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Problems with a sense of smell may help predict a higher risk for age-related health problems, according to researchers from the Department of Otolaryngology-Head and Neck Surgery at Johns Hopkins University School of Medicine.

What to know:

  • Smell dysfunction acts as an early indicator of cognitive decline as well as signs of frailty in the brain and unhealthy aging.

  • Researchers assessed olfactory sensitivity and olfactory identification, which describe the ability to detect an odor and the ability to detect and name an odor, respectively.

  • As with vision and hearing, sense of smell weakens as we age.

  • Impaired olfactory identification and sensitivity functions are associated with frailty. This is interesting because it shows that it’s not just the aging brain at work here, but it may also be something peripheral, like something at the level of the nose that is able to predict impending frailty and death.

  • Study participants were exposed to five scents to measure identification skills and six scents to measure sensitivity, then matched to their frailty score.

  • For each one-point increase in both olfactory identification and sensitivity scores, frailty status declined significantly, which suggests that the ability to smell well has a connection to better overall health in the aging population.

  • Keeping an eye on sense of smell may serve as an influential biomarker and risk factor for frailty.

  • Smell tests may become an integral part to clinical care for aging people who may be cognitively impaired. A simple smell test that takes only minutes could potentially be used as a valuable tool to assess the risk of frailty or unhealthy aging.

  • Someone who flunks a smell test may need to improve their nutrition or undergo a more detailed neurologic or medical workup.

  • Smell tests may be able to enhance clinical and research efforts in improving care for older adults, new article medicine especially with COVID-19 affecting  many patients’ sense of smell.

This is a summary of the article “The Association of Peripheral and Central Olfaction With Frailty in Older Adults” published in the Journals of Gerontology on January 10, 2023. The full article can be found on

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