Abstract Rationale Olfactory dysfunction has been described in multiple systemic and pulmonary diseases but has not been characterized in interstitial lung disease (ILD). Because ILD patients frequently experience malnutrition and reduced quality of life, unrecognized olfactory impairment could further exacerbate these outcomes. We aimed to determine whether olfactory dysfunction is present in ILD and to define potential scent-specific differences. Methods Adults with a confirmed diagnosis of ILD were recruited from a specialty ILD clinic. Age-matched control data were drawn from a preexisting olfactory databank. All participants completed the Sino-Nasal Outcome Test (SNOT-22) and the Questionnaire of Olfactory Disorders-Negative Statements (QoD-NS). Objective olfactory testing was performed using the Affordable Rapid Olfaction Measurement Array (AROMA), which assesses detection and identification of 14 distinct odors at four concentrations (1X-8X). Composite and scent-specific scores (0-100) were calculated. Analyses were performed in R (v4.4.0) using Wilcoxon rank-sum, t-tests, and chi-square tests, with p 0.05 considered significant. Results Forty-eight participants (24 ILD, 24 controls) were analyzed. Mean age was 71 (ILD) and 70 (controls, p = 0.4). ILD participants had significantly lower composite olfactory scores compared with controls (64.4±14.1 vs 74.3±16.5; p = 0.0114, Cohen’s d = -0.64). ILD patients performed worse for several scents, including lavender (62.5 vs 84.4, p = 0.004), lemon (31.2 vs 55.2, p = 0.012), clove (79.2 vs 94.8, p = 0.044), licorice (68.8 vs 86.5, p = 0.010), and eucalyptus (45.9 vs 65.6, p = 0.043). No association was observed between olfactory performance and pulmonary function (FVC ρ=-0.13, p = 0.56; DLCO ρ = 0.24, p = 0.27). SNOT-22 and QoD-NS scores were slightly higher in ILD but not statistically significant. Conclusions Patients with ILD exhibit measurable olfactory dysfunction, with deficits in specific scents suggesting selective sensory impairment. Given the established links between smell, nutrition, and well-being, olfactory dysfunction may represent an underrecognized contributor to malnutrition and reduced quality of life in ILD. Future studies should explore mechanisms underlying this dysfunction and