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JAMA Otolaryngol Head Neck Surg. 2018 Sep 1;144(9):807-814. doi: 10.1001/jamaoto.2018.1446.

Factors Associated With Phantom Odor Perception Among US Adults: Findings From the National Health and Nutrition Examination Survey.

Author information

1
National Institute on Deafness and Other Communication Disorders, National Institutes of Health, Bethesda, Maryland.
2
Social & Scientific Systems, Inc, Silver Spring, Maryland.
3
University of Vermont Medical Center, Burlington.

Abstract

Importance:

Phantom odor perception can be a debilitating condition. Factors associated with phantom odor perception have not been reported using population-based epidemiologic data.

Objective:

To estimate the prevalence of phantom odor perception among US adults 40 years and older and identify factors associated with this condition.

Design, Setting, and Participants:

In this cross-sectional study with complex sampling design, 7417 adults 40 years and older made up a nationally representative sample from data collected in 2011 through 2014 as part of the National Health and Nutrition Examination Survey.

Exposures:

Sociodemographic characteristics, cigarette and alcohol use, head injury, persistent dry mouth, smell function, and general health status.

Main Outcomes and Measures:

Phantom odor perception ascertained as report of unpleasant, bad, or burning odor when no actual odor exists.

Results:

Of the 7417 participants in the study, 52.8% (3862) were women, the mean (SD) age was 58 (12) years, and the prevalence of phantom odor perception occurred in 534 participants, which was 6.5% of the population (95% CI, 5.7%-7.5%). Phantom odor prevalence varied considerably by age and sex. Women 60 years and older reported phantom odors less commonly (7.5% [n = 935] and 5.5% [n = 937] among women aged 60-69 years and 70 years and older, respectively) than younger women (9.6% [n = 1028] and 10.1% [n = 962] among those aged 40-49 years and 50-59 years, respectively). The prevalence among men varied from 2.5% (n = 846) among men 70 years and older to 5.3% (n = 913) among men 60 to 69 years old. Phantom odor perception was 60% (n = 1602) to 65% (n = 2521) more likely among those with an income-to-poverty ratio of less than 3 compared with those in the highest income-to-poverty ratio group (odds ratio [OR], 1.65; 95% CI, 1.06-2.56; and OR, 1.60; 95% CI, 1.01-2.54 for income-to-poverty ratio <1.5 and 1.5-2.9, respectively). Health conditions associated with phantom odor perception included persistent dry mouth (OR, 3.03; 95% CI, 2.17-4.24) and history of head injury (OR, 1.74; 95% CI, 1.20-2.51).

Conclusions and Relevance:

An age-related decline in the prevalence of phantom odor perception is observed in women but not in men. Only 11% (n = 64) of people who report phantom odor perception have discussed a taste or smell problem with a clinician. Associations of phantom odor perception with poorer health and persistent dry mouth point to medication use as a potential explanation. Prevention of serious head injuries could have the added benefit of reducing phantom odor perception.

PMID:
30128498
PMCID:
PMC6233628
[Available on 2019-08-16]
DOI:
10.1001/jamaoto.2018.1446

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