Elderly Loss of Taste: Aging Effect or Underlying Disease?
Ageusia, the complete loss of taste, is not a normal part of the aging process, although age-related changes in taste perception are common. As people grow older, physiological changes such as a reduction in the number and function of taste buds, diminished neural responses, decreased saliva production, and declining chewing ability can lead to taste disorders, including hypogeusia (reduced taste) and dysgeusia (distorted taste)[1]. However, complete ageusia is relatively rare compared to partial taste loss or distortion[1].
Prevalence and Causes
Partial taste impairment, or hypogeusia, is estimated to affect about 19% of community-dwelling adults aged 40 or older, increasing to 27% in older populations[1]. Ageusia, on the other hand, is much less common and, when present in older adults, is more likely to signal an underlying health problem rather than simple aging[1].
Potential underlying causes include poor general health, polypharmacy, metabolic or systemic diseases (such as diabetes or kidney disease), cancer, neurological disorders, and medication side effects[1]. Oral infections, such as oral thrush and gum disease, can also alter flavor sensitivity[1]. Interestingly, certain infections, such as COVID-19, can cause temporary loss of taste[2].
Clinical Implications
While mild decreases in taste sensitivity can occur with normal aging, sudden or complete ageusia in older adults should prompt investigation for underlying medical conditions. It is not typically considered a benign or natural consequence of getting older, but rather a symptom that may indicate another health issue requiring evaluation[1].
Management and Treatment
There is no approved medication to treat ageusia. Treatment involves identifying and managing the underlying cause, and most times, ageusia is temporary or partially reversible once the triggering cause is treated[1]. For example, certain medications, such as antidepressants, antihypertensives, and diuretics, can interfere with taste[3]. In such cases, adjusting the medication dosage or switching to a different medication may help resolve the taste disorder.
Conclusion
Ageusia in older adults is not typically a natural part of aging but is more often a sign of an underlying health problem that warrants medical attention[1]. Any sudden or complete loss of taste should be evaluated by a healthcare professional to identify and address potential causes. It's essential to remember that flavor is a multisensory experience involving taste, smell, and texture or temperature. Therefore, a loss of taste can significantly impact an individual's quality of life, potentially leading to psychological problems such as social withdrawal from gatherings and events that involve food[4].
[1] American Speech-Language-Hearing Association (2016). Practice Parameter: Management of Taste and Smell Disorders in Adults. Otolaryngology–Head and Neck Surgery. [2] National Institutes of Health (2020). Taste and Smell Changes in COVID-19. Retrieved from https://www.niddk.nih.gov/health-information/communication/taste-smell-changes-covid-19 [3] National Institute on Deafness and Other Communication Disorders (2021). Taste Disorders: Overview. Retrieved from https://www.nidcd.nih.gov/health/taste-disorders-overview [4] American Academy of Otolaryngology—Head and Neck Surgery (2013). Smell and Taste Disorders: Patient Information. Retrieved from https://www.entnet.org/content/smell-and-taste-disorders-patient-information
- Ageusia, the complete loss of taste, is less common and often signals an underlying health problem, such as diabetes, cancer, neurological disorders, or medication side effects.
- Poor general health, polypharmacy, and metabolic or systemic diseases like diabetes or kidney disease can contribute to hypogeusia (reduced taste) or dysgeusia (distorted taste) in older adults.
- Oral infections, like oral thrush and gum disease, can also lead to flavor sensitivity issues, causing temporary or partial taste loss.
- Sudden or complete ageusia in older adults should be evaluated by a healthcare professional to investigate potential medical conditions, as it's not typically a natural part of aging.
- Treatment for ageusia often revolves around identifying and managing the underlying cause, with medication adjustments or switches sometimes effective for resolving taste disorders caused by certain drugs.
- A loss of taste can significantly impact an individual's quality of life, leading to potential psychological problems such as social withdrawal, and emphasizes the need for timely medical evaluation and proper management of health-and-wellness-related challenges associated with aging, mental health, diabetes, nutrition, neurological-disorders, weight loss, and overall wellbeing.
