THE SITUATION

Why can’t you smell? Normal aging is the most common cause of loss of smell or taste, with the disorder occurring in 50 percent of people aged 65 to 80, and 75 percent of the population over 80. Two-thirds of the remaining problems with chronic smell loss are due to other causes, including various neurological disorders such as Alzheimer’s disease, frontotemporal dementia and Parkinson’s disease. Studies show problems with smell function in 90 percent of people with Alzheimer’s disease. It occurs because specialized nerve cells in the nasal smell organ—the olfactory system—are damaged. Still, the vast majority of older adults and people with Alzheimer’s disease do not notice that they have a problem. Key indicators of smell and taste disorders are reduced appetite, less interest in food, weight loss and malnourishment.

THE SOLUTION

  • Visit an ear, nose and throat (ENT) physician and/or neurologist. For example, the neurologist will ask about headaches, double vision, facial numbness, balance problems or trouble with memory. The answers to these questions will help determine any problem with the olfactory nerve or the structures inside the brain. The doctor will test nerves related to smell, taste and sensory function of the mouth and tongue, will probably do blood tests, and may also require an MRI of the brain and olfactory region to gain detailed images of many structures involved in smell.
  • Probe further, if necessary. It may be necessary to go to one of the few smell and taste speciality disorders clinics and research centers in the United States for more detailed testing, more treatment options and patient education if the cause and long-term outcome of the disorder is unclear or troubling, or if symptoms such as increasing weight loss, decreased appetite and depression are present.
  • Cook with care. Be extra attentive while cooking to prevent burned food or a possible fire.
  • Spice up food preparation. In order to improve the taste of food, choose foods with varying colors and textures. Add spicy condiments like peppers, horseradish, mustard or salsa. Increase the flavor of fish, poultry and meat by marinating it in sweet fruit juices, sweet wine, sweet and sour sauce, or spicy salad dressing. Eat tart foods such as oranges and grapefruits, and tart beverages such as lemonade and grapefruit juice with their pulp.
  • Serve foods hot and steaming. This will allow the aroma to fill the dining area.
  • Watch how you eat. Chew food slowly and move food around in the mouth in order to stimulate all taste and sensory receptors. Alternate bites of different foods during the meal.
  • Get educated about the disorder. If doable, join support groups and exchange recipes with others who have a similar condition. Among the many suggestions from people with the disorder are char-grilled hamburgers (almost burned), grilled salmon with chopped onions, grilled pork (almost burned) and barbecued chicken with BBQ sauce for extra dipping.

PREPARE IN ADVANCE

Be aware that smell and taste disorders can put your health and safety at risk. Be sure to have working smoke detectors and a natural gas or propane monitor in your home. Date all perishable foods and refrigerate them to prevent accidental food poisoning. Label and properly store all garden products and household cleaning products.

Adapted with permission from the American Academy of Neurology from “Navigating Smell and Taste Disorders” by Ronald DeVere, M.D., and Marjorie Calvert (Demos Medical Publishing, 2011).