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Aging & Longevity

Older People Who Cannot Distinguish Smells Likely to Die Before Those Who Can

After first test, 39 percent who failed died within five years

male senior citizenOct. 1, 2014 – Here is a smell test senior citizens don’t want to fail. Those who did the worst in this study of older people trying to identify scents died off the fastest. The researchers now say it may predict which older people are most at risk of dying.

A large nationally representative sample of men and women ages 57 to 85 were part of the National Social Life, Health and Aging Project (NSHAP). The researchers first surveyed 3,000 participants in 2005-06, assessing their ability to identify five distinct common odors, one at a time, from a set of four choices. The five odors, in order of increasing difficulty, were peppermint, fish, orange, rose and leather.

In 2010-11 the research team checked to see which participants were still living. During that five-year gap, 430 (12.5%) of the original 3005 study subjects had died, while 2,565 were still alive.


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What caught their attention was that thirty-nine percent of the subjects who failed the smelling test in the first test had died before the second survey.

Their interest really peaked when they compared that death rate to the number of deaths in among those more successful in the test. They found that 19 percent of those with moderate smell loss had died and just 10 percent of those with a healthy sense of smell.

For those already at high risk, lacking a sense of smell more than doubled the probability of death, according to the report published today in the journal PLOS ONE by Jayant M. Pinto, MD, and colleagues from The University of Chicago.

When the researchers adjusted for demographic variables, such as age, gender, socioeconomic status (as measured by education or assets), overall health, and race, they concluded that those with greater smell loss when first tested were substantially more likely to have died five years later.

Precisely how smell loss contributes to mortality is unclear, but olfactory dysfunction was better at predicting mortality than a diagnosis of heart failure, cancer or lung disease. Only severe liver damage was a more powerful predictor of death.

"We think loss of the sense of smell is like the canary in the coal mine," said the study's lead author Pinto, who is associate professor of surgery at the University of Chicago.

"It doesn't directly cause death, but it's a harbinger, an early warning system, that something has already gone badly wrong, that damage has been done. Our findings could provide a useful clinical test, a quick and inexpensive way to identify patients most at risk."

Funding for the study was from The National Institutes of Health, including the National Institute on Aging, the Office of Women's Health Research, the Office of AIDS Research, and the Office of Behavioral and Social Sciences Research. Support was also provided by the National Institute on Aging, the McHugh Otolaryngology Research Fund, the American Geriatrics Society, The Center on the Demography and Economics of Aging, a Mellon Foundation Social Sciences Dissertation-Year Fellowship, and the Institute of Translational Medicine at The University of Chicago.).

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