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Aging Clinical and Experimental Research

, Volume 24, Issue 6, pp 570–579 | Cite as

Taste loss in the elderly: epidemiology, causes and consequences

  • Alessandra ImoscopiEmail author
  • Emine Meral Inelmen
  • Giuseppe Sergi
  • Fabrizia Miotto
  • Enzo Manzato
Review Article
  • 691 Downloads

Abstract

Taste disorders are common among older people and may have serious consequences on their health status: each of the five main flavors (salty, sweet, sour, bitter and umami) has a specific function and a declining taste acuity or taste loss predisposes the elderly to a higher risk of developing certain diseases. Taste disorders often go unrecognized or underestimated in elderly people, however, and there is little medical literature on this issue. This study focused on analyzing the existing literature, paying particular attention to the causes of taste disorders in the elderly and their potential consequences. The most common causes of taste disorders are drug use (21.7%), zinc deficiency (14.5%) and oral and systemic diseases (7.4% and 6.4%, respectively). All these factors can have a negative effect on gustatory system deficiencies due to physiological changes associated with aging. Elderly people are liable to have several chronic diseases and to routinely need multiple medications, and this carries a particular risk of taste disorders or severe loss of the ability to taste the five basic flavors. It is noteworthy that the most useful drugs for treating chronic diseases typical of the elderly are also a potential cause of taste disorders, so periodically reviewing pharmacological therapies is not just a matter of good clinical practice, but also helps to prevent or contain taste disorders. Assessing gustatory function should be a part of any comprehensive geriatric assessment, especially in elderly hospital outpatients or inpatients, or institutionalized cases, with severe conditions that require multiple pharmacological therapies, as well as in elderly patients who are malnourished or at risk of malnutrition, with a view to limiting the modifiable causes of taste disorders.

Key words

Taste thresholds taste disorders taste aging taste disease polypharmacy malnutrition 

