Factors Associated With Phantom Odor Perception Among US Adults: Findings From the National Health and Nutrition Examination Survey | Traumatic Brain Injury | JAMA Otolaryngology–Head & Neck Surgery | JAMA Network
[Skip to Navigation]
Access to paid content on this site is currently suspended due to excessive activity being detected from your IP address 35.170.64.36. Please contact the publisher to request reinstatement.
1.
Rawal  S, Hoffman  HJ, Bainbridge  KE, Huedo-Medina  TB, Duffy  VB.  Prevalence and risk factors of self-reported smell and taste alterations: results from the 2011-2012 US National Health and Nutrition Examination Survey (NHANES).  Chem Senses. 2016;41(1):69-76. doi:10.1093/chemse/bjv057PubMedGoogle ScholarCrossref
2.
Sjölund  S, Larsson  M, Olofsson  JK, Seubert  J, Laukka  EJ.  Phantom smells: prevalence and correlates in a population-based sample of older adults.  Chem Senses. 2017;42(4):309-318. doi:10.1093/chemse/bjx006PubMedGoogle ScholarCrossref
3.
Philpott  CM, Boak  D.  The impact of olfactory disorders in the United Kingdom.  Chem Senses. 2014;39(8):711-718. doi:10.1093/chemse/bju043PubMedGoogle ScholarCrossref
4.
Croy  I, Yarina  S, Hummel  T.  Enhanced parosmia and phantosmia in patients with severe depression.  Psychol Med. 2013;43(11):2460-2464. doi:10.1017/S0033291713001773PubMedGoogle ScholarCrossref
5.
Jion  YI, Grosberg  BM, Evans  RW.  Phantosmia and migraine with and without headache.  Headache. 2016;56(9):1494-1502. doi:10.1111/head.12890PubMedGoogle ScholarCrossref
6.
Yang  JC, Khakoo  Y, Lightner  DD, Wolden  SL.  Phantosmia during radiation therapy: a report of 2 cases.  J Child Neurol. 2013;28(6):791-794. doi:10.1177/0883073812450616PubMedGoogle ScholarCrossref
7.
Nordin  S, Murphy  C, Davidson  TM, Quiñonez  C, Jalowayski  AA, Ellison  DW.  Prevalence and assessment of qualitative olfactory dysfunction in different age groups.  Laryngoscope. 1996;106(6):739-744. doi:10.1097/00005537-199606000-00014PubMedGoogle ScholarCrossref
8.
Mott  AE, Leopold  DA.  Disorders in taste and smell.  Med Clin North Am. 1991;75(6):1321-1353. doi:10.1016/S0025-7125(16)30391-1PubMedGoogle ScholarCrossref
9.
Leopold  D.  Distortion of olfactory perception: diagnosis and treatment.  Chem Senses. 2002;27(7):611-615. doi:10.1093/chemse/27.7.611PubMedGoogle ScholarCrossref
10.
Frasnelli  J, Landis  BN, Heilmann  S,  et al.  Clinical presentation of qualitative olfactory dysfunction.  Eur Arch Otorhinolaryngol. 2004;261(7):411-415. doi:10.1007/s00405-003-0703-yPubMedGoogle ScholarCrossref
11.
Lin  SH, Chu  ST, Yuan  BC, Shu  CH.  Survey of the frequency of olfactory dysfunction in Taiwan.  J Chin Med Assoc. 2009;72(2):68-71. doi:10.1016/S1726-4901(09)70025-5PubMedGoogle ScholarCrossref
12.
Landis  BN, Reden  J, Haehner  A.  Idiopathic phantosmia: outcome and clinical significance.  ORL J Otorhinolaryngol Relat Spec. 2010;72(5):252-255. doi:10.1159/000317024PubMedGoogle ScholarCrossref
13.
Leopold  DA, Hornung  DE.  Olfactory cocainization is not an effective long-term treatment for phantosmia.  Chem Senses. 2013;38(9):803-806. doi:10.1093/chemse/bjt047PubMedGoogle ScholarCrossref
14.
Hoffman  HJ, Rawal  S, Li  C-M, Duffy  VB.  New chemosensory component in the U.S. National Health and Nutrition Examination Survey (NHANES): first-year results for measured olfactory dysfunction.  Rev Endocr Metab Disord. 2016;17(2):221-240. doi:10.1007/s11154-016-9364-1PubMedGoogle ScholarCrossref
15.
Hosmer  DW, Lemeshow  S.  Applied Logistic Regression. New York, NY: John Wiley & Sons; 1989.
16.
Patel  RM, Pinto  JM.  Olfaction: anatomy, physiology, and disease.  Clin Anat. 2014;27(1):54-60. doi:10.1002/ca.22338PubMedGoogle ScholarCrossref
17.
Murphy  C, Schubert  CR, Cruickshanks  KJ, Klein  BE, Klein  R, Nondahl  DM.  Prevalence of olfactory impairment in older adults.  JAMA. 2002;288(18):2307-2312. doi:10.1001/jama.288.18.2307PubMedGoogle ScholarCrossref
18.
Dong  J, Pinto  JM, Guo  X,  et al.  The prevalence of anosmia and associated factors among U.S. black and white older adults.  J Gerontol A Biol Sci Med Sci. 2017;72(8):1080-1086. doi:10.1093/gerona/glx081PubMedGoogle ScholarCrossref
19.
Ajmani  GS, Suh  HH, Wroblewski  KE,  et al.  Fine particulate matter exposure and olfactory dysfunction among urban-dwelling older US adults.  Environ Res. 2016;151:797-803. doi:10.1016/j.envres.2016.09.012PubMedGoogle ScholarCrossref
20.
Evans  GW, Kantrowitz  E.  Socioeconomic status and health: the potential role of environmental risk exposure.  Annu Rev Public Health. 2002;23:303-331. doi:10.1146/annurev.publhealth.23.112001.112349PubMedGoogle ScholarCrossref
21.
Coleman  ER, Grosberg  BM, Robbins  MS.  Olfactory hallucinations in primary headache disorders: case series and literature review.  Cephalalgia. 2011;31(14):1477-1489. doi:10.1177/0333102411423315PubMedGoogle ScholarCrossref
22.
Fife  D, Faich  G, Hollinshead  W, Boynton  W.  Incidence and outcome of hospital-treated head injury in Rhode Island.  Am J Public Health. 1986;76(7):773-778. doi:10.2105/AJPH.76.7.773PubMedGoogle ScholarCrossref
23.
Kraus  JF, Fife  D, Ramstein  K, Conroy  C, Cox  P.  The relationship of family income to the incidence, external causes, and outcomes of serious brain injury, San Diego County, California.  Am J Public Health. 1986;76(11):1345-1347. doi:10.2105/AJPH.76.11.1345PubMedGoogle ScholarCrossref
24.
Scheidt  PC, Harel  Y, Trumble  AC, Jones  DH, Overpeck  MD, Bijur  PE.  The epidemiology of nonfatal injuries among US children and youth.  Am J Public Health. 1995;85(7):932-938. doi:10.2105/AJPH.85.7.932PubMedGoogle ScholarCrossref
25.
Ajmani  GS, Suh  HH, Wroblewski  KE, Pinto  JM.  Smoking and olfactory dysfunction: A systematic literature review and meta-analysis.  Laryngoscope. 2017;127(8):1753-1761. doi:10.1002/lary.26558PubMedGoogle ScholarCrossref
26.
Sutherland  GT, Sheahan  PJ, Matthews  J,  et al.  The effects of chronic alcoholism on cell proliferation in the human brain.  Exp Neurol. 2013;247:9-18. doi:10.1016/j.expneurol.2013.03.020PubMedGoogle ScholarCrossref
27.
Kamel  UF, Maddison  P, Whitaker  R.  Impact of primary Sjogren’s syndrome on smell and taste: effect on quality of life.  Rheumatology (Oxford). 2009;48(12):1512-1514. doi:10.1093/rheumatology/kep249PubMedGoogle ScholarCrossref
28.
Henkin  RI, Talal  N, Larson  AL, Mattern  CF.  Abnormalities of taste and smell in Sjogren’s syndrome.  Ann Intern Med. 1972;76(3):375-383. doi:10.7326/0003-4819-76-3-375PubMedGoogle ScholarCrossref
29.
Malaty  J, Malaty  IA.  Smell and taste disorders in primary care.  Am Fam Physician. 2013;88(12):852-859.PubMedGoogle Scholar
30.
Idler  E, Leventhal  H, McLaughlin  J, Leventhal  E.  In sickness but not in health: self-ratings, identity, and mortality.  J Health Soc Behav. 2004;45(3):336-356. doi:10.1177/002214650404500307PubMedGoogle ScholarCrossref
31.
Doty  RL, Yousem  DM, Pham  LT, Kreshak  AA, Geckle  R, Lee  WW.  Olfactory dysfunction in patients with head trauma.  Arch Neurol. 1997;54(9):1131-1140. doi:10.1001/archneur.1997.00550210061014PubMedGoogle ScholarCrossref
32.
Faul  M, Coronado  V.  Epidemiology of traumatic brain injury.  Handb Clin Neurol. 2015;127:3-13. doi:10.1016/B978-0-444-52892-6.00001-5PubMedGoogle ScholarCrossref
33.
Kim  DH, Kim  SW, Hwang  SH,  et al.  Prognosis of olfactory dysfunction according to etiology and timing of treatment.  Otolaryngol Head Neck Surg. 2017;156(2):371-377. doi:10.1177/0194599816679952PubMedGoogle ScholarCrossref
Original Investigation
September 2018

Factors Associated With Phantom Odor Perception Among US Adults: Findings From the National Health and Nutrition Examination Survey

Author Affiliations
  • 1National Institute on Deafness and Other Communication Disorders, National Institutes of Health, Bethesda, Maryland
  • 2Social & Scientific Systems, Inc, Silver Spring, Maryland
  • 3University of Vermont Medical Center, Burlington
JAMA Otolaryngol Head Neck Surg. 2018;144(9):807-814. doi:10.1001/jamaoto.2018.1446
Key Points

Question  How does the prevalence of phantom odor perception vary by age, sex, socioeconomic position, health status, health behaviors, smell function, and oral and sinonasal symptoms among US adults?

Findings  In this cross-sectional study of 7417 adults, the prevalence of phantom odor perception was 6.5% (n = 534) and was greater among women, younger age groups, and those of lower socioeconomic position. Phantom odor perception was more common among those with poorer health, a history of head injury, or dry mouth symptoms.

Meaning  Epidemiologic characterization may provide clues to cause and alert clinicians to the importance of this disorder.

Abstract

Importance  Phantom odor perception can be a debilitating condition. Factors associated with phantom odor perception have not been reported using population-based epidemiologic data.

Objective  To estimate the prevalence of phantom odor perception among US adults 40 years and older and identify factors associated with this condition.

Design, Setting, and Participants  In this cross-sectional study with complex sampling design, 7417 adults 40 years and older made up a nationally representative sample from data collected in 2011 through 2014 as part of the National Health and Nutrition Examination Survey.

Exposures  Sociodemographic characteristics, cigarette and alcohol use, head injury, persistent dry mouth, smell function, and general health status.

Main Outcomes and Measures  Phantom odor perception ascertained as report of unpleasant, bad, or burning odor when no actual odor exists.

Results  Of the 7417 participants in the study, 52.8% (3862) were women, the mean (SD) age was 58 (12) years, and the prevalence of phantom odor perception occurred in 534 participants, which was 6.5% of the population (95% CI, 5.7%-7.5%). Phantom odor prevalence varied considerably by age and sex. Women 60 years and older reported phantom odors less commonly (7.5% [n = 935] and 5.5% [n = 937] among women aged 60-69 years and 70 years and older, respectively) than younger women (9.6% [n = 1028] and 10.1% [n = 962] among those aged 40-49 years and 50-59 years, respectively). The prevalence among men varied from 2.5% (n = 846) among men 70 years and older to 5.3% (n = 913) among men 60 to 69 years old. Phantom odor perception was 60% (n = 1602) to 65% (n = 2521) more likely among those with an income-to-poverty ratio of less than 3 compared with those in the highest income-to-poverty ratio group (odds ratio [OR], 1.65; 95% CI, 1.06-2.56; and OR, 1.60; 95% CI, 1.01-2.54 for income-to-poverty ratio <1.5 and 1.5-2.9, respectively). Health conditions associated with phantom odor perception included persistent dry mouth (OR, 3.03; 95% CI, 2.17-4.24) and history of head injury (OR, 1.74; 95% CI, 1.20-2.51).

Conclusions and Relevance  An age-related decline in the prevalence of phantom odor perception is observed in women but not in men. Only 11% (n = 64) of people who report phantom odor perception have discussed a taste or smell problem with a clinician. Associations of phantom odor perception with poorer health and persistent dry mouth point to medication use as a potential explanation. Prevention of serious head injuries could have the added benefit of reducing phantom odor perception.

×