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[Drug related taste disturbances: emphasis on the elderly].

BACKGROUND
Taste disturbances are common among the elderly due to physiologic changes, diseases, and medications. As many as 11% of elderly persons using multiple drugs report taste aberrations. The main danger of taste decline and disturbance in the old is food-anhedonia, causing loss of body weight via decreased calorie and nutrient intake.


GOALS
To overview drug related taste disturbances emphasizing the elderly.


METHODS
Review of Hebrew and English medical literature.


RESULTS
Taste-disturbances can be divided into hypogeusia [diminished sense of taste], ageusia [absence of taste], and the 2 types of dysgeusia [taste distortion]: aliageusia [food related] and phantogeusia [taste illusions]. The mechanisms by which drugs impair taste are numerous, and may be related to drug chemical structure. The treatment of taste disturbances is empiric and has limited success. Treatments include: shifting drugs within the same class, zinc replacement (proven to enhance taste sensation for sweet, bitter and salty flavors), palliative measures (use of mints, sugarless chewing-gums, and bicarbonate mouthwashes), niacin and vitamin A ameliorate hypo and dysgeusia.


CONCLUSIONS
Disturbed taste sensation is common among the elderly, and should be considered whenever unexplained nutritional decline is present. Scrupulous drug screening is mandatory, and other intervention modalities can be beneficial.