Prescription Medication Use and Phantom Odor Perception Among US Adults.

INTRODUCTION: Prescription medication use may be associated with phantom odor perception. We evaluated associations between number of prescription medications and their therapeutic class and phantom odor perception among U.S. adults. METHODS: Data were collected between 2011-2014 as part of the National Health and Nutrition Examination Survey (NHANES). A complex sampling design resulted in a nationally representative sample of 7,417 adults aged 40 years and older. During an in-home interview, participants were asked whether they had experienced an unpleasant, bad, or burning odor when nothing is there. Prescription medication use was assessed using validation with prescription bottles, when possible. RESULTS: Almost one quarter (23.3%) of adults uses ≥5 prescription medications. Use of five or more prescription medications is associated with 70% greater odds of phantom odor perception (OR 1.69 (1.09, 2.63)). Among adults 60 years and older, antidiabetic medications, antihyperlipidemic agents, and proton pump inhibitors are associated with 74-88% greater odds of report of phantom odor [OR=1.74 (1.09, 2.77), OR=1.85 (1.22. 2.80), and OR=1.88 (1.15, 3.07)], respectively. CONCLUSIONS: Phantom odor perception may be a side effect of antidiabetic or antihyperlipidemic agents. Among people taking proton pump inhibitors, phantom odors may also be a consequence of gastric gas reflux. IMPLICATIONS: Common prescription medications may be providing an olfactory stimulus.

Phantom odor perception and vascular conditions among adults in the United States: National Health and Nutrition Examination Survey 2011-2014.

OBJECTIVES/HYPOTHESIS: Phantom odor perception has been correlated with burden of vascular risk among older adults. We evaluated associations between vascular conditions and phantom odor perception among adults in the United States. STUDY DESIGN: Cross-sectional analysis. METHODS: Cross-sectional data were collected as part of the 2011 to 2014 National Health and Nutrition Examination Survey, yielding a nationally representative sample of 7,417 adults aged 40 years and older. Phantom odor perception was defined as report of an unpleasant, bad, or burning odor when nothing is there. Participants reported on vascular conditions including history of stroke. Total cholesterol and glycated hemoglobinwere measured. High blood pressure was ascertained during an examination. RESULTS: Stroke was associated with a 76% greater likelihood of phantom odor perception. Congestive heart failure and angina were associated with three times and 2.8 times the odds of phantom odor perception among adults 40 to 59 years and 60 years and older, respectively. Adults with diagnosed, but controlled, high cholesterol reported phantom odors more frequently than those without high cholesterol. Adults with diagnosed, but controlled, high blood pressure reported phantom odors more frequently than those without high blood pressure. We observed a threefold greater odds of phantom odor perception among adults aged 60 years and older with diabetes, but only among those who use both insulin and oral medications. CONCLUSIONS: Stroke, angina, congestive heart failure, well-managed high blood pressure, and well-managed high cholesterol are associated with phantom odor perception. Vascular or metabolic conditions or their treatments may contribute to reporting of phantom odor perception. LEVEL OF EVIDENCE: NA Laryngoscope, 130:332-337, 2020.

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

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.

U.S. hospitalizations for colorectal cancer 1970-2010.

BACKGROUND AND AIMS: The occurrence of colorectal cancer has been declining in the United States. The aim of the present study was to confirm such time trends using hospitalization data for colorectal cancer from the past four decades. METHODS: U.S. hospital utilization data were available for individual years from 1970 to 2010 through the National Hospital Discharge Survey. Colon and rectum cancer were analyzed separately stratified by their ICD-9CM codes. Hospitalizations during consecutive 5-year periods were expressed as annual rates per 100,000 living U.S. population. RESULTS: After an initial rise between 1970 and 1985, U.S. hospitalizations for colorectal cancer have declined ever since. Similar trends were found in men and women, and for colon and rectum cancer analyzed separately. The rise and fall of both cancer types were statistically significant (p < 0.001). The decline was most pronounced in the 65 years and older age group. CONCLUSIONS: Hospitalizations for colorectal cancer have declined in the United States since the mid-1980s. The onset of this decline preceded the widespread use of screening for colorectal cancer. Other mechanisms besides screening may have contributed to this observed decline.

Disease severity is associated with the use of complementary medicine to treat or manage type-2 diabetes: data from the 2002 and 2007 National Health Interview Survey.

BACKGROUND: The overall prevalence of complementary medicine (CM) use among adults in the United States with diabetes has been examined both in representative national samples and in more restricted populations. However, none of these earlier studies attempted to identify predictors of CM use to treat diabetes among the populations sampled, nor looked for a relationship between CM use and diabetes severity. METHODS: Combining data from the 2002 and 2007 National Health Interview Survey (NHIS), we constructed a nationally representative sample of 3,978 U.S. adults aged ≥18 years with self-reported diabetes. Both the 2002 and 2007 NHIS contained extensive questions on the use of CM. We used logistic regression to examine the association between diabetes severity and overall CM use, as well as the use of specific categories of CM. RESULTS: In adults with type-2 diabetes, 30.9% used CM for any reason, but only 3.4% used CM to treat or manage their type-2 diabetes versus 7.1% of those with type-1 diabetes. Among those using CM to treat/manage their type-2 diabetes, 77% used both CM and conventional prescription medicine for their diabetes. The most prevalent types of CM therapies used were diet-based interventions (35.19%, S.E. 5.11) and non-vitamin/non-mineral dietary supplements (33.74%, S.E. 5.07). After controlling for sociodemographic factors, we found that, based on a count of measures of diabetes severity, persons with the most severe diabetes had nearly twice the odds of using CM as those with less severe disease (OR=1.9, 95%CI 1.2-3.01). Persons who had diabetes 10 years or more (OR=1.66, 95%CI 1.04-3.66) and those that had a functional limitation resulting from their diabetes (OR=1.74, 95%CI 1.09-2.8) had greater odds of using CM than those not reporting these measures. No significant associations were observed between overall CM use and other individual measures of diabetes severity: use of diabetic medications, weak or failing kidneys, coronary heart disease, or severe vision problems. CONCLUSIONS: Our results demonstrate that individuals with more severe diabetes are more likely to use CM independent of sociodemographic factors. Further studies are essential to determine if CM therapies actually improve clinical outcomes when used to treat/manage diabetes.