Relationship Between Poor Olfaction and Mortality Among Community-Dwelling Older Adults

Liu, Bojing; Luo, Zhehui; Pinto, Jayant M.; Shiroma, Eric J.; Tranah, Gregory J.; Wirdefeldt, Karin; Fang, Fang; Harris, Tamara B.; Chen, Honglei

doi:10.7326/m18-0775

Cited by 91 publications

(121 citation statements)

References 55 publications

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“…Weight loss, as a surrogate marker for malnutrition, was also found to contribute to the association between OI and mortality (Liu et al, 2019). Indeed, their mediation analysis demonstrated that weight loss could account for, respectively, 6 and 11% of the 10-year and 13-year higher mortality linked to poor olfaction.…”

Section: Effects Of Olfactory Loss On Eating Behavior Danger Warningmentioning

confidence: 98%

“…In regard to age groups, results vary between studies. Some found a stronger OI-mortality link in older subjects, while others demonstrated a slightly stronger relationship in middleaged groups (Gopinath et al, 2012;Ekström et al, 2017;Liu et al, 2019). This latter finding may be due to the increased prevalence of anosmia with advancing age.…”

Section: Summary Of Existing Studies Linking Olfactory Impairment Andmentioning

confidence: 99%

“…Until now, seven longitudinal studies have been published on the relationship between olfactory function at baseline and risk of mortality (Wilson et al, 2011;Gopinath et al, 2012;Pinto et al, 2014;Devanand et al, 2015;Schubert et al, 2016;Ekström et al, 2017;Liu et al, 2019). Demographics and methods are summarized in Table 1.…”

Section: Summary Of Existing Studies Linking Olfactory Impairment Andmentioning

confidence: 99%

“…Unfortunately, while clearly revealing the existence of a link between OI and risk of mortality, these studies leave possible explanations of such a link quite unexplored. Indeed, causespecific mortality is only explored in one study (Liu et al, 2019) whereas others do not report cause of death. Yet, this parameter could have largely contributed to the understanding of the mechanisms of the OI-mortality relationship.…”

Section: Summary Of Existing Studies Linking Olfactory Impairment Andmentioning

confidence: 99%

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Mechanisms Linking Olfactory Impairment and Risk of Mortality

et al. 2020

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Olfaction is a sense involved in a complex set of tasks, influencing eating behavior, increasing awareness of environmental hazards and affecting social communication. Surprisingly, smell disorders are very frequent, especially in the elderly population. Several recent studies conducted mostly in older subjects have demonstrated a strong association between olfactory impairment and overall mortality risk, with anosmia being even more predictive of 5 years mortality risk than cardiovascular disease. Presently, the underlying pathophysiology linking olfactory impairment to mortality remains unknown and only putative mechanisms are suggested. This review aims to examine the link between olfactory impairment and mortality and to discuss existing ideas on underlying existing mechanisms including, (1) the effect of olfactory loss on nutrition, life-threatening situations and social interactions, (2) associated neurodegenerative diseases, (3) accelerated brain aging, and (4) reflection of general health status being reflected in olfactory function.

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Section: Effects Of Olfactory Loss On Eating Behavior Danger Warningmentioning

confidence: 98%

Section: Summary Of Existing Studies Linking Olfactory Impairment Andmentioning

confidence: 99%

Section: Summary Of Existing Studies Linking Olfactory Impairment Andmentioning

confidence: 99%

Section: Summary Of Existing Studies Linking Olfactory Impairment Andmentioning

confidence: 99%

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Mechanisms Linking Olfactory Impairment and Risk of Mortality

et al. 2020

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“…However, a number of high-profile studies have found an association between olfactory loss and increased 5-year mortality rates. [9][10][11] This association persists even after controlling for neurologic disease (known to impact olfaction) and weight loss (presumably from dietary modification). Whether olfactory loss truly contributes to increased mortality, or is simply an associated factor, is still unknown, but these studies suggest that loss of smell is important, nonetheless.…”

Section: Introductionmentioning

confidence: 99%

A primer on viral‐associated olfactory loss in the era of COVID‐19

Soler

Patel

Turner

et al. 2020

Int Forum Allergy Rhinol

126

168

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Early reports have suggested that smell loss may be an early symptom associated with the pandemic known as COVID-19. The possibility that severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) might cause olfactory dysfunction is certainly plausible. Patients presenting to specialized smell clinics are commonly diagnosed with upper This article is protected by copyright. All rights reserved. respiratory infection (URI)-associated olfactory loss and most are presumed to be viral related. In acute phases of infection, it is common to experience some smell loss as a result of nasal inflammation, mucosal edema, and obstruction of airflow into the olfactory cleft. In most cases, these episodes of smell loss are self-limiting and coincide with resolution of URI symptoms. However, in some cases the smell loss persists for months to years and this is presumed to occur through a more direct olfactory insult by the virus. It remains too early to know whether infection with SARS-CoV-2 causes persistent olfactory dysfunction. However, given the scale of this pandemic, if SARS-CoV-2 does cause chronic olfactory loss in even a small portion of those infected, then the overall population prevalence could be quite large. This review provides a brief, practical overview of viral-associated olfactory loss, realizing that evidence related to COVID-19 will likely not be clear for some time. Our goal is to highlight the existence and importance of this condition and provide information geared for both providers and patients. Practical suggestions regarding evaluation and treatment will be provided, realizing that there may be constraints on medical resources and the nature of this pandemic remains dynamic. A primer on viral-associated olfactory loss in the era of COVID-19

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Association Between Olfactory Dysfunction and Mortality in US Adults

Choi

Jang

Kim

et al. 2021

JAMA Otolaryngol Head Neck Surg

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oor olfactory function has been directly implicated in malnutrition, 1 decreased safety, 2 and overall worse quality of life. 3 It is responsible for more than 200 000 physician visits per year, representing a significant public health burden. 4,5 Emerging evidence suggests that olfactory dysfunction is significantly associated with increased all-cause mortality among older adults. 4,[6][7][8][9][10][11] Most notably, a recent study by Liu et al 12 examining community-dwelling older adults aged 71 to 82 years showed clear evidence that poor olfaction alone explains higher long-term mortality, particularly in individuals with excellent to good health at baseline. Liu et al 12 found the elevated risk of mortality of patients with poor olfaction was only partially explained by neurodegenerative dis-ease, cardiovascular disease, and weight loss. Olfaction is emerging as an early indicator of brain aging that can be objectively measured with a relatively simple smell test in the clinical setting.Choi et al 13 previously used the National Health and Nutrition Examination Survey (NHANES) to demonstrate that objectively measured olfactory dysfunction is associated with cognitive impairment independently of demographics and cardiovascular factors. Herein we further investigate the associations of olfactory dysfunction (measured by both objective smell test and self-report) with all-cause 5-year mortality in US adults 40 years or older, independently of cardiovascular factors, cognition, and depression. IMPORTANCE A study of olfactory dysfunction and mortality in a large national cohort will aid in better understanding their association when accounting for multiple relevant factors and possible underlying mechanisms. OBJECTIVE To investigate the association of olfactory dysfunction with all-cause 5-year mortality in US adults.

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Relationship Between Poor Olfaction and Mortality Among Community-Dwelling Older Adults

Cited by 91 publications

References 55 publications

Mechanisms Linking Olfactory Impairment and Risk of Mortality

Mechanisms Linking Olfactory Impairment and Risk of Mortality

A primer on viral‐associated olfactory loss in the era of COVID‐19

Association Between Olfactory Dysfunction and Mortality in US Adults

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