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Ask the Mayo Clinic: Why do we lose our sense of taste and small as we age?

Published 10:00 pm, Sunday, December 21, 2008
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Dear Mayo Clinic: Why do people lose their sense of taste and smell as they get older? Is there anything I can do to prevent this from happening? Are there any treatments available?

A: A reduced sense of smell (hyposmia) -- and less often taste (hypogeusia) -- are common conditions that are more likely to occur as we get older.

In fact, some loss of taste and smell occurs normally with aging. The nerves and nerve endings that send smell and taste signals to the brain can degenerate as we age.

The senses of smell and taste are rarely lost simultaneously.

Loss of the sense of smell is more common. Because our sense of smell plays a critical role in the appreciation of flavors, loss of our sense of smell frequently gives the perception that our sense of taste is lost or greatly diminished.

When tested, most patients who report the loss of smell and taste are able to identify basic flavors placed on their tongue. The sense of smell is mostly conducted through the first cranial nerve, while the sense of taste is transmitted through the seventh, ninth and tenth cranial nerves.

While the loss of taste and/or smell may not be as debilitating as the loss of another one of your senses -- sight or hearing, for example -- changes in the ability to taste and smell can significantly affect one's quality of life.

Diminished taste and smell can lead to decreased appetite and poor nutrition because eating may lose some of its appeal. To compensate, people may add extra salt or sugar to their food, which can lead to problems for those who have high blood pressure or diabetes.

There are many causes for both conditions. Those that cause a reduced sense of smell include nasal and sinus diseases, head trauma, aging, cigarette smoking, many medications, toxic chemical exposure, nutritional deficiencies, some endocrinologic disorders, some neurodegenerative diseases (e.g., Alzheimer's, Parkinson's), and even a brain tumor.

Causes of a reduced sense of taste include oral and perioral infections, oral appliances (such as dentures) and other dental causes, medications, aging, vitamin and mineral deficiencies, toxic chemical exposure and Bell's palsy.

Any sustained loss of smell or taste should prompt a consultation with your physician to determine the cause. Evaluation may include blood tests, a CT scan of the paranasal sinuses, or a magnetic resonance imaging study of the brain. Many causes, such as a side effect of medication, allergies, sinus disease and dental and gingival (gum) disease, can be treated, and smoking cessation may be helpful for those who use cigarettes.

If your loss of smell and/or taste is permanent, you will need to learn to live with this impairment. Our senses of smell and taste protect us from some dangerous situations. If you have an impaired or absent sense of smell, you should have smoke detectors wherever you live or sleep; take precautions when working with volatile, toxic substances, especially in closed spaces; take care when cooking to avoid burning your food and causing a fire; and, if you have reduced smell or taste, be careful when eating leftovers that may have spoiled. Most people who have lost their sense of smell and/or taste are able to function quite well despite their impairment.

The bottom line is that you should not ignore or dismiss this problem. Don't be shy about addressing any loss of smell and/or taste with your health care provider. While aging can be the cause, in many other cases treatable conditions are the source of the problem. If so, there may be ways to help restore either or both senses, which substantially enhance our quality of life.

-- Joseph Sirven, M.D. Neurology, Mayo Clinic, Phoenix, Ariz.