This “Cinderella sense” could be linked to more than 130 disorders

A The critical sense linked to a whole series of illnesses has long been hidden under – or rather under – our noses.

While doctors often check patients’ hearing and vision, it is much less common to test people’s sense of smell. But a person’s “smell health” is potentially linked to more than 139 conditions that occur throughout the body, including Alzheimer’s disease, congestive heart failure and Parkinson’s disease, according to a study recently published in Clinical otolaryngology.

The COVID-19 pandemic has focused more attention on olfactory dysfunction, which refers to a loss of or impaired sense of smell, but the authors noted that cases are likely underdiagnosed. “The sense of smell lags behind the senses of sight and hearing in terms of perceived importance and remains the Cinderella sense,” they wrote.

The authors cite the fact that olfactory dysfunction currently affects about 22% of people worldwide, and is particularly prevalent among men and people over 60 years old. Most commonly associated with aging, olfactory dysfunction can also be caused by upper respiratory infections like COVID-19, head trauma, or chronic sinus inflammation. Some people report it as a side effect of certain medications, such as some medications that treat high cholesterol.

Read more: »The doctor will sniff you now»

Regular screening for olfactory dysfunctions is crucial because it can allow early detection of certain diseases. For example, partial or total loss of smell can occur more than four years before the onset of motor symptoms of Parkinson’s disease, the journal points out. The nose can signal neurodegenerative diseases years before other signs appear, because damage can begin in parts of the brain associated with smell before such deterioration leads to more systemic problems.

Olfactory dysfunction may also be linked to a 10-year risk of stroke and a long-term risk of congestive heart failure, a finding among older adults who reported otherwise good health. More broadly, olfactory health appears to strongly predict mortality in the elderly.

A good sense of smell is also essential for a healthy diet: people with smell and taste disorders tend to eat diets higher in calories, fats and added sugars, which can lead to nutritional deficiencies and obesity.

Ultimately, fragrances are essential to our overall well-being, the paper points out. People with olfactory dysfunction experience high rates of eating disorders, depression, and social isolation. Indeed, the sense of smell is inextricably linked to our pleasure of eating, our social communication and the need to avoid harms like spoiled food and smoke.

The authors insisted that smell “should be promoted as an essential pillar of health.” They recommend educating health care providers around the world about olfactory dysfunction, intensifying related research to identify treatments, and increasing access to olfactory testing.

After all, the nose knows a lot more about our health than we think.

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Main image: Rijksmuseum / Wikimedia Commons

• Molly Glick

  Published on December 3, 2025

  Molly Glick is the newsletter editor of Nautilus.