Springer Nature is making SARS-CoV-2 and COVID-19 research free. View research | View latest news | Sign up for updates

Influence of Olfactory Function on Appetite and Nutritional Status in the Elderly Requiring Nursing Care

  • 8 Accesses

Abstract

Objective

To investigate olfactory function in elderly subjects requiring nursing care to clarify its association with appetite and nutritional status.

Setting

Facility for the elderly requiring nursing care. Participants: The subjects were 158 elderly people requiring nursing care and 37 elderly people not requiring nursing care.

Measurements

Experiment I: Olfactory function and factors (cognitive function, appetite, and nutritional status) that may be associated with it were compared between the elderly subjects requiring nursing care and those not requiring nursing care using covariance analysis in consideration of age. For evaluation, the OSIT-J was used for olfactory function, the HDS-R for cognitive function, the CNAQ for appetite, and BMI for nutritional status. Experiment II: The subjects were the same elderly subjects requiring nursing care in Experiment I, and food intake was surveyed in addition to the OSIT-J, HDS-R, CNAQ, and BMI. A univariate linear regression analysis was performed with OSIT-J as the response variable, and age, HDS-R, CNAQ, BMI, and food intake as the explanatory variables.

Results

Experiment I: On covariance analysis, the OSIT-J score was significantly lower for the elderly subjects requiring nursing care than for those not requiring nursing care (p<0.01). The mean score was 8 or lower in both groups, demonstrating lower olfactory function in both groups. Regarding factors that may be associated with olfactory function, a significant difference was noted in the HDS-R (p<0.01), confirming significantly lower cognitive function in the elderly subjects requiring nursing care. No significant difference was noted in the CNAQ or BMI. Experiment II: On a univariate linear regression analysis, an association with the OSIT-J was noted for age and HDS-R. Age was inversely correlated and the HDS-R was positively correlated. Factors associated with lower olfactory function in the elderly subjects requiring nursing were age and cognitive function, whereas appetite, nutritional status, and food intake were not associated.

Conclusion

Olfactory function in elderly subjects requiring nursing care was poorer than that in those not requiring nursing care, suggesting that aging and cognitive decline are associated with lower olfactory function. In addition, no association of lower olfactory function with appetite, nutritional status, or food intake was noted in the elderly subjects requiring nursing care.

This is a preview of subscription content, log in to check access.

References

  1. 1.

    Donini L, Saina C, Carlo C. Eating habits and appetite control in the elderly: The anorexia of aging. International Psychogeriatrics 2003; 15: 73–87.

  2. 2.

    Tanvir A, Nadim H. Assessment and management of nutrition in older people and its importance to health: Clin Interv Aging. 2010; 5: 207–216.

  3. 3.

    Rolls E. Taste, Olfactory and Food-texture Processing in the Brain and the Control of Appetite. Obesity Prevention 2010; 41–56.

  4. 4.

    Ayabe S, Saito K, Naito N, Mise M, Gotow N, Ichikawa H, Deguchi Y, Kobayakawa Y. Odor identification in different age and gender groups assessed by the Odor Stick Identification Test (OSIT). Aroma Research 2005; 6: 368–371.

  5. 5.

    Umeda Y, Ishii S, Kameyama M, Kondo K, Ochi A, Yamasoba T, Ogawa S, Akishita M. Heterogeneity of odorant identification impairment in patients with Alzheimer’s Disease. Scientific Reports 2017; 7:1–7.

  6. 6.

    Roessner V, Bleich S, Banaschewski T, Rothenberger A. Olfactory deficits in anorexia nervosa. European Archives of Psychiatry and Clinical Neuroscience 2005; 255:6–9.

  7. 7.

    Schreder T, Albrecht J, Kleemann A, Schöpf V, Kopietz R, Anzinger A, Demmel M, Linn J, Pollatos O, Wiesmann M. Olfactory performance of patients with anorexia nervosa and healthy subjects in hunger and satiety. Rhinology 2008; 46: 175–183.

  8. 8.

    Deems D, Doty R, Settle R, Mooregillon V, Shaman P, Mester A, Kimmelman C, Brightman V, Snow J. Smell and taste disorders, a study of 750 patients from the University of Pennsylvania Smell and Taste Center. Arch Otolaryngol Head Neck Surg 1991; 117 (5): 519–528.

  9. 9.

    Brod M, Stewart A. L, Sands L. Conceptualization and Measurement of Quality of Life in Dementia: The Dementia Quality of Life Instrument (DQoL). The Gerontologist 1999; 39: 25–36.

  10. 10.

    Doty R. The olfactory system and Its disorders. Seminars in Neurology 2009;29: 74–81.

  11. 11.

    Saito S, Ayabe S, Takashima Y, Gotow N, Naito N, Nozawa T, Mise M, Deguchi Y, Kobayakawa T. Development of a smell identification test using a novel stick-type odor presentation kit. Chemical Senses 2006;31: 379–391.

  12. 12.

    Mesholam R, Moberg P, Mahr R, Doty R. Olfaction in Neurodegenerative Disease. Arch Neurol 1998; 55: 84–90.

  13. 13.

    Takahashi K, Tsukishima S. Diseases requiring severe-level care certification for long-term care insurance. The Japanese Journal of Public Health 2017; 64: 655–663.

  14. 14.

    Imai Y, Hasegawa K. The revised Hasegawa’s dementia scale (HDS-R) - Evaluation of its usefulness as a screening test for dementia. Journal of the Hong Kong College of Psychiartrists 1994; 4:20–24.

  15. 15.

