Individual Significance of Olfaction: A Comparison Between Normosmic and Dysosmic People

Background: Olfactory dysfunction is common in older individuals. The importance of such dysfunction to individuals is highly variable: many people do not seem to care about their olfactory dysfunction, others suffer and complain about problems in daily life, a reduced quality of life, or symptoms of depression. Objective: Understanding the importance of olfaction for different age groups in normosmic as well as in smell-disordered subjects may help to find reasons for insufficient coping with olfactory dysfunction. Methods: We used a questionnaire to capture the individual importance of olfaction in a sample of 433 normosmic and 172 dysosmic people from 1582 years of age. Furthermore, all participants underwent standardized assessment of olfactory function. Results: The importance of olfaction was highest in the group of young (<= 25-year-old) normosmic women. Dysosmia was associated with a decreased importance of olfaction, irrespective of age. However, 18 % of the dysosmic patients showed a tendency to aggravate their symptoms. This high degree of aggravation could not be explained by sex, age, or severity of olfactory dysfunction. Conclusions: The high importance of olfaction observed in young women may reflect the specific needs of this group, such as mate selection and child care. The strongly reduced importance of olfaction in dysosmic subjects seems to serve as an adaptive coping mechanism. A tendency to aggravate symptoms may indicate insufficient coping. Hence, detecting high aggravation could be a first step to recognizing high psychological strain and the need for psychotherapeutic treatment.