The Nose Knows: Smell Loss as a Health Red Flag

Emerging research shows that loss of smell may be a strong predictor of mortality. And it’s not because your nose causes problems, but because olfactory decline might reflect hidden health risks. Together, let’s take a closer look at why a fading sense of smell could be more than just an annoyance.

Smell Loss: An Unexpected Death Predictor

Recent findings have reinforced what earlier studies hinted at. Smell decline and aging might provide indicators about our overall health. 

A large cohort study published in JAMA Otolaryngology - Head & Neck Surgery examined over 2,500 older adults and found that olfactory deficits (i.e., errors in identifying odors) were significantly associated with higher all-cause mortality over 6 and 12 years. 

Each additional mistake on a simple odor test increased the risk of mortality. The strongest links were for deaths tied to neurodegenerative, cardiovascular, or respiratory conditions.

This relationship isn’t entirely new, either. Past work has already flagged the loss of smell as one of the strongest predictors of a five-year death risk. What’s new are the details provided. 

Dementia, frailty, and malnutrition explain much of the link in the short term. Over longer periods of time, frailty and physical decline remained two of the key components.

Of course, the loss of smell is not a cause of death, but it may serve as a warning sign that something deeper is going on.

Why Does Smell Decline Signal Health Risks?

A Mirror of Neural Health

The olfactory system is closely connected to brain areas involved in memory, emotion, and cognition. A decline in the sense of smell may reflect early neurodegenerative changes before they become more obvious.

Frailty, Nutrition, and Systemic Decline

The sense of smell drives our appetite and enjoyment of food. When it fades, people often eat less or choose bland foods, increasing the risk of malnutrition. 

A decline in the sense of smell can also accompany systemic inflammation and a reduced capacity to repair the body, something that comes with aging.

A Signal Across Systems

Because smell receptors are vulnerable to different types of attacks, a decline in smell may reflect damage elsewhere in the body. 

That could include blood vessels, the immune system, or other sensory systems. Some experts believe olfactory testing could help to diagnose people who are at a higher risk for dementia and physical decline well before other signs emerge.

Smell Decline and Aging: What to Know

Smell decline is common with age, but its severity and speed vary. Not everyone with mild smell loss is in trouble, and many factors – such as sinus issues, medications, or infections – can influence our sense of smell. 

Still, when the loss is greater than what’s expected for a certain age, or when it accelerates, it may require closer attention.

Because smell is rarely tested in routine checkups, many people don’t notice gradual loss until it’s advanced. 

Researchers are calling for smell testing in older adults along with hearing and vision checks as a low-cost way to monitor health. 

There’s also interest in interventions like smell training, where repeated exposure to odors may help to maintain or restore function. Treating underlying conditions such as allergies or sinus disease can also help.

What You Can Do If You Notice a Loss of Smell

• Don’t Ignore It: Let your physician know if you notice sustained changes in your sense of smell.

• Ask About a Baseline Test: Formal odor identification tests can measure changes over time.

• Keep Track of Other Health Markers: Because smell loss may indicate broader issues, it’s important to monitor blood pressure, cognition, and nutrition.

• Support Your Nutrition: Use spices and flavors to keep food appealing, and focus on nutrient-rich meals.

• Stay Tuned for Research: New diagnostic tools and therapies may emerge in the coming years.

What the Future Holds

Emerging research is reinforcing the idea that smell isn’t just a quirky sense. It may be a window into systemic health. 

Since smell loss as an indicator of health may have inherent value, doctors may one day include smell testing in routine checkups, especially for older adults.

More studies are needed on younger populations and diverse backgrounds, but the direction these studies are going offers interesting insights.

Don’t Overlook the Loss of Smell

The loss of smell may seem like a minor annoyance, but mounting evidence suggests it could be an important health signal. 

While the change does not mean death is imminent, the association between the loss of smell and mortality, sometimes described as the link between decline in smell and death, is strong enough to pay attention to. 

Taking the loss of smell seriously may help us to uncover hidden risks before they develop into more serious conditions. So, if you notice changes in your ability to smell, it’s worth discussing it with your doctor because your nose may notice trouble before the rest of your body does.

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