Association of Frailty Status and Dietary Patterns in a Nationally Representative Sample of United States Adults with Olfactory Dysfunction

Abstract

Background: Olfactory dysfunction (OD) is a strong, independent predictor of frailty and mortality risk. This study evaluated the association of dietary patterns and frailty status in older adults with OD. Methods: This cross-sectional study utilized the 2013–2014 National Health and Nutrition Examination Survey. Dietary patterns (DPs) characteristic of OD were derived using exploratory factor analysis (EFA). Multiple logistic regressions adjusted for demographics and frailty risk factors assessed the association of DPs with two frailty metrics: the frailty index (FI) and physical frailty (PF). Results: EFA yielded six distinct DPs in persons with OD. The protein/selenium (OR 0.82 [95% CI 0.74–0.92], p = 0.041) and β-carotene/vitamin A DPs (OR 0.76 [95% CI 0.66–0.88], p = 0.028) were independently associated with frailty by FI. Only the protein/selenium DP (OR 0.82 [95% CI 0.74–0.92], p = 0.036) was associated with frailty by PF. No DPs were associated with either frailty measure in normosmic persons. Conclusions: Dietary patterns high in protein/selenium and β-carotene/vitamin A are associated with lower frailty prevalence in adults with OD. While the relationship between OD and frailty is likely multifaceted, these findings suggest that dietary patterns are uniquely associated with frailty in older adults with OD.

Exploring Olfactory Dysfunction as a Marker of Frailty and Postoperative Outcomes in Head and Neck Cancer

“…60,61 Disruptions in the ability to smell may represent a set of risks uniquely poised to worsen the outcomes of survivors of HNC, including dietary changes and weight loss in individuals who have inherently decreased oral intake secondary to their pathology, decreased social interactions, and an increased risk of depression and anxiety. 29,[62][63][64][65] Pre-existing depression and depression diagnosed after HNC diagnosis are associated with a greater hazard of both cancer-specific and allcause mortality. 66 Several robust prospective studies have demonstrated a link between mental disorders, including major depressive disorder, with increased risk of age-related medical illnesses, such as cardiovascular disease, type 2 diabetes, metabolic syndrome, and neurodegenerative diseases.…”

“…Disruptions in the ability to smell may represent a set of risks uniquely poised to worsen the outcomes of survivors of HNC, including dietary changes and weight loss in individuals who have inherently decreased oral intake secondary to their pathology, decreased social interactions, and an increased risk of depression and anxiety . Pre-existing depression and depression diagnosed after HNC diagnosis are associated with a greater hazard of both cancer-specific and all-cause mortality .…”

Reduction in olfactory dysfunction prevalence among patients with diabetes taking metformin

“…1 Though the exact mechanism for this relationship remains unclear, prior studies have linked OD with neurodegenerative diseases, poor nutrition, diminished danger warning, and frailty. 2,3 This suggests that OD may be reflective of pathophysiologic changes associated with overall reduced physiologic reserve. Importantly, therapeutic interventions for OD are limited, and the potential benefits of OD-targeted therapies are largely unknown.…”

“…Mounting evidence has demonstrated that olfactory dysfunction (OD) is predictive of overall mortality 1 . Though the exact mechanism for this relationship remains unclear, prior studies have linked OD with neurodegenerative diseases, poor nutrition, diminished danger warning, and frailty 2,3 . This suggests that OD may be reflective of pathophysiologic changes associated with overall reduced physiologic reserve.…”