title: Sensitivity and Specificity of Self-Reported Olfactory Function in a Home-Based Study of Independent-Living, Healthy Older Women.
abstract: BACKGROUND
  The 2011-14 US National Health and Nutrition Examination Survey chemosensory protocol asks adults to self-rate their orthonasal (via nostrils) and retronasal (via mouth) smell abilities for subsequent odor identification testing. From data collected with a similar protocol, we aimed to identify a self-reported olfactory index that showed the best sensitivity (correctly identifying dysfunction) and specificity (correctly indentifying normosmia) with measured olfaction.
  
  
  METHODS
  In home-based testing, 121 independent-living older women (age 73±7 years) reported their olfactory function by interviewer-administered survey. Olfactory function was measured orthonasally via composite (odor threshold, identification task) or identification task alone.
  
  
  RESULTS
  Only 16 % of women self-rated "below average" smell function. More women perceived loss of smell (38 %) or flavor (30 %) with aging. The rate of measured dysfunction was 30 % by composite (threshold and identification) and 21.5 % by identification task, the latter misclassifying some mild dysfunction as normosmia. An index of self-rated smell function and perceived loss yielded the most favorable sensitivity (65 %) and specificity (77 %) to measured function. Self-rated olfaction showed better agreement with severe measured dysfunction; mild dysfunction was less noticed.
  
  
  CONCLUSIONS
  Self-reported indices that query about current and perceived changes in smell and flavor with aging showed better sensitivity estimates than those previously reported. Specificity was somewhat lower-some older adults may correctly perceive loss unidentified in a single assessment, or have a retronasal impairment that was undetected by an orthonasal measure.
  
  
  CONCLUSIONS
  Our findings should inform self-rated measures that screen for severe olfactory dysfunction in clinical/community settings where testing is not routine.
authors: Department of Allied Health Sciences, College of Agriculture, Health, and Natural Resources, University of Connecticut-UCONN, 358 Mansfield Road, Box U1101, Storrs, CT 06269-2101, USA.
authors: Shristi
authors: S
authors: Rawal
authors: Epidemiology & Statistics Program, Division of Scientific Programs, National Institute on Deafness and Other Communication Disorders, National Institutes of Health, Suite 8300, 6001 Executive Boulevard, Bethesda, MD 20892-9670, USA.
authors: Howard J
authors: HJ
authors: Hoffman
authors: Department of Allied Health Sciences, College of Agriculture, Health, and Natural Resources, University of Connecticut-UCONN, 358 Mansfield Road, Box U1101, Storrs, CT 06269-2101, USA.
authors: Audrey K
authors: AK
authors: Chapo
authors: Department of Allied Health Sciences, College of Agriculture, Health, and Natural Resources, University of Connecticut-UCONN, 358 Mansfield Road, Box U1101, Storrs, CT 06269-2101, USA.
authors: Valerie B
authors: VB
authors: Duffy
keywords: Aging; Females; Health status; Odor identification; Odor threshold; Smell