A simple 12-item smell identification test may help identify older adults at higher short-term risk of heart disease, according to a recent study.
In a large community-based cohort study, published in JAMA Otolaryngology–Head & Neck Surgery, poor olfaction was linked to a higher short-term risk of coronary heart disease in older adults. Researchers found that participants with impaired olfaction had approximately twice the risk of developing coronary heart disease (CHD) within the first 4 years of follow-up compared with those with normal smell function, although the association weakened over time.
The analysis included 5,142 adults (mean [SD] age, 75.4 [5.1] years; 62.9% female; 23.9% Black) from the Atherosclerosis Risk in Communities Study, a long-term cohort investigating cardiovascular outcomes in US adults. Researchers assessed olfactory function using a 12-item Sniffin’ Sticks odor identification test. Scores were categorized as good (scores 11–12), moderate (9–10), or poor (0–8). Participants were followed for adjudicated CHD events—defined as definite or probable hospitalized myocardial infarction or fatal CHD—through December 31, 2020, with a median follow-up of 8.4 years (interquartile range, 7.4–8.9).
Over 9.6 years, 280 incident CHD events (5.4%) occurred: 83 among participants with good olfaction (4.4%), 101 with moderate olfaction (5.9%), and 96 with poor olfaction (6.3%). Using discrete-time subdistribution hazard models that accounted for competing mortality, poor olfaction was associated with an adjusted marginal risk ratio (RR) of 2.06 at year 2, 2.02 at year 4, and 1.59 at year 6, with the association attenuating to 1.22 at year 8 and 1.08 by year 9.6.
These results remained consistent across subgroups defined by age, sex, and race, and in sensitivity analyses excluding participants with cognitive impairment. “Therefore, poor olfaction may signal subclinical atherosclerosis and indicate future CHD risk. Alternatively, this sensory deficit may be associated with increased CHD risk by compromising nutrition, mental health, and the physical well-being of older adults,” noted the lead author Keran W. Chamberlin, PhD, of the Department of Epidemiology and Biostatistics, College of Human Medicine, Michigan State University, East Lansing, and colleagues.
Disclosures can be found in the study.