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References

  1. 1.
    Fukunaga A, Uematsu H, Sugimoto K. Influences of aging on taste perception and oral somatic sensation. J Gerontol A Biol Sci Med Sci 2005; 6: 109–13.CrossRefGoogle Scholar
  2. 2.
    Schiffman SS, Graham BG. Taste and smell perception affect appetite and immunity in the elderly. Eur J Clin Nutr 2000; 54 (Suppl 3): 54–63.CrossRefGoogle Scholar
  3. 3.
    Spitzer ME. Taste acuity in institutionalized and non-institutionalized elderly men. J Gerontol 1988; 43: 71–4.CrossRefGoogle Scholar
  4. 4.
    Schiffman SS. Critical illness and changes in sensory perception. Proc Nutr Soc 2007; 66: 331–45.PubMedCrossRefGoogle Scholar
  5. 5.
    Fukasawa T, Orii T, Tanaka M, Yano S, Suzuki N, Kanzaki Y. Statistical approach to the drug-induced taste disorders based on zinc chelating ability. Yakugaku Zasshi 2005; 125: 377–87.PubMedCrossRefGoogle Scholar
  6. 6.
    Schiffman S. Effects of aging on the human taste system. Ann NY Acad Sci 2009; 1170: 725–9.PubMedCrossRefGoogle Scholar
  7. 7.
    Hoffman HJ, Cruickshanks KJ, Davis B. Perspective on population- based epidemiological studies of olfactory and taste impairment. Ann NY Acad Sci 2009; 1170: 514–30.PubMedCrossRefGoogle Scholar
  8. 8.
    Bergdahl M, Bergdahl J. Perceived taste disturbances in adults: prevalence and association with oral and psychological factors and medication. Clin Oral Invest 2002; 6: 145–9.CrossRefGoogle Scholar
  9. 9.
    Kettaneh A, Paries J, Stirnemann J et al. Clinical and biological features associated with taste loss in internal medicine patients. A cross-sectional study of 100 cases. Appetite 2005; 44: 163–9.PubMedCrossRefGoogle Scholar
  10. 10.
    Glazar I, Urek MM, Brumini G, Pezelj-Ribaric S. Oral sensorial complaints, salivary flow rate and mucosal lesions in the institutionalized elderly. J Oral Rehabil 2010; 37: 93–9.PubMedCrossRefGoogle Scholar
  11. 11.
    Handelman SL, Baric JM, Saunders RH et al. Hyposalivatory drug use, whole stimulated salivary flow, and mouth dryness in older, long-term care residents. Spec Care Dent 1989; 9: 12–8.CrossRefGoogle Scholar
  12. 12.
    Shklar G. The effects of aging upon oral mucosa. J Invest Dermatol 1966; 47: 115–20.PubMedCrossRefGoogle Scholar
  13. 13.
    Loe H, Karring T. The three-dimensional morphology of the epithelium connective tissue interface of the gingiva as related to age and sex. Scand J Dent Res 1971; 79: 315–26.PubMedGoogle Scholar
  14. 14.
    Moreira CR, Azevedo LR, Pereira Lauris JR, Taga R, Damante JH. Quantitative age-related differences in human sublingual gland. Arch Oral Biol 2006; 51: 960–6.PubMedCrossRefGoogle Scholar
  15. 15.
    Nordin S, Bramerson A, Bringlov E et al. Substance and tongueregion specific loss in basic taste-quality identification in elderly adults. Eur Arch Otorhinolaryngol 2007; 264: 285–9.PubMedCrossRefGoogle Scholar
  16. 16.
    Kullaa-Mikkonen A, Koponen A, Seilonen A. Quantitative study of human fungiform papillae and taste buds: variation with aging and in different morphological forms of the tongue. Gerodontics 1987; 3: 131–5.PubMedGoogle Scholar
  17. 17.
    Ship JA. The influence of aging on oral health and consequences for taste and smell. Physiol Behav 1999; 66: 209–15.PubMedCrossRefGoogle Scholar
  18. 18.
    Mac Donald DE. Principles of geriatric dentistry and their application to the older adult with a physical disability. Clin Geriatr Med 2006; 22: 413–34.CrossRefGoogle Scholar
  19. 19.
    Ritchie CS. Oral health, taste, and olfaction. Clin Geriatr Med 2002; 18: 709–17.PubMedCrossRefGoogle Scholar
  20. 20.
