Q I heard that smell disorders can be an early sign of Parkinson's disease or dementia. Should I be worried?
A Smell disorder is known to be one of the early signs that can appear years before Parkinson's disease and Alzheimer's disease. However, most smell disorders are due to other causes such as rhinitis or COVID-19 and do not immediately indicate a neurodegenerative disease. If gradual smell decline of unknown cause appears after the age of 50 along with accompanying symptoms such as hand tremor or memory decline, a neurology evaluation is recommended.
Detailed Answer
The association between smell disorders and neurodegenerative diseases is well established in neuroscience.
Parkinson's disease:
- In over 90% of Parkinson's patients, smell decline occurs several years before motor symptoms
- Lewy bodies accumulate in the olfactory bulb from an early stage
- Smell testing is being studied as an early Parkinson's screening tool
Alzheimer's disease:
- The entorhinal cortex is one of the early sites of damage
- Decline in the ability to identify odors is particularly prominent
Realistic interpretation:
- The majority of smell disorders are caused by rhinitis, viruses, smoking, and the like, and are unrelated to neurodegeneration
- Neurology consultation is needed when there is unknown cause + age over 50 + gradual progression + accompanying memory/motor symptoms
Korean Medicine Clinic Perspective
At Dongjedang, for smell decline of unknown cause, we first recommend a neurology evaluation. After neurodegenerative causes are ruled out, adjunctive Korean medicine treatment that maintains and strengthens overall brain and body function can be combined.
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