Posted by Bob on September 17, 2011, at 16:03:24
In reply to Loss of Olfactory Sense Leads to Depression /Disor, posted by Phillipa on September 16, 2011, at 19:21:45
> Well lost mine in mid fifties so does this mean will develop alzheimers or parkinson's. Oh definitely inpacts quality of life. Phillipa
>
> From Medscape Medical News > Psychiatry
> Olfactory Impairment May Lead to Depression in Elderly
> Deborah Brauser
>
> Authors and Disclosures
>
> September 14, 2011 An impaired sense of smell may lead to depression in the elderly and, in turn, a poorer quality of life, new research suggests.
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> In further analysis from the Blue Mountain Eye Study (BMES), investigators found that Australian patients older than 70 years who had olfactory dysfunction also had a 66% increased likelihood of experiencing depressive symptoms compared with those without the dysfunction.
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> In addition, the impaired participants were found to have lower quality-of-life scores in areas such as physical functioning and vitality.
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> "These findings suggest that older adults with olfactory loss experience limitations in relation to the enjoyment of food and drinks and socializing that could negatively impact on their psychological well-being," write Bamini Gopinath, PhD, from the Center for Vision Research at the University of Sydney and Westmead Hospital, Australia, and colleagues.
>
>
> Dr. Bamini Gopinath
>
> They note that further prospective studies are needed to identify "causal directions" between these and other variables.
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> Still, they write that simple and inexpensive tests should be used by clinicians to evaluate for smell impairment in this patient population.
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> "Assessing olfaction in the older patient could be a valuable adjunct in patient counseling, particularly for monitoring for interrelated conditions such as depression and cognitive impairment," Dr. Gopinath told Medscape Medical News.
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> The study appears in the September issue of the American Journal of Geriatric Psychiatry.
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> Linked to Other Disorders
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> According to the researchers, olfactory loss is strongly age dependent and is a significant problem because sense of smell is essential to enjoyment of life.
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> "Olfaction determines flavor and serves as the early detection for smoke, toxic fumes, and spoiled foodstuffs," they write.
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> Past studies have shown an association between odor dysfunction and Alzheimer's disease ( J Clin Exp Neuropsychol . 1995;17:793-803), as well as with schizophrenia ( Am J Psychiatry . 2009;166:226-233).
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> In a study published last year in the Journal of Aging and Health , the BMES investigators found that olfactory impairment was also significantly associated with both cognitive impairment and Parkinson's disease.
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> However, "there is very little population-derived data on the link between olfactory impairment with quality of life and depressive symptoms. Further, the existing data on these relationships is equivocal," said Dr. Gopinath.
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> The original BMES was set up to assess common eye diseases in 3654 Australian residents older than 49 years. Baseline exams were conducted between 1992 and 1994, with follow-ups performed 5 and 10 years later.
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> For this analysis, the investigators evaluated data on 1375 of those who participated in the BMES 10-year follow-up.
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> Each filled out health history questionnaires and underwent physical exams, as well as the San Diego Odor Identification Test. They also filled out the 36-Item Short-Form Survey (SF-36) to measure depressive symptoms and quality of life, and the Center for Epidemiologic Studies Depression Scale (CES-D-10).
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> Public Health Concern
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> Results showed that 24.2% of the participants had olfactory impairment. The impairment was more likely to be found in participants who were older, men, had a walking disability or a history of stroke, underwent 1 or more hospital stays, and had poor overall self-rated health.
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> Among those with the olfactory dysfunction, 15.4% had depressive symptoms as shown by the SF-36 Mental Health Index, and 20.2% had the symptoms as shown by the CES-D-10.
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> There was no significant association found between the dysfunction and depressive symptoms in the overall group.
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> However, the association was deemed significant by the CES-D-10 for patients older than 70 years (adjusted odds ratio, 1.66; 95% confidence interval, 1.03 - 2.66).
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> Finally, the patients with olfactory impairment had significantly lower adjusted mean SF-36 scores, representing lower quality of life, than did those without impairment in 6 of 8 measurement categories, including physical functioning (P = .02), vitality (P < .0001), social functioning (P = .004), and role limitation because of emotional problems (P < .0001).
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> "Our results highlight some public health concerns and implications," write the researchers.
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> They note that many elderly patients will not mention olfactory dysfunction on their own, often because they are not even aware of it. This can be particularly problematic, "as most medical practitioners have limited experience dealing with chemosensory disorders."
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> The investigators write that the San Diego Odor Identification Test is a quick tool that can easily be used by primary physicians and other clinicians who suspect problems.
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> "Our results suggest that the identification of suspected olfactory loss and evaluation of the impact it has on patient's lives should be encouraged."
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> Powerful Predictor
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> "The results weren't at all surprising to me, because there's now substantial evidence to suggest that the olfactory regions are significantly tied with emotional regions of the brain," Vidya Kamath, PhD, from the University of Pennsylvania's Department of Psychiatry and the University of Pennsylvania Olfaction and Gustatory Laboratory in Philadelphia, told Medscape Medical News.
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> Dr. Kamath, who was not involved with this study, agreed with the investigators that olfaction could be an important screening tool.
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> "We know that olfactory function decreases with aging, and know that it can be a precursor to things like Alzheimer's disease [and] Parkinson's disease. We see it in people with mild cognitive impairment, and at times it predicts transition from mild cognitive impairment to Alzheimer's disease."
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> She noted that a significant strength of the study was the large sample size followed up for such a long period of time.
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> "One of the future directions for the study that would be interesting is to see if olfactory impairment in their healthy participants, the ones without current depression, predicts depression at a later time," she said.
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> She added that "there is evidence now to suggest" that anhedonia and apathy can be 2 aspects of depression that may be related to olfactory performance. So "it would be nice" to see these particular domains, beyond an overall depression score, evaluated in a future study with this patient group.
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> Dr. Kamath noted that her laboratory is currently working on studies examining the role of olfaction in schizophrenia.
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> "One of the things we see is that patients with schizophrenia who are also reporting anhedonia also show an association with olfactory disturbance. The unique thing about olfaction is that it can be looked at in several neuropsychiatric and neurodegenerative disorders," she said.
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> "While an olfactory impairment isn't in itself something to be concerned about, if it's tied to other tests that are being used, it can possibly be a powerful predictor and be indicative of something going on in the brain."
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> The study was supported by the Australian National Health and Medical Research Council. The study authors and Dr. Kamath have disclosed no relevant financial relationships
>When I finished my course of ETC a few years back I was arguably worse than I had ever been in my life and I noticed that my sense of smell had been "burned out". It was all but gone. It came back somewhat very slowly over the ensuing years.
poster:Bob
thread:996950
URL: http://www.dr-bob.org/babble/20110914/msgs/997029.html