    Heckmann JG, Stossel C, Lang CJG, Neundorfer B, Tomandl B, Hummel T. Taste disorder in acute stroke. Stroke 2005; 36: 1690–4.PubMedCrossRefGoogle Scholar
  21. 21.
    Kim JS, Choi-Kwon S, Kwon SU, Kwon JH. Taste perception abnormalities after acute stroke in postmenopausal women. J Clin Neurosci 2009; 16: 797–801PubMedCrossRefGoogle Scholar
  22. 22.
    Steinbach S, Hundt W, Vaitl A et al. Taste in mild cognitive impairment and Alzheimer’s disease. J Neurol 2010; 257: 238–46.PubMedCrossRefGoogle Scholar
  23. 23.
    Shah M, Deeb J, Fernando M et al. Abnormality of taste and smell in Parkinson’s disease. Parkinsonism Relat Disord 2009; 15: 232–7.PubMedCrossRefGoogle Scholar
  24. 24.
    Scinska A, Sienkiewicz-Jarosz H, Kuran W, Ryglewicz D et al. Depressive symptoms and taste reactivity in humans. Physiol Behav 2004; 82: 899–904.PubMedGoogle Scholar
  25. 25.
    Ship JA. Diabetes and oral health: an overview. J Am Dent Assoc 2003; 134: 4s–10s.PubMedGoogle Scholar
  26. 26.
    Gondivkar SM, Indurkar A, Degwekar S, Bhowate R. Evaluation of gustatory function in patients with diabetes mellitus type 2. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2009; 6: 876–80.Google Scholar
  27. 27.
    Naka A, Riedl M, Luger A, Hummel T, Mueller CA. Clinical significance of smell and taste disorders in patients with diabetes mellitus. Eur Arch Otorhinolaryngol 2010; 267: 547–50.PubMedCrossRefGoogle Scholar
  28. 28.
    Brosvic GM, Doty RL, Rowe MM. Influences of hypothyroidism on the taste detection performance of rats: a signal detection analysis. Behav Neurosci 1992; 6: 992–8.CrossRefGoogle Scholar
  29. 29.
    Cranganu A, Camporeale J. Nutrition aspects of lung cancer. Nutr Clin Pract 2009; 6: 688–700.CrossRefGoogle Scholar
  30. 30.
    Epstein JB, Barasch A. Taste disorders in cancer patients: pathogenesis and approach to assessment and management. Oral Oncol 2010; 46: 77–81.PubMedCrossRefGoogle Scholar
  31. 31.
    Ripamonti C. Taste alterations in cancer patients. J Pain Symptom Manag 1998; 6: 349–51.Google Scholar
  32. 32.
    Harris AM, Griffin SM. Postoperative taste and smell deficit after upper gastrointestinal cancer surgery — an unreported complication. J Surg Oncol 2003; 82: 147–52.PubMedCrossRefGoogle Scholar
  33. 33.
    Astbäck J, Fernström A, Hylander B, Arvidson K, Johansson O. Taste buds and neuronal markers in patients with chronic renal failure. Perit Dial Int 1999; 19 (Suppl 2): S315–23PubMedGoogle Scholar
  34. 34.
    Deems RO, Friedman MI, Friedman LS, Munoz SJ, Maddrey WC. Chemosensory function, food preference and appetite in human liver disease. Appetite 1993; 20: 209–16.PubMedCrossRefGoogle Scholar
  35. 35.
    Smith FR, Henkin RI, Dell RB. Disordered gustatory acuity in liver disease. Gastroenterology 1976; 70: 568–71.PubMedGoogle Scholar
  36. 36.
    Burch RE, Sackin DA, Ursick JA, Jetton MM, Sullivan JF. Decreased taste and smell acuity in cirrhosis. Arch Intern Med 1978; 138: 743–6.PubMedCrossRefGoogle Scholar
  37. 37.
    Madden AM, Bradbury W, Morgan MY. Taste perception in cirrhosis: its relationship to circulating micronutrients and food preferences. Hepatology 1997; 1: 40–6.CrossRefGoogle Scholar
  38. 38.
    Doty RL, Philip S, Reddy K, Kerr KL. Influences of antihyperlipemic drugs on the senses of taste and smell: a review. J Hypertension 2003; 10: 1805–13.CrossRefGoogle Scholar
  39. 39.
    Kamel VF, Maddison P, Whitaker R. Impact of primary Sjogren syndrome on smell and taste: effect on quality of life. Rheumatology 2009; 48: 1512–4.PubMedCrossRefGoogle Scholar
  40. 40.
    Whorwell PJ, McCallum M, Creed FH, Roberts CT. Non-colonic features of irritable bowel syndrome. Gut 1986; 27: 37–40.PubMedCrossRefGoogle Scholar
  41. 41.
