This study demonstrates that prevalence of olfactory impairment among older adults is high and increases with age. Self-report significantly underestimated prevalence rates obtained by olfaction testing. Physicians and caregivers should be particularly alert to the potential for olfactory impairment in the elderly population.

The objective of this study was to determine the prevalence of olfactory impairment and associated risk factors and the effects of olfactory impairment on dietary choices and quality of life. Odor identification was measured in 2838 participants aged 21-84 years (mean 49 years) in the Beaver Dam Offspring Study. The overall prevalence of olfactory impairment was 3.8%, increased with age (from 0.6% in those<35 years to 13.9% among those≥65 years) and was more common in men than women. In a multivariate model age (odds ratio [OR]=1.48, 95% confidence interval [CI]=1.33, 1.64 for every 5-year increase), nasal polyps or deviated septum (OR=2.69, 95% CI=1.62, 4.48), ankle-brachial index<0.9 (OR=3.62, 95% CI=1.45, 9.01), and smoking (women only) (OR=2.43, 95% CI=1.19, 4.98 ever smoked vs. never) were associated with an increased odds of olfactory impairment, whereas higher household income, ≥$50,000 versus <$50,000 per year, was associated with a decreased odds of olfactory impairment (OR=0.48, 95% CI=0.31, 0.73). Participants with olfactory impairment were less likely to report that food tasted as good as it used to, or that they experienced food flavors the same. There was no association between olfactory impairment and general health-related quality of life, depressive symptoms, or dietary choices. The prevalence of olfactory impairment was low in this largely middle-aged cohort, and some factors associated with olfactory impairment are potentially modifiable.

Objectives To determine associations between smoking, adiposity, diabetes, and other cardiovascular disease (CVD) risk factors and the 15-yr incidence of hearing impairment (HI). Design The Epidemiology of Hearing Loss Study (EHLS) is a longitudinal population-based cohort study (1993–95 to 2009–2010). Setting Beaver Dam, WI. Participants Participants in the Beaver Dam Eye Study (1988–90; residents of Beaver Dam, WI ages 43–84 years in 1987–88) were eligible for the EHLS. There were 1925 participants with normal hearing at baseline. Measurements 15-year cumulative incidence of HI (pure-tone average (PTA) of hearing thresholds at 0.5, 1, 2 and 4 kHz > 25 decibels Hearing Level (dB HL) in either ear). Cigarette smoking, exercise, and other factors were ascertained by questionnaire. Blood pressure, waist circumference, body mass index and glycosylated hemoglobin were measured. Results Follow-up examinations (≥1) were obtained from 87.2% (n=1678; mean baseline age 61 years). The 15-year cumulative incidence of HI was 56.8%. Adjusting for age and sex, current smoking (Hazard Ratio (HR) =1.31, p=0.048), education (<16 yrs; HR=1.35, p=0.01), waist circumference (HR=1.08 per 10 cm, p=0.017), and poorly controlled diabetes (HR=2.03, p=0.048) were associated with increased risk of HI. Former smokers and people with better controlled diabetes were not at increased risk. Conclusion Smoking, central adiposity and poorly controlled diabetes predicted incident HI. These well-known CVD risk factors, suggest vascular changes may contribute to HI in aging. Interventions targeting reductions in smoking and adiposity, and improved glycemic control in people with diabetes, may help to prevent or delay the onset of HI.

Background/Objectives To evaluate the associations of sensory impairments with the 10-year risk of cognitive impairment. Previous work has primarily focused on the relationship between a single sensory system and cognition. Design The Epidemiology of Hearing Loss Study (EHLS) is a longitudinal, population-based study of aging in the Beaver Dam, WI community. Baseline examinations were conducted in 1993 and follow-up exams have been conducted every 5 years. Setting General community Participants EHLS members without cognitive impairment at EHLS-2 (1998–2000). There were 1,884 participants (mean age = 66.7 years) with complete EHLS-2 sensory data and follow-up information. Measurements Cognitive impairment was a Mini-Mental State Examination score of < 24 or history of dementia or Alzheimer’s disease. Hearing impairment was a pure-tone average of hearing thresholds (0.5, 1, 2 and 4 kHz) of > 25 decibel Hearing Level in either ear. Visual impairment was Pelli-Robson contrast sensitivity of < 1.55 log units in the better eye and olfactory impairment was a San Diego Odor Identification Test score of < 6. Results Hearing, visual, and olfactory impairment were independently associated with cognitive impairment risk [Hearing: Hazard Ratio (HR) = 1.90, 95% Confidence Interval (C.I.) = 1.11, 3.26; Vision: HR = 2.05, 95% C.I. = 1.24, 3.38; Olfaction: HR = 3.92, 95% C.I. = 2.45, 6.26]. However, 85% with hearing impairment, 81% with visual impairment, and 76% with olfactory impairment did not develop cognitive impairment during follow-up. Conclusion The relationship between sensory impairment and cognitive impairment was not unique to one sensory system suggesting sensorineural health may be a marker of brain aging. The development of a combined sensorineurocognitive measure may be useful in uncovering mechanisms of healthy brain aging.