Judith Boyd, a blogger who hosts Style Crone, a blog dedicated to older women, has always had an eye for fashion. That’s why she stays sharp on all of her senses, not just her fashion sense.
“I have hearing aids,” she says. “I also started having problems with eyesight when I was 81. I had a macular hole and had surgery for that in my right eye. I also had cataract surgery.” This past October, she developed another macular hole, this time in her left eye. “So I had surgery there as well. Now I don't need glasses to see far, but I do need reading glasses.”
Many of us experience changes in our eyesight and hearing over the years, but did you know that the other senses could decline as well? Not long ago, we learned that people could lose their sense of smell (called anosmia) if they caught COVID-19, but loss of smell isn’t restricted to getting a virus. As people get older, they can develop anosmia too.
“Studies show 22% to 30% of older adults have changes in their ability to smell, and this rises to over 62% in those 80 and older,” says Emmanuel Osei-Boamah, MD, a primary care doctor at Mercy Medical Center in Baltimore, Maryland. Osei-Boamah is board certified in geriatric medicine.
The changes to the senses can be very gradual to the point that you don’t notice that they’re happening. “Many older adults are unaware that their ability to smell has changed, particularly among certain demographic groups,” Osei-Boamah says. And many people have more than one impaired sense. “Multisensory impairment is the norm rather than the exception. Two-thirds of older adults have impairment in two or more senses (most commonly hearing and vision), with only 6% having no sensory deficits,” he explains.
Since you might not realize your senses aren’t as sharp as they used to be, it’s important to understand how the changes occur, what checkups you need (and how often), and how caring for your senses may lower your risks of future problems. Perhaps even more important though is that knowing and understanding might help us destigmatize the decline of the senses so people feel more comfortable asking for help.
Changing Senses Can Be More Than Inconvenient
There’s been a lot of research into how changing senses can affect you as you age.
Hearing. Several studies have found that untreated hearing loss is related to social isolation as well as cognitive decline, frailty, depression, and dementia. Hearing loss often happens when the tiny hair cells in your ear are damaged, but there are also other causes, including reactions to medications and how your brain interprets the sounds.
Sight. Losing your vision, even partially, can lead to isolation too because you might stop driving or feel unsure of walking down the street, shopping, or participating in your regular activities.
“I think that not being able to hear [and] not being able to see creates loneliness, and loneliness as we get older is a possible side effect of loss,” says Boyd.
Low vision can also be a danger. If you can’t see something clearly, you can trip over it. You might not see that a stove burner is on or the name of a cleaning fluid, and so on. Eye changes can be related to many things, Osei-Boamah says. They can be structural (like when the retina gets thin) or cataracts, or related to how your brain processes what you see.
Smell. At first, losing your sense of smell might not seem so bad, but not being able to smell can cause problems as simple as not being able to smell food that has gone bad, or as serious as not noticing if there’s smoke or gas in the air. One reason for the change in smell might be that the smell-sensing nerves get damaged over time or that the brain doesn’t interpret the smells as clearly any more.
Taste. Part of the pleasure of eating (and often socializing) is being able to taste your food and drink and enjoy it. Loss of taste doesn’t happen as often as the loss of smell, but it can be a problem. If you can’t taste the food, you might lose interest in eating, which can lead to fewer meals with friends and family or even malnutrition if nothing tastes good.
Touch. Humans have a need to be touched. Socially, you might not feel a pat on the arm or the fur of your pet as you touch it. That feeling of being touched is an important aspect of mental health. It also affects your safety. You might not feel rubbing that might cause a blister, or you might get a cut or burn but not know it.
Osei-Boamah explains that this happens because as you age, there are fewer nerve endings in the skin and they lose some of their protective coating, so they’re not as efficient anymore. “Interestingly, pleasant touch sensations may be preserved or even enhanced in older age,” he says.
