Gustatory and Olfactory Changes with Age

描述(申请人提供)：不良感觉和认知副作用 来自处方药的药物会导致不依从，从而危及 老年人的健康和福祉。然而，这些疾病的流行 对人口的影响，它们的严重性，它们的时间进程，它们 其特殊性、可逆性及其根本原因/机制 在前瞻性研究中没有被量化。这项假设驱动的研究将 探讨抗胆碱能活动作为感觉和心理调节机制的作用 药物的认知副作用。超过250种药物(包括47.5% 根据IMS America的数据，在131种最常开出的药物中， 国家处方审计)已被临床报道会损害感官 味道和/或气味。这些药物中的大多数在临床上也与 视力、听力、构思和/或认知受损。所有的药物中 导致味觉、嗅觉和其他感觉/认知扭曲，显著 比例具有抗胆碱能活性(例如，唾液分泌减少/干燥 口腔、瞳孔扩大/视力模糊，认知功能改变，包括 记忆力丧失和挫伤)，这些药物不良反应的报道更多 通常发生在年长的人身上。这项前瞻性研究将确定 全身用药对化学感官的影响 视觉、听觉、合成和认知。我们将检验三个假设： A)显示抗胆碱能活性的药物(第1组)将损害所有 感官(味觉、嗅觉、视觉、听觉、合成)和认知。为 这些药物，损失的大小将与水平有关 用唾液总流量测定抗胆碱能活性。的程度 感觉障碍也将与认知程度相关。 功能障碍。预计损失的大小将随着 服用了抗胆碱能药物。B)临床上报告给 导致味觉和嗅觉障碍，但没有抗胆碱能副作用 根据心理生理测量，(第2组)被预测会损害味觉和嗅觉 但不会损害认知功能。它们可能会也可能不会改变 视觉和试镜。C)将发现味觉和嗅觉敏感度的变化 对于组I和组2中的药物随时间的变化以及与对照组的比较 不服用药物的小组。这些研究将为以下方面提供循证数据 医生和患者对相对风险、程度、进展和 药物诱导的感觉和认知副作用的潜在可逆性 老年人的药物治疗。

DESCRIPTION (provided by applicant): Adverse sensory and cognitive side effects from prescription medications can lead to noncompliance and thus jeopardize the health and well-being of older individuals. However, the prevalence of these effects in the population, their severity, their time course, their specificity, their reversibility, and their underlying causes/mechanisms has not been quantified in prospective studies. This hypothesis-driven study will investigate the role of anticholinergic activity as a mechanism for sensory and cognitive side-effects of medications. Over 250 drugs (including 47.5 percent of the 131 most frequently prescribed medications as measured by IMS America's National Prescription Audit) have been reported clinically to impair the senses of taste and/or smell. Most of these drugs are also associated clinically with impaired vision, audition, somesthesis and/or cognition. Of the drugs that cause taste, smell and other sensory/cognitive distortions, a significant proportion has anticholinergic activity (e.g. reduced salivary secretion/dry mouth, dilated pupils/blurred vision, altered cognitive function including memory loss and contusion), and these adverse drug reactions are reported more frequently in older individuals. This prospective study will determine the effects of medications taken systemically on the chemical senses as well as vision, audition, somesthesis, and cognition. Three hypotheses will be tested: a) Medications that exhibit anticholinergic activity (group 1) will impair all the senses (taste, smell, vision, audition, somesthesis) and cognition. For these drugs, the magnitude of loss will be related to the level of anticholinergic activity as measured by total salivary flow. The degree of sensory impairment will also be correlated with the degree of cognitive dysfunction. The magnitude of loss is expected to increase with the number of anticholinergic drugs taken. b) Medications that are reported clinically to cause taste and smell impairments but have no anticholinergic side-effects (group 2) are predicted to impair taste and smell as measured psychophysically but will not impair cognitive function. They may or may not alter the senses of vision and audition. c) Changes in taste and smell sensitivity will be found for medications in groups I and 2 both over time and in comparison to a control group not on medications. These studies will provide evidence-based data for physicians and patients on relative risks, magnitude, progression, and potential reversibility of drug-induced sensory and cognitive side-effects of medications in elderly people.