240 likes | 244 Views
Dysguesia in the Elderly. Quratulain Syed, M.D. Emory University School of Medicine, Atlanta, GA. Disclosure. No Financial Disclosures. Learning Objectives. Describe the association between taste and smell disorders Describe the commonly prevalent etiologies of taste disorders
E N D
Dysguesia in the Elderly Quratulain Syed, M.D. Emory University School of Medicine, Atlanta, GA
Disclosure • No Financial Disclosures
Learning Objectives • Describe the association between taste and smell disorders • Describe the commonly prevalent etiologies of taste disorders • Describe initial assessment and management of taste disorders in primary care settings
Case Scenario • Ms. Smith is an 89 year old female nursing home resident admitted to hospital for failure to thrive. • loss of appetite • Lack of taste in food • 25 lb weight loss in the past 6 months
Background Dysgeusia can impact: • enjoyment of food • nutritional status • management of chronic diseases
Overlap of taste and smell disorders (Deems, Doty et al. 1991)
Statistics-community dwellers (Bhattacharyya and Kepnes 2015)
Institutionalized Elderly (Glazar, Urek et al. 2010)
Hospitalized Elderly (Solemdal, Sandvik et al. 2014)
Hospitalized Elderly (Solemdal, Sandvik et al. 2014)
Hospitalized Elderly (Toffanello, Inelmen et al. 2013)
Etiology • Upper respiratory infections • Head trauma • Medications • Oral/dental health • Chronic diseases • Nutritional deficiencies
Oral and dental conditions • Xerostomia • Dentures issues • Dental caries • Periodontal disease • Candidiasis, stomatitis • Dental-alveolar infections
Chronic Diseases • Diabetes • Untreated hypothyroidism • Chronic kidney disease • Chronic hepatitis C • Heart disease • Cognitive disorders • Parkinson’s disease • Head and neck cancer
Nutritional Deficiencies • Zinc • Vitamin A • Vitamin B12 • Hyponatremia
Management (Syed, Hendler et al. 2016)
Follow up on Ms. Smith • Review of medicines • Dietician consult • Treatment of periodontal disease
Conclusion • Recognize dysguesias in older adults presenting with weight loss • Look into: • Oral health • Medicine list