    Steinbach S, Reindl W, Kessel C et al. Olfactory and gustatory function in irritable bowel syndrome. Eur Arch Otolarhinolaryngol 2010; 267: 1081–7.CrossRefGoogle Scholar
  42. 42.
    Gaude GS. Pulmonary manifestations of gastroesophageal reflux disease. Ann Thoracic Med 2009; 3: 115–23.CrossRefGoogle Scholar
  43. 43.
    Schutz T, Drude C, Paulisch E, Lange KP, Lochs H. Sugar intake, taste changes and dental health in Crohn’s disease. Dig Dis 2003; 21: 252–7.PubMedCrossRefGoogle Scholar
  44. 44.
    Zopf Y, Rabe C, Kollmann S, Hahn EG, Thurauf N, Schwab D. Alterations of taste perception in Crohn’s disease and their dependency on disease activity and nutritional behavior. J Clin Gastroenterol 2009; 7: 617–21.CrossRefGoogle Scholar
  45. 45.
    Dewan NA, Bell W, Moore J et al. Smell and taste function in subjects with chronic obstructive pulmonary disease. Chest 1990; 3: 595–9.CrossRefGoogle Scholar
  46. 46.
    Chapman-Novakofski K, Brewer S, Riskowski J, Burkowski C, Winter L. Alterations in taste thresholds in men with chronic obstructive pulmonary disease. J Am Diet Assoc 1999; 12: 1536–41.CrossRefGoogle Scholar
  47. 47.
    Sadananda Naik B, Shetty N, Maben EVS. Drug-induced taste disorders. Eur J Intern Med 2010; 21: 240–3.PubMedCrossRefGoogle Scholar
  48. 48.
    Tomita H, Yoshikawa T. Drug-related taste disturbance. Acta Otolaryngol 2002; 546: 116–21.CrossRefGoogle Scholar
  49. 49.
    Doty RL, Shah M, Bromley SM. Drug-induced taste disorders. Drug Safety 2008; 31: 199–215.PubMedCrossRefGoogle Scholar
  50. 50.
    Zervakis J, Graham BG, Schiffman SS. Taste effects of lingual application of cardiovascular medications. Physiol Behav 2000; 68: 405–13.PubMedCrossRefGoogle Scholar
  51. 51.
    Boyd I. Captopril-induced taste disturbance (letter). Lancet 1993; 342: 304.PubMedCrossRefGoogle Scholar
  52. 52.
    Young TM, Mathias CJ. Taste and smell disturbance with the a- adrenoceptor agonist midodrine. Ann Pharmacother 2004; 38: 1868–70.PubMedCrossRefGoogle Scholar
  53. 53.
    Cave AJ, Cox DW. Loss of taste with clopidogrel. Can Fam Physician 2008; 54: 195–6.PubMedGoogle Scholar
  54. 54.
    Golka K, Roth E, Huber J, Schmitt K. Reversible ageusia as an effect of clopidogrel treatment. Research Letters. The Lancet 2000; 5: 465–6.Google Scholar
  55. 55.
    Shiffman SS, Zervakis J, Westall HL et al. Effect of antimicrobial and anti-inflammatory medications on the sense of taste. Physiol Behav 2000; 69: 413–24.CrossRefGoogle Scholar
  56. 56.
    Breslin A, Gingrich TN, Green BG. Ibuprofen as a chemesthetic stimulus: evidence of a novel mechanism of throat irritation. Chem Sens 2001; 26: 55–65.CrossRefGoogle Scholar
  57. 57.
    Furniss L, Lloyd Craig SK, Burns A. Medication use in nursing homes for elderly people. Int J Geriatr Psychiatry 1998; 13: 433–9.PubMedCrossRefGoogle Scholar
  58. 58.
    Schiffman SS, Zervakis J, Suggs M, Cole Budd K, Iuga L. Effect of tricyclic antidepressants on taste responses in humans and gerbils. Pharmacol Biochem Behav 2000; 65: 599–609.PubMedCrossRefGoogle Scholar
  59. 59.
    Pahwa R, Lyons KE. Mirtazapine in essential tremor: a doubleblind, placebo-controlled pilot study. Mov Disord 2003; 18: 584–8.PubMedCrossRefGoogle Scholar
  60. 60.
    Muench J, Hamer A. Adverse effects of antipsychotic medications. Am Fam Physician 2010; 81: 617–22.PubMedGoogle Scholar
  61. 61.
    Phull PS, Price AB, Halliday D, Jacyna MR. Lansoprazole plus clarithromycin: evaluation of a new dual therapy for Helicobacter pylori eradication. Br J Clin Pract 1996; 50: 360–2.PubMedGoogle Scholar
  62. 62.
    Spielman AI. Chemosensory function and dysfunction. Crit Rev Oral Biol Med 1998; 9: 267–91.PubMedCrossRefGoogle Scholar
  63. 63.
