Clinical features of olfactory dysfunction in elderly patients.

Area of Science:

• Otolaryngology
• Neurology
• Geriatrics

Background:

• Olfactory dysfunction (OD) affects a significant portion of the population, with increasing prevalence in elderly individuals.
• Understanding the diverse causes of OD is critical for timely diagnosis and management, particularly in aging populations.

Purpose of the Study:

• To investigate the primary causes of olfactory dysfunction (OD) in a large patient cohort.
• To analyze the characteristics of OD in elderly patients and compare them to younger individuals.
• To explore the implications of unknown-cause OD in the elderly population.

Main Methods:

• Retrospective analysis of 4300 patients with OD treated between 1996 and 2020.
• Patients categorized into younger (<65 years) and elderly (≥65 years) groups.
• Causative diseases identified, including chronic rhinosinusitis (CRS), post-viral (PV), post-traumatic (PT), CNS, PNS, congenital, psychogenic, and unknown. Olfactory function assessed using T&T olfaction test and Visual Analogue Scale (VAS).

Main Results:

• Unknown-cause OD was significantly more prevalent in the elderly group (30%) compared to younger patients (12%).
• Elderly patients exhibited significantly worse olfactory detection and recognition thresholds than younger patients (p < 0.05).
• Olfactory thresholds for unknown-cause OD were comparable to those with central nervous system (CNS) dysfunction.

Conclusions:

• Unknown-cause olfactory dysfunction is a prominent issue in the elderly population.
• The olfactory acuity in unknown-cause OD mirrors that of CNS OD, suggesting potential underlying neurological links.
• These findings underscore the importance of ongoing monitoring for neurodegenerative diseases in elderly patients with OD.