title: Olfactory impairment in older adults is associated with poorer diet quality over 5 years.
abstract: OBJECTIVE
  Decreased smell could cause appetite suppression and malnutrition. However, there is a paucity of longitudinal data between olfaction and nutritional status in older adults. We aimed to prospectively examine the relationship between olfactory impairment and overall diet quality (reflecting adherence to dietary guidelines) in a population-based cohort of older adults.
  
  
  METHODS
  We used 5-year follow-up data from 557 adults (aged 60+ years at baseline) whose olfaction was measured using the San Diego Odor Identification Test (SDOIT). Dietary data were collected using a validated semiquantitative food frequency questionnaire. A total diet score (TDS) was calculated for intake of selected food groups and nutrients for each participant as described in the national dietary guidelines. Final scores ranged from 0 to 20; higher scores indicated closer adherence to dietary guidelines.
  
  
  RESULTS
  After adjusting for all potential confounders, older adults with moderate/severe olfactory impairment (SDOIT score ≤ 3; lower scores indicate impairment) compared with those with no olfactory impairment had significantly lower adjusted mean (±SE) TDS, 9.09 (0.40) versus 9.94 (0.10), p = 0.04. Women with moderate/severe impaired olfaction (i.e., scored poorly on the odor identification test) compared with those with normal olfaction had significantly lower adjusted mean TDS, 8.87 (0.69) versus 10.31 (0.13), p = 0.04. No associations were observed between olfaction and TDS in men.
  
  
  CONCLUSIONS
  Olfactory impairment in older women could signal an increased risk of poorer diet quality, defined as adherence to national dietary guidelines. Additional longitudinal studies are needed to confirm or refute the observed link between olfactory loss and overall patterns of food intake in older adults.
authors.affiliation: Centre for Vision Research, Department of Ophthalmology and Westmead Millennium Institute, University of Sydney, Sydney, Australia. bamini.gopinath@sydney.edu.au.
authors.forename: Bamini
authors.initials: B
authors.lastname: Gopinath
authors.affiliation: School of Health and Society, University of Wollongong, Wollongong, Australia.
authors.forename: Joanna
authors.initials: J
authors.lastname: Russell
authors.affiliation: Departments of Neurology and Neurogenetics, Kolling Institute, University of Sydney, Sydney, Australia.
authors.forename: Carolyn M
authors.initials: CM
authors.lastname: Sue
authors.affiliation: Faculty of Health Sciences, University of Sydney and St Vincent's Hospital, Sydney, Australia.
authors.forename: Victoria M
authors.initials: VM
authors.lastname: Flood
authors.affiliation: Centre for Vision Research, Department of Ophthalmology and Westmead Millennium Institute, University of Sydney, Sydney, Australia.
authors.forename: George
authors.initials: G
authors.lastname: Burlutsky
authors.affiliation: Centre for Vision Research, Department of Ophthalmology and Westmead Millennium Institute, University of Sydney, Sydney, Australia.
authors.forename: Paul
authors.initials: P
authors.lastname: Mitchell
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D015992:Body Mass Index; D004032:Diet; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016014:Linear Models; D008297:Male; D044342:Malnutrition / Q000150:complications / Q000503:physiopathology*; D018977:Micronutrients / Q000008:administration & dosage / Q000172:deficiency; D008875:Middle Aged; D015596:Nutrition Assessment; D018673:Nutrition Policy; D000857:Olfaction Disorders / Q000150:complications / Q000503:physiopathology*; D055696:Olfactory Perception / Q000502:physiology; D010349:Patient Compliance; D011446:Prospective Studies; D011795:Surveys and Questionnaires
chemical_list: D018977:Micronutrients
keywords: Blue Mountains Eye Study; Diet quality; Older adults; Olfactory impairment