Finally, a decrease in the feeling of touch can lead to falls. If you can’t feel the floor as you walk, this can change your gait (how you walk) and your balance.
Tests to Monitor Your Senses
There aren’t routine tests for smelling or tasting, but if there are any signs of changes, they should be checked. “Evaluation is recommended when patients or family members report concerns or there are associated conditions like depression, dementia, or unintentional weight loss,” Osei-Boamah explains. He also says that if there’s a significant impact on someone’s quality of life, they should see an otolaryngologist (ear, nose, and throat specialist).
There also aren’t any routine tests for touch, he adds, but if there seems to be an issue, then a neurological exam should be done.
Vision. The American Academy of Ophthalmologists recommends that healthy people aged 65 and older see their eye doctor every one to two years. “More frequent screening is recommended for high-risk groups, including African Americans and Hispanics (for glaucoma), and patients with diabetes,” Osei-Boamah says.
Most people can see an optometrist for regular eye checkups, but if you have a complex condition like cataracts, glaucoma, macular degeneration, or another type of eye disease, you’ll be referred to an ophthalmologist, a specialist in eye health.
Hearing. The World Health Organization (WHO) recommends that everyone aged 65 and older get their hearing tested every one to three years. This screening can be performed by trained health workers, primary care doctors, or audiologists using simple methods like questionnaires and special devices that check how your eardrum responds to sound. If the screening shows anything concerning, an audiologist (a hearing specialist) can do a hearing test, which will check for hearing loss.
Helping Yourself
Vision. Glasses and contact lenses can correct many types of vision problems, but sometimes surgery is the answer, like for cataracts. Macular degeneration might be treated with injected medications, and glaucoma can often be managed with eye drops. If your vision can’t be improved, low vision devices like magnifiers can be helpful. You can find local resources by visiting the National Federation of the Blind or the American Council of the Blind. While the word “blind” is in their name, these organizations also help people with low vision.
Hearing. Hearing aids used to be only available through audiologists, but in 2022, the FDA created a new category of hearing aids to help people with mild-to-moderate hearing loss. A more advanced tool if hearing aids don’t help is a cochlear implant. This is used to treat moderate to severe hearing loss. These implants don’t give you back your hearing, but they help you understand the sounds that you can hear.
Some causes of hearing loss are treatable. Sometimes a decrease in hearing is due to a buildup of earwax, and once it’s removed, the sound is much clearer. Or perhaps antibiotics are needed if you have an ear infection, or corticosteroids to reduce swelling. Surgery is an option for certain types of hearing loss as well.
Smell and taste. It’s important to speak to your doctor if you find that either sense is decreasing because it might be caused by something treatable. If there isn’t a disease or some treatable issue causing it, then some lifestyle changes might help you stay safe and enjoy food again:
- Set a timer when cooking, since you won’t be able to smell if your food starts to burn.
- Install a smoke detector and make sure to change the batteries regularly.
- Check expiration dates on foods.
- Work with a dietitian to find ways to make foods you enjoy, even if you don’t taste the food.
Touch. Whether your doctor has found a cause for the reduced sensation or not, it’s important to take steps to protect yourself from harm, such as:
- Check your skin, especially your feet, regularly for any wounds or blisters.
- Treat all minor skin injuries quickly.
- Wear good shoes to help maintain balance.
- Install handrails in the bathroom and other areas of the home where you can hold for balance.
- Use a cane or walker if needed.
- Remove all fall and trip risks (scatter rugs, electrical wires, etc.).
As we age, it’s not unusual to lose the sharpness of some of your senses, but it’s important to recognize that this might happen so you can protect yourself from possible serious outcomes, like depression, dementia, falls, and a lower quality of life.
“To be able to be out in our culture and to be able to see the beauty around us and to be able to hear the people that are dear to us is so important to maintain,” says Boyd.
Speak with your doctor about how you can help yourself or someone you care about who you suspect may be losing some of their ability to sense things.
