Dataset Information

Relationship Between Poor Olfaction and Mortality Among Community-Dwelling Older Adults: A Cohort Study.

ABSTRACT: Background:Poor olfaction is common among older adults and has been linked to higher mortality. However, most studies have had a relatively short follow-up and have not explored potential explanations. Objective:To assess poor olfaction in relation to mortality in older adults and to investigate potential explanations. Design:Community-based prospective cohort study. Setting:2 U.S. communities. Participants:2289 adults aged 71 to 82 years at baseline (37.7% black persons and 51.9% women). Measurements:Brief Smell Identification Test in 1999 or 2000 (baseline) and all-cause and cause-specific mortality at 3, 5, 10, and 13 years after baseline. Results:During follow-up, 1211 participants died by year 13. Compared with participants with good olfaction, those with poor olfaction had a 46% higher cumulative risk for death at year 10 (risk ratio, 1.46 [95% CI, 1.27 to 1.67]) and a 30% higher risk at year 13 (risk ratio, 1.30 [CI, 1.18 to 1.42]). Similar associations were found in men and women and in white and black persons. However, the association was evident among participants who reported excellent to good health at baseline (for example, 10-year mortality risk ratio, 1.62 [CI, 1.37 to 1.90]) but not among those who reported fair to poor health (10-year mortality risk ratio, 1.06 [CI, 0.82 to 1.37]). In analyses of cause-specific mortality, poor olfaction was associated with higher mortality from neurodegenerative and cardiovascular diseases. Mediation analyses showed that neurodegenerative diseases explained 22% and weight loss explained 6% of the higher 10-year mortality among participants with poor olfaction. Limitation:No data were collected on change in olfaction and its relationship to mortality. Conclusion:Poor olfaction is associated with higher long-term mortality among older adults, particularly those with excellent to good health at baseline. Neurodegenerative diseases and weight loss explain only part of the increased mortality. Primary Funding Source:National Institutes of Health and Michigan State University.

SUBMITTER: Liu B

PROVIDER: S-EPMC7673250 | biostudies-literature | 2019 May

REPOSITORIES: biostudies-literature

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Relationship Between Poor Olfaction and Mortality Among Community-Dwelling Older Adults: A Cohort Study.

Liu Bojing B Luo Zhehui Z Pinto Jayant M JM Shiroma Eric J EJ Tranah Gregory J GJ Wirdefeldt Karin K Fang Fang F Harris Tamara B TB Chen Honglei H

Annals of internal medicine 20190430 10

<h4>Background</h4>Poor olfaction is common among older adults and has been linked to higher mortality. However, most studies have had a relatively short follow-up and have not explored potential explanations.<h4>Objective</h4>To assess poor olfaction in relation to mortality in older adults and to investigate potential explanations.<h4>Design</h4>Community-based prospective cohort study.<h4>Setting</h4>2 U.S. communities.<h4>Participants</h4>2289 adults aged 71 to 82 years at baseline (37.7% bl ...[more]

PMID: 31035288

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Project description:BackgroundIn older adults, kidney function declines with age. People with advanced kidney diseases may have poor olfaction. However, it is unclear whether poor olfaction is a marker for declining renal function or future risk of chronic kidney disease (CKD). We therefore investigated olfaction in relation to kidney function and risk of CKD.MethodsThese secondary data analyses were limited to participants of the year 3 clinical visit of the Health Aging and Body Composition Study. The analytic sample size varied between 1427 to 2531, depending on participant eligibility and data availability for each analysis. Olfaction was tested using the Brief Smell Identification Test (B-SIT), defined as anosmia (score≤6), hyposmia (7-8), moderate (9-10), and good function (10-11) at baseline. We estimated glomerular filter rate (eGFR) at baseline and seven years later using the CKD-EPI creatinine-cystatin C equation, and defined incident CKD as eGFR<60 ml/min/1.73m2 and eGFR decline ≥1 ml/min/1.73m2/year. Further, we identified CKD hospitalization events from hospitalization and death records. We used inverse probability weighting and weighted multivariable regressions to account for censoring in the prospective analyses and used absolute risk regression to account for competing risk of death.ResultsAt baseline, compared to participants with good olfaction, the multivariable-adjusted mean eGFR was 3.00 ml/min/1.73m2 lower (95% confidence interval (CI): -5.25, -0.75) for those with anosmia and 1.87 lower (95% CI: -3.94, 0.21) for those with hyposmia with a P for linear trend < 0.001. Those with anosmia at baseline was had a significantly lower eGFR seven years later (-5.31, 95% CI: -8.58, -2.04, P for trend = 0.002), but the association was attenuated after further accounting for baseline eGFR (-2.37, 95%CI: -4.91, 0.16, P for linear trend = 0.147). Olfactory function was not associated with incident CKD or CKD hospitalization.ConclusionIn older adults > age 70 years, poor olfaction is associated with lower kidney function, but not future CKD risk. These associations should be further investigated in relatively younger population.

Dataset Information

Relationship Between Poor Olfaction and Mortality Among Community-Dwelling Older Adults: A Cohort Study.

Publications

Relationship Between Poor Olfaction and Mortality Among Community-Dwelling Older Adults: A Cohort Study.

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