Anosmia or loss of smell is one of the early symptoms that accompany Alzheimer's disease and other forms of dementia. In addition to the detrimental effect of quality of life, the loss of the sense of smell poses a myriad of health and safety concerns for those afflicted with this sensory deficit. The person with anosmia will miss the odor of a gas leak, the smell of a smoldering fire, the telltale scent of sour milk or other spoiled foods. A person's sense of smell is also closely related to the sense of taste, thusloss of smellcan potentially lead to changes in appetite causing either weight loss or gain. Many people who experience the loss of the sense of smell also experience depression. Additionally, certain aromas serve as memory cues, such as the smell of pine eliciting memories of Christmas.
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A person who thinks their sense of smell is impaired is usually referred to an otolaryngologist, a specialist who focuses on disorders of the ear, nose, and throat. Diagnostic tests include assessing the amount of a scent it takes for a person to notice it and the ability to identify and discern among a variety of scents. There will also be a physical exam and a comprehensive review of the individual's health history. The findings of the otolaryngologist's examination are then forwarded to the patient's primary care physician along with treatment recommendations and referrals for additional evaluations, if warranted.
Treatment and Prognosis
Anosmia related to Alzheimer's disease and dementia appears to be related to the progressive degeneration of neurons in the olfactory tract of the cranial nerves. At this time, there is no known treatment for the loss of smell caused by neurodegenerative diseases and the prognosis is poor. Those afflicted with anosmia can be taught means to compensate for their lack of smell in order to decrease the safety issues related to the inability to discern odors that serve as "warning signs." This type of rehabilitative therapy is usually provided by an occupational therapist.
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The National Institute on Deafness and Other Communication Disorders support research scientists working to find treatment for olfactory deficits related to Alzheimer disease and the dementias. Current studies underway focus on ways to diminish the effects of the loss of smell on appetite in those diagnosed with progressive neurodegenerative disorders. This organization also has resources available atwww.nidcd.nih.gov/directory .
For more information about this topic consider these resources:
Remembering Smell: A Memoir of Losing--and Discovering--the Primal Sense by Bonnie Blodgett
Navigating Smell and Taste Disorders by Ronald Devere and Marjorie Calvert