Doctors sniff out way to spot early onset of frailty in older people

Calls to test sense of smell in the elderly after study finds that olfactory abilities may be indicator of decline

A DIMINISHING sense of smell could be a sign of declining health and potential frailty, doctors have warned.

A team of medics at John Hopkins University in the US compared the olfactory abilities of more than 1,000 elderly people who completed a questionnaire and assessed their health to produce a score for frailty.

They found that those who were the most frail and had the worst standards of overall physical health also had the most compromised sense of smell. The medics’ findings suggest that smell could be a useful indicator of health in older people and have called for it to be included in health check-ups. Adding it to routine screenings could help identify the risk of unhealthy ageing and indicate whether additional tests are needed, they say.

“We already do tests to assess how well we can see or hear and it’s just as easy to conduct a simple smell test that takes only minutes, which could potentially be used as a valuable tool to assess the risk of frailty or unhealthy ageing,” said Dr Nicholas Rowan, study author and associate professor of head and neck surgery at John Hopkins. “For example, if someone flunks a smell test then maybe [they] need to improve their nutrition” or undergo more detailed neurological or medical tests.

The study builds on research that found declining olfactory ability is often an early sign of cognitive decline. The study, published in the Journal of Gerontolog y, tested participants’ ability to detect odours’ presence and name a scent. These measures are called olfactory sensitivity and olfactory identification, respectively.

Olfactory identification relies on the brain to help work out what the smell is and suggests that neurological function may help to explain the relationship between smell and frailty.

Dr Rowan said: “We use our sense of smell to identify the threat of a fire or to enjoy the fragrance of flowers on a spring day. But just like vision and hearing, this sense weakens as we age.

“We found that impaired olfactory identification and sensitivity functions are associated with frailty, which is interesting because it shows that it’s not just your ageing brain at work here, but it may also be something peripheral, like something at the level of your nose that is able to predict our impending frailty and death.”

Consequences of loss of sense of smell include reduced appetite, difficulties with personal hygiene, depression and inability to detect toxic fumes.