    Lindley C, McCune JS, Thomason TE et al. Perception of chemotherapy side effects cancer versus noncancer patients. Cancer Pract 1999; 7: 59–65.PubMedCrossRefGoogle Scholar
  64. 64.
    Bernhardson BM, Tishelman C, Rutqvist LE. Self-reported taste and smell changes during cancer chemotherapy. Support Care Cancer 2008; 16: 275–83.PubMedCrossRefGoogle Scholar
  65. 65.
    Henkin RI. Drug-induced taste and smell disorders. Incidence, mechanisms and management related primarily to treatment of sensory receptor dysfunction. Drug Saf 1994; 11: 318–77.PubMedCrossRefGoogle Scholar
  66. 66.
    Jensen SB, Mouridsen HT, Bergmann OJ, Reibel J, Brünner N, Nauntofte B. Oral mucosal lesions, microbial changes, and taste disturbances induced by adjuvant chemotherapy in breast cancer patients. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2008; 106: 217–26.PubMedCrossRefGoogle Scholar
  67. 67.
    Alt-Epping B, Nejad RK, Jung K, Gross U, Nauck F. Symptoms of the oral cavity and their association with local microbiological and clinical findings — a prospective survey in palliative care. Support Care Cancer 2012; 20: 531–7.PubMedCrossRefGoogle Scholar
  68. 68.
    Rosenhall U, Hederstierna C, Idrizbegovic E. Otological diagnoses and probable age-related auditory neuropathy in “younger” and “older” elderly persons. Int J Audiol 2011; 50: 578–81.PubMedCrossRefGoogle Scholar
  69. 69.
    Huang CC, Lin CD, Wang CY, Chen JH, Shiao YT, Tsai MH. Gustatory changes in patients with chronic otitis media, before and after middle-ear surgery. J Laryngol Otol 2012; 126: 470–4.PubMedCrossRefGoogle Scholar
  70. 70.
    Windfuhr P, Sack F, Sesterhenn AM, Landis BN, Chen YS. Post-tonsillectomy taste disorders. Eur Arch Otorhinolaryngol 2010; 267: 289–93.PubMedCrossRefGoogle Scholar
  71. 71.
    Karatzanis A, Bourolias C, Prokopakis E, Panagiotaki I, Velegrakis G. Thermal welding technology vs ligasure tonsillectomy: a comparative study. Am J Otolaryngol 2008; 29: 238–41.PubMedCrossRefGoogle Scholar
  72. 72.
    Saunders J, Smith T. Malnutrition: causes and consequences. CME Nutrition 2010; 10: 624–7.Google Scholar
  73. 73.
    Kubrak C, Jensen L. Malnutrition in acute care patients: a narrative review. Int J Nurs Stud 2007; 44: 1036–54.PubMedCrossRefGoogle Scholar
  74. 74.
    Vanderwee K, Clays E, Bocquaert I, Gobert M, Folens B, Defloor T. Malnutrition and associated factors in elderly hospital patients: a Belgian cross-sectional, multi-centre study. Clin Nutr 2010; 29: 469–76. doi: 10.1016/j.clnu.2009.12.013._Epub 2010 Jan 25PubMedCrossRefGoogle Scholar
  75. 75.
    Stewart-Knox BJ, Simpson EEA, Parr H et al. Zinc status and taste acuity in older Europeans: the ZENITH study. Eur J Clin Nutr 2005; 59: 31–6.CrossRefGoogle Scholar
  76. 76.
    Yen PK. Nutrition: taste, smell, and appetite — they go together. Geriatr Nurs 1982; 3: 56–7.PubMedCrossRefGoogle Scholar
  77. 77.
    Vellappally S, Fiala Z, Smejkalova J, Jacob V, Somanathan R. Smoking-related systemic and oral disease. Acta Medica 2007; 50: 161–6.PubMedGoogle Scholar
  78. 78.
    Bogucka-Bonikowska A, Scinska A, Koros E et al. Taste responses in alcohol-dependent men. Alcohol Alcohol 2001; 36: 516–9.PubMedCrossRefGoogle Scholar
  79. 79.
    Russell R. Vitamin A and zinc metabolism in alcoholism. Am J Clin Nutr 1980; 33: 2741–9.PubMedGoogle Scholar
  80. 80.
    Akar GC, Ergul S. The oral hygiene and dentature status among residential home residents. Clin Oral Invest 2008; 12: 61–5.CrossRefGoogle Scholar
  81. 81.
    Baran I, Nalcaci R. Self-reported denture hygiene habits and oral tissue conditions of complete denture wearers. Arch Gerontol Geriatr 2009; 49: 237–41.PubMedCrossRefGoogle Scholar
  82. 82.
