • et al.
        Functional and metabolic early changes in calf muscle occurring during nutritional repletion in malnourished elderly patients.
        Am J Clin Nutr. 2001; 73: 832-838
        • Odlund O.A.
        • Koochek A.
        • Ljungqvist O.
        • Cederholm T.
        Nutritional status, well-being and functional ability in frail elderly service flat residents.
        Eur J Clin Nutr. 2005; 59: 263-270
        • Potter J.M.
        • Roberts M.A.
        • McColl J.H.
        • Reilly J.J.
        Protein energy supplements in unwell elderly patients – a randomized controlled trial.
        J Parenter Enteral Nutr. 2001; 25: 323-329
        • Christen-Zaech S.
        • Kraftsik R.
        • Pillevuit O.
        • et al.
        Early olfactory involvement in Alzheimer's disease.
        Can J Neurol Sci. 2003; 30: 20-25
        • Boyle P.A.
        • Buchman A.S.
        • Wilson R.S.
        • Leurgans S.E.
        • Bennett D.A.
        Physical frailty is associated with incident mild cognitive impairment in community-based older persons.
        J Am Geriatr Soc. 2010; 58: 248-255
        • Bennett D.A.
        • Schneider J.A.
        • Arvanitakis Z.
        • et al.
        Neuropathology of older persons without cognitive impairment from two community-based studies.
        Neurology. 2006; 66: 1837-1844
        • Buchman A.S.
        • Wilson R.S.
        • Boyle P.A.
        • Tang Y.
        • Fleischman D.A.
        • Bennett D.A.
        Physical activity and leg strength predict decline in mobility performance in older persons.
        J Am Geriatr Soc. 2007; 55: 1618-1623
        • Fried L.P.
        • Tangen C.M.
        • Walston J.
        • et al.
        Frailty in older adults: evidence for a phenotype.
        J Gerontol A Biol Sci Med Sci. 2001; 56: M146-M156
        • Mawby L.
        • Clark M.S.
        • Kalucy E.
        • Hobbin E.R.
        • Andrews G.R.
        Determinants of formal service use in an aged population.
        Aust J Ageing. 1998; 15: 177-181
        • Drageset J.
        • Eide G.E.
        • Ranhoff A.H.
        Depression is associated with poor functioning in activities of daily living among nursing home residents without cognitive impairment.
        J Clin Nurs. 2011;
        • Schubert C.R.
        • Cruickshanks K.J.
        • Fischer M.E.
        • et al.
        Olfactory impairment in an adult population: The Beaver Dam Offspring Study.
        Chem Senses. 2011;
        • Bohnen N.I.
        • Muller M.L.
        • Kotagal V.
        • et al.
        Olfactory dysfunction, central cholinergic integrity and cognitive impairment in Parkinson's disease.
        Brain. 2010; 133: 1747-1754