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First Prevalence Data on ‘Phantom Odors’ Show Women Often Affected

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More than 6% of US residents over age 40 years expertise “phantom odors” — smells for which there is no such thing as a exterior stimulus, new analysis reveals.

Investigators studied 7400 adults who participated within the National Heath and Nutrition Examination Survey (NHANES) and located that 1 in 15 members smelled an disagreeable odor when nothing was there to supply it.

The prevalence was larger amongst ladies, youthful people, individuals of decrease socioeconomic standing, these with poorer health, and people with a historical past of head harm or dry mouth signs.

“This study is the first in the US to use nationally representative data to examine the prevalence of and risk factors for phantom odor perception,” lead creator Kathleen Bainbridge, PhD, from the Epidemiology and Biostatistics Program on the National Institute on Deafness and Other Communication Disorders, a part of the National Institutes of Health, advised Medscape Medical News.

“This study could inform future research aiming to unlock the mysteries of phantom odors,” she mentioned.

The examine was published online August 16 in JAMA Otolaryngology-Head & Neck Surgery.

“Miserable” Quality of Life

“The perception of phantom odors is a qualitative olfactory dysfunction whereby affected individuals perceive odors in the absence of an eternal stimulus,” with the odor sometimes described as “foul,” rotten,” or “chemical,” the authors write.

Few epidemiologic research have addressed this notion, and most proof has been restricted to case reviews and small scientific research, they observe.

The organic mechanism of phantom odor notion might come up from aberrant peripheral olfactory neurons that sign notion facilities within the mind or from overactive mind cells that create the notion.

“We knew that phantom odor perception had been observed in medical clinics, but we did not know how common this condition was, nor what types of people are more commonly affected,” Bainbridge commented.

The researchers had been additionally motivated by the “miserable quality of life” that folks with this situation expertise, she mentioned.

To examine, the researchers used knowledge collected between 2011 and 2014 by the NHANES performed by the National Center for Health Statistics.

Study members (aged ≥ 40 years) had been interviewed about phantom odors and likewise underwent a bodily examination.

Participants had been requested, “Do you sometimes smell an unpleasant, bad, or burning odor when nothing is there?”

The researchers obtained details about sociodemographic traits, together with age, intercourse, and academic attainment, in addition to race/ethnic background.

Individuals categorized as “never” having smoked had been those that reported by no means having smoked 100 cigarettes of their lifetime. Otherwise, smoking standing was outlined as at the moment smoking every single day, at the moment smoking some days, or former smoker.

Alcohol use was categorized by utilizing a threshold of 12 alcoholic drinks previously yr.

Participants had been requested to evaluate their basic health standing in addition to reporting on particular bodily circumstances through the previous yr, together with nasal congestion from allergy symptoms, colds or flu lasting greater than 1 month, and chronic dry mouth.

In addition, interview questions assessed lifetime historical past of head harm with ensuing loss of consciousness, damaged nostril or different facial/cranium harm, and greater than two sinus infections.

To assess the potential presence of diminished scent perform, members had been requested to determine eight odors, with diminished scent perform outlined as fewer than six accurately recognized odorants.

Female Sex, Head Injury More Common

The researchers estimated the prevalence of phantom odor notion as 6.5% (n = 534) (95% CI, 5.7% – 7.5%).

Of those that skilled it, solely 11.1% (n = 64) reported discussing a style or scent drawback of any form with a clinician.

Those who reported phantom odors had been much less prone to be youthful than age 70 years than those that didn’t report phantom odors (12.4% [n = 85] vs 19.7% [n = 1698]).

There had been racial/ethnic variations between individuals affected by phantom odors — a larger proportion of non-Hispanic black individuals had been represented amongst those that reported phantom odors.

Conversely, non-Hispanic white people and non-Hispanic Asian people had been represented in larger proportions amongst those that didn’t report phantom odors in contrast with those that did.

The total nationwide pattern was barely greater than half feminine (52.8% [n = 3862]). Of those that reported phantom odors, 68.0% (n = 356) had been ladies.

Men in youthful age teams had been twice as prone to report phantom odors as males aged 70 years or older, though this affiliation was statistically vital just for males aged 40 to 49 years

However, in contrast with males aged 70 years or older, ladies on this age group had no larger chance of phantom odor notion; on the opposite hand, ladies within the youthful age teams (40 – 49, 50 – 59, 60 – 69 years) had 5, 6, and 3 instances the chances of phantom odor notion, respectively.

Phantom odors had been extra widespread in people with solely a highschool schooling.

Two thirds of these (n = 762) who reported phantom odors had been of decrease revenue (income-to-poverty ration < 3) vs 46.1% of those that didn’t report phantom odors (n = 3749).

Over one quarter (25.3%) of those that reported phantom odors had a historical past of present or former cigarette smoking, in contrast with 17.8% of those that didn’t report phantom odors.

Of individuals categorized as being in truthful or poor health, greater than 13% (n = 227) reported phantom odors, in contrast with 5.8% (n = 169) and 4.2% (n = 84) of these in good and superb/glorious health, respectively.

People with persistent dry mouth had greater than 3 times the prevalence of reporting phantom odors vs those that didn’t (17.4% [n = 204] vs 4.9% [n = 330], respectively).

Of individuals who had sustained head accidents accompanied by loss of consciousness, 10% (n = 112) reported phantom odors, vs 5.7% (n = 422) of these with out a historical past of head harm.

People who had sustained accidents to their nostril, face, or cranium had no larger prevalence of phantom odor notion, though individuals with diminished scent perform had considerably, however not considerably, decrease prevalence.

“We found some risk factors that may be related to the perception of phantom odor — people are more likely to experienced this condition if they are female and are relatively young,” Bainbridge commented.

Other threat components included head harm, dry mouth, poor total health, and low socioeconomic standing.

She urged that folks with low socioeconomic standing might “have health conditions that contribute to phantom odors, either directly or because of medications needed to treat their health conditions.”

Temporary Condition

Commenting on the examine for Medscape Medical News, Jeffrey D. Suh, MD, affiliate professor-in-residence, Department of Head and Neck Surgery, David Geffen School of Medicine at UCLA, California, who was not concerned with the examine, known as it “important, because dysosmia can significantly impair quality of life, and because there is very little consensus in the diagnosis, management, and treatment of patients that suffer from this condition.”

Greater understanding “of the incidence of phantosmias and risk factors” ought to allow clinicians “to better be able to diagnose and treat their treatment,” mentioned Suh, who’s the coauthor of an accompanying editorial.

Study coauthor Donald Leopold, MD, scientific professor, Department of Surgery, University of Vermont Medical Center, Burlington, urged reassuring sufferers that experiencing phantom odors is normally a short lived situation and resolves spontaneously in 1 yr.

Treatment approaches would possibly embody blocking nasal airflow with saline, particularly when utilized with the top inverted, and contemplating a trial with antidepressants or anticonvulsants, notably gabapentin.

The National Institute on Deafness and Other Communication Disorders offered funding help for National Health and Nutrition Examination Survey chemosensory knowledge assortment through interagency agreements with theNational Center for Health Statistics of the Centers for Disease Control and Prevention and the University of Connecticut. Support for the statistical evaluation was offered by Social & Scientific Systems Inc. Bainbridge, Leopold, and the opposite examine authors, in addition to Suh and the editorial coauthor, have disclosed no related monetary relationships.

JAMA Otolaryngol Head Neck Surg. Published on-line August 16, 2018. Abstract, Editorial

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