    Yamauchi Y, Endo S, Yoshimura I. A new whole-mouth gustatory test procedure. Acta Otolaryngol 2002; Suppl 546: 49–59.CrossRefGoogle Scholar
  83. 83.
    Mojet J, Christ-Hazelhof E, Heidema J. Taste perception with age: generic or specific losses in threshold sensitivity to the five basic tastes? Chem Senses 2001; 26: 845–60.PubMedCrossRefGoogle Scholar
  84. 84.
    Uneyama H, Kawai M, Sekine-Hayakawa Y, Torii K. Contribution of umami taste substances in human salivation during meal. J Med Invest 2009; 56 (Suppl): 197–204.PubMedCrossRefGoogle Scholar
  85. 85.
    Jyotaki M, Shigemura N, Ninomiya Y. Modulation of sweet taste sensivity by orexigenic and anorexigenic factors. Endocr J 2010; 57: 467–75.PubMedCrossRefGoogle Scholar
  86. 86.
    Rolls BJ. Do chemosensory changes influence food intake in the elderly? Physiol Behav 1999; 66: 193–7.PubMedCrossRefGoogle Scholar
  87. 87.
    Shiue I, Arima H, Hankey GJ, Anderson CS. Dietary intake of key nutrients and subarachnoid hemorrhage: a population-based case-control study in Australasia. Cerebrovasc Dis 2011; 31: 464–70.PubMedCrossRefGoogle Scholar
  88. 88.
    Liang W, Lee AH, Binns CW. Dietary intake of minerals and risk of ischemic stroke in Guangdong Province, China, 2007-2008. Prev Chron Dis 2011; 8: 1–9.Google Scholar
  89. 89.
    Strazzullo P, D’Elia L, Kandala NB, Cappuccio FP. Salt intake, stroke, and cardiovascular disease: meta-analysis of prospective studies. BMJ 2009; 339: b4567.PubMedCrossRefGoogle Scholar
  90. 90.
    Thomas MC, Moran J, Forsblom C et al. Association between dietary sodium intake, ESRD, and all-cause mortality in patients with type 1 diabetes. http:// care.diabetesjournals.org. January 2011.Google Scholar
  91. 91.
    Ekinci EI, Clarke S, Thomas MC et al. Dietary salt intake and mortality in patients with type 2 diabetes. Diabetes Care 2011; 34: 703–9.PubMedCrossRefGoogle Scholar
  92. 92.
    Frassetto LA, Morris Curtis R jr, Sellmeyer DE, Sebastian A. Adverse effects of sodium chloride on bone in the aging human population resulting from habitual consumption of typical American diets. J Nutr 2008; 138: 419s–22s.PubMedGoogle Scholar
  93. 93.
    Yang WG, Chen CB, Wang ZX et al. A case-control study on the relationship between salt intake and salty taste and risk of gastric cancer. World J Gastroenterol 2011; 17: 2049–53.PubMedCrossRefGoogle Scholar
  94. 94.
    Jarosz M, Sekula W, Rychlik E, Figurska K. Impact of diet on long-term decline in gastric cancer incidence in Poland. World J Gastroenterol 2011; 17: 89–97.PubMedCrossRefGoogle Scholar
  95. 95.
    Stolarz-Skrzypek K. Sugar and salt in the pathogenesis of elevated blood pressure. Hypertension 2011; 57: 676–8.PubMedCrossRefGoogle Scholar
  96. 96.
    Brown IJ, Stamler J, Van Horn L et al. Sugar-sweetened beverage, sugar intake of individuals, and their blood pressure. Hypertension 2011; 57: 695–701.PubMedCrossRefGoogle Scholar
  97. 97.
    Donaldson LF, Bennett L, Baic S, Melichar JK. Taste and weight: is there a link? Am J Clin Nutr 2009; 90 (Suppl): 800S–3S.PubMedCrossRefGoogle Scholar
  98. 98.
    Horio N, Jyotaki M, Yoshida R, Sanematsu K, Shigemura N, Ninomiya Y. New frontiers in gut nutrient research: nutrient sensors in the gastrointestinal tract: modulation of sweet taste sensivity by leptin. J Pharmacol Sci 2010; 112: 8–12.PubMedCrossRefGoogle Scholar
  99. 99.
    Umabiki M, Tsuzaki K, Kotani KK et al. The improvement of sweet taste sensivity with decrease in serum leptin levels during weight loss in obese females. Tohoku J Exp Med 2010; 220: 267–71.PubMedCrossRefGoogle Scholar
  100. 100.
    De Simone JA, Lyall V. Taste receptors in the gastrointestinal tract III. Salty and sour taste: sensing of sodium and protons by tongue. Am J Physiol Gastrointest Liver Physiol 2006; 291: G1005–10.CrossRefGoogle Scholar