    Tokudome Y, Okumura K, Kumagai Y, Hirano H, Kim H, Morishita S, Watanabe Y. Development of the Japanese version of the Council on Nutrition Appetite Questionnaire and its simplified versions, and evaluation of their reliability, validity, and reproducibility. Journal of Epidemiology 2017; 27: 524–530.

  16. 16.

    Kuzuya M, Izawa S, Enoki H, Okada K, Iguchi A. Is serum albumin a good marker for malnutrition in the physically impaired elderly? Clinical Nutrition 2007; 26: 84–90.

  17. 17.

    Matthias P, Herbert L. Nutrition in the elderly. Best Practice & Research Clinical Gastroenterology 2001; 15: 869–884.

  18. 18.

    Kobal G, Hummel T, Sekinger B. “Sniffin’ sticks”: screening of olfactory performance. Rhinology 1996; 34: 222–226.

  19. 19.

    Doty R, Shaman P, Kimmelman C, Dann S. University of Pennsylvania smell identification test: A rapid quantitative olfactory function test for the clinic. Laryngoscope 1984; 94: 176–178.

  20. 20.

    Saiki K, Fukazawa O, Asaka H. T&T Olfactometer for Standardized Olfactory Test and Its Uses. Olfaction and Taste XI 2013;12–16.

  21. 21.

    Kobayashi M. The Odor Stick Identification Test for the Japanese (OSIT-J): Clinical Suitability for Patients Suffering from Olfactory Disturbance. Chemical Senses 2005; Volume 30; Issue suppl_1: i216–i217.

  22. 22.

    Shiga H, Toda H, Kobayakawa T, Saito S, Hirota K, Tsukatani T, Furukawa M, Miwa T. Usefulness of curry odorant of odor stick identification test for Japanese in olfactory impairment screening. Acta Otolaryngol Suppl, 2009; 562: 91–4.

  23. 23.

    Baba T, Kikuchi A, Hirayama K, Nishio Y, Hosokai Y, Kanno S, Hasegawa T, Sugeno N, Konno M, Suzuki K, Takahashi S, Fukuda H, Aoki M, Itoyama Y, Mori E, Takeda A. Severe olfactory dysfunction is a prodromal symptom of dementia associated with Parkinson’s disease: a 3 year longitudinal study. Brain 2012; 135 (Pt 1): 161–169.

  24. 24.

    Ansari K, Johnson A. Olfactory function in patients with Parkinson’s disease. Journal of Chronic Diseases 1975; 28: 493–497.

  25. 25.

    Schiffman S. The Use and Utility of Glutamates as Flavoring Agents in Foods Intensification of Sensory Properties of Foods for the Elderly. The Journal of Nutrition 2000; 130: 927S–930S.

  26. 26.

    Stafford L, Welbeck K. High hunger state increases olfactory sensitivity to neutral but not food odors. Chemical Senses 2011; 36: 189–198.

  27. 27.

    Boesveldt S, Lindau S, McClintock M, Hummel T, Lundström J. Gustatory and olfactory dysfunction in older adults: A national probability study. Rhinology 2011; 49: 324–330.

  28. 28.

    Schubert C, Fischer M, Pinto A, Klein K, Klein R, Cruickshanks J. Odor detection thresholds in a population of older adults. The Laryngoscope 2016; 127: 1258–1262.

  29. 29.

    Toussaint N, Roon M, Campen J, Kremer S, Boesveldt S. Loss of olfactory function and nutritional status in vital older adults and geriatric patients. Chemical Senses 2015; 40: 197–203.

  30. 30.

    D A BOOTH M. The Physiology of the Appetite. British Medical Bulletin 1981; 37: 135–140.

  31. 31.

    Gregersen N, Møller B, Raben A. Determinants of appetite ratings: The role of age, gender, BMI, physical activity, smoking habits, and diet/weight concern. Food and Nutrition Research 2011; 55: 1–10.

  32. 32.

    Joseph C. Stevens, William S. Cain. Age-related deficiency in the perceived. strength of six odorants. Chemical Senses 1985; 10: Issue 4: 517–529.

  33. 33.

    Stevenson R, Tomiczek C. Olfactory-induced synesthesias: A review and model. Psychological Bulletin 2007; 133: 294–309.

  34. 34.

    Sakai N, Kobayakawa T, Gotow N, Saito S, Imada S. Enhancement of sweetness ratings of aspartame by a vanilla odor presented either by orthonasal or retronasal routes. Percept Mot Skills 2001; 92: 1002–1008.

  35. 35.

    Rapps N, Giel K, Söhngen E. Olfactory deficits in patients with anorexia nervosa. European Eating Disorders Review 2010; 18: 285–389.

  36. 36.

    Pinel J. P. J., Assanand S., & Lehman D. R. (2000). Hunger, eating, and ill health. American Psychologist, 55 (10), 1105–1116

Download references

Acknowledgement

This study was supported by a grant from JSPS KAKENHI (No. JP18K09876, Grant-in-Aid for Scientific Research C).

Author information

Correspondence to Kanji Nohara.

Ethics declarations

This study was performed after approval by the ethics committees of the School & Graduate School of Dentistry, Osaka University, and Osaka University Dental Hospital (approval number: H29-E24-1).

Additional information

Conflict of interest

The authors declare that there are no conflicts of interest regarding the publication of this manuscript.

Electronic Supplementary Information

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Arikawa, E., Kaneko, N., Nohara, K. et al. Influence of Olfactory Function on Appetite and Nutritional Status in the Elderly Requiring Nursing Care. J Nutr Health Aging (2020). https://doi.org/10.1007/s12603-020-1334-3

Download citation

Key words

  • Olfactory function
  • appetite
  • nutritional status
  • elderly requiring nursing care