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Murphy C, Schubert CR, Cruickshanks KJ, Klein BEK, Klein R, Nondahl DM. Prevalence of Olfactory Impairment in Older Adults. JAMA. 2002;288(18):2307–2312. doi:10.1001/jama.288.18.2307
Author Affiliations: San Diego State University and University of California, San Diego, School of Medicine (Dr Murphy); and the Departments of Ophthalmology and Visual Sciences (Ms Schubert, Drs Cruickshanks, B. Klein, and R. Klein, and Mr Nondahl) and Population Health Sciences (Dr Cruickshanks), University of Wisconsin, Madison.
Context Older adults represent the fastest-growing segment of the US population,
and prevalences of vision and hearing impairment have been extensively evaluated.
However, despite the importance of sense of smell for nutrition and safety,
the prevalence of olfactory impairment in older US adults has not been studied.
Objective To determine the prevalence of olfactory impairment in older adults.
Design, Setting, and Participants A total of 2491 Beaver Dam, Wis, residents aged 53 to 97 years participating
in the 5-year follow-up examination (1998-2000) for the Epidemiology of Hearing
Loss Study, a population-based, cross-sectional study.
Main Outcome Measures Olfactory impairment, assessed by the San Diego Odor Identification
Test and self-report.
Results The mean (SD) prevalence of impaired olfaction was 24.5% (1.7%). The
prevalence increased with age; 62.5% (95% confidence interval [CI], 57.4%-67.7%)
of 80- to 97-year-olds had olfactory impairment. Olfactory impairment was
more prevalent among men (adjusted prevalence ratio, 1.92; 95% CI, 1.65-2.19).
Current smoking, stroke, epilepsy, and nasal congestion or upper respiratory
tract infection were also associated with increased prevalence of olfactory
impairment. Self-reported olfactory impairment was low (9.5%) and this measure
became less accurate with age. In the oldest group, aged 80 to 97 years, sensitivity
of self-report was 12% for women and 18% for men.
Conclusions This study demonstrates that prevalence of olfactory impairment among
older adults is high and increases with age. Self-report significantly underestimated
prevalence rates obtained by olfaction testing. Physicians and caregivers
should be particularly alert to the potential for olfactory impairment in
the elderly population.
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