  101. 101.
    Cola PC, Gatto AR, Da Silva RG, Spadotto AA, Schelp AO, Henry MAC. The influence of sour taste and cold temperature in pharyngeal transit duration in patients with stroke. Arq Gastroenterol 2010; 47: 18–21.PubMedGoogle Scholar
  102. 102.
    Pelletier CA, Lawless HT. Effect of citric acid and citric-acid sucrose mixtures on swallowing in neurogenic oropharyngeal dysphagia. Dysphagia 2003; 18: 231–41.PubMedCrossRefGoogle Scholar
  103. 103.
    Rozin P. Preference and affect in food selection. In: Kroeze JHA (Ed) Preference Behavior and Chemoreception. London: Information Retrieval Limited, pp 289–97.Google Scholar
  104. 104.
    Dotson CD, Zhang L, Xu H et al. Bitter taste receptors influence glucose homeostasis. PLoS ONE 2008; 3: e3974.PubMedCrossRefGoogle Scholar
  105. 105.
    Lindemann B. Receptors and transduction in taste. Nature 2001; 13: 413: 219–25.CrossRefGoogle Scholar
  106. 106.
    Schiffman SS, Miletic ID. Effect of taste and smell on secretion rate of salivary IgA in elderly and young persons. J Nutr Health Aging 1999; 3: 158–64.PubMedGoogle Scholar
  107. 107.
    Kurihara K, Kashiwayanagi M. Physiological studies on umami taste. J Nutr 2000; 130(4S Suppl): 931S–4S.PubMedGoogle Scholar
  108. 108.
    Shi HB, Masuda M, Umezaki T et al. Irradiation impairment of umami taste in patients with head and neck cancer. Auris Nasus Larynx 2004; 31: 401–6.PubMedCrossRefGoogle Scholar
  109. 109.
    Toyama K, Tomoe M, Inoue Y, Sanbe A, Yamamoto S. A possible application of monosodium glutamate to nutritional care for elderly people. Biol Pharm Bull 2008; 31: 1852–4.PubMedCrossRefGoogle Scholar
  110. 110.
    Yamamoto S, Tomoe M, Toyama K, Kawai M, Uneyama H. Can dietary supplementation of monosodium glutamate improve the health of the elderly? Am J Clin Nutr 2009; 90: 844S–9S.PubMedCrossRefGoogle Scholar
  111. 111.
    Van den Busche H, Koller D, Kolonko T et al. Which chronic diseases and disease combinations are specific to multimorbidity in the elderly? Results of a claims data based cross-sectional study in Germany. BMC Public Health 2011; 11: 101.CrossRefGoogle Scholar
  112. 112.
    Frutos Bernal E, Martin Corral JC, Villardon PG. Factores asociados a la polifarmacia en poblacion anciana no istitucionalizada. Analisis de la submuestra de la Encuesta Nacional de Salud 2006 para personas mayores de Castilla Leon. Revista Espanola de Geriatria y Gerontologia 2011, in press.Google Scholar
  113. 113.
    Dwyer L, Han B, Woodwell DA, Rechtsteiner EA. Polypharmacy in nursing home residents in the United States: results of the 2004 National Nursing Home Survey. Am J Geriatr Pharmacother 2010; 1: 63–72.CrossRefGoogle Scholar
  114. 114.
    Nobili A, Licata G, Salerno F et al. Polypharmacy, length of hospital stay, and in-hospital mortality among elderly patients in internal medicine wards. The REPOSI study. Eur J Clin Pharmacol 2011; 67: 507–19.PubMedCrossRefGoogle Scholar
  115. 115.
    Secoli SR. Polifarmacia: interacoes e reacoes adversas no uso de medicamentos por idosos. Revista Brasileira de Enfermagem 2010; 63: 136–40.PubMedCrossRefGoogle Scholar

Copyright information

© Editrice Kurtis 2012

Authors and Affiliations

  • Alessandra Imoscopi
    • 1
    • 2
    Email author
  • Emine Meral Inelmen
    • 1
  • Giuseppe Sergi
    • 1
  • Fabrizia Miotto
    • 1
  • Enzo Manzato
    • 1
  1. 1.Department of Medical and Surgical Sciences, Geriatric DivisionUniversity of PaduaPaduaItaly
  2. 2.Clinica Geriatrica — Ospedale Giustinianeo (2° piano)PadovaItaly

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