Abstract
ObjectivesThe olfactory decline that often accompanies aging is thought to contribute to undernutrition in older adults. It is believed to negatively affect eating pleasure, appetite, food intake and subsequently nutritional status. We have evaluated the associations of olfactory function with BMI, appetite and prospective weight change in a cohort of Dutch community-dwelling older adults.DesignCross-sectional cohort study.ParticipantsDutch community-dwelling older adults from the ongoing Longitudinal Aging Study Amsterdam (LASA).Measurements and settingIn 2012–2013, the 40-item University of Pennsylvania Smell Identification Test (UPSIT) was administered to 824 LASA participants to evaluate their olfactory function. Body weight, height, appetite, comorbidity, cognitive status and socio-demographic factors were also assessed. Follow-up weight was measured after three years.Results673 participants (aged 55–65 years) were included in the regression analyses. Median UPSIT-score was 33. When adjusted for potential confounders, lower UPSIT-score (indicative of poorer olfactory function) was not associated with poor appetite (OR = 1.062, p = 0.137) or prospective weight change (B = −0.027, p = 0.548). It was, however, associated with lower BMI in smokers (B = 0.178, p = 0.032), but not in non-smokers (B = −0.015, p = 0.732).ConclusionLower olfactory function scores were associated with lower BMI in community-dwelling older adults who smoke, but not with appetite or prospective weight change. Therefore, smoking older adults with olfactory impairments may pose as a vulnerable group with respect to developing undernutrition.
Highlights
An important health concern in the older population is protein-energy undernutrition [1]
In a large cohort of 1636 older adults aged over 60, poorer olfactory function was associated with lower BMI [20]
It has been reported that olfactory dysfunction was not at all related to diminished eating pleasure or poor appetite [17] or to risk of malnutrition, measured by either low BMI or low MiniNutritional Assessment score [16, 18, 19]
Summary
An important health concern in the older population is protein-energy undernutrition [1]. This is a form of malnutrition frequently resulting from insufficient energy or protein uptake [2]. The age-related decline in olfactory function (presbyosmia) is argued to be one of these determinants [6, 7]. In a large cohort of 1636 older adults aged over 60, poorer olfactory function was associated with lower BMI [20]. It has been reported that olfactory dysfunction was not at all related to diminished eating pleasure or poor appetite [17] or to risk of malnutrition, measured by either low BMI or low MiniNutritional Assessment score [16, 18, 19]. Aside from the study by Gopinath et al [14] these studies were all cross-sectional [15,16,17,18,19,20]
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