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[Drug related taste disturbances: emphasis on the elderly]
1Clinical Pharmacology Unit, Kaplan Medical Center, Rehovot.
Background:
Taste disturbances are common among the elderly due to physiologic changes, diseases, and medications. As many as 11% of elderly persons using multiple drugs report taste aberrations. The main danger of taste decline and disturbance in the old is food-anhedonia, causing loss of body weight via decreased calorie and nutrient intake.
Goals:
To overview drug related taste disturbances emphasizing the elderly.
Methods:
Review of Hebrew and English medical literature.
Results:
Taste-disturbances can be divided into hypogeusia [diminished sense of taste], ageusia [absence of taste], and the 2 types of dysgeusia [taste distortion]: aliageusia [food related] and phantogeusia [taste illusions]. The mechanisms by which drugs impair taste are numerous, and may be related to drug chemical structure. The treatment of taste disturbances is empiric and has limited success. Treatments include: shifting drugs within the same class, zinc replacement (proven to enhance taste sensation for sweet, bitter and salty flavors), palliative measures (use of mints, sugarless chewing-gums, and bicarbonate mouthwashes), niacin and vitamin A ameliorate hypo and dysgeusia.
Conclusions:
Disturbed taste sensation is common among the elderly, and should be considered whenever unexplained nutritional decline is present. Scrupulous drug screening is mandatory, and other intervention modalities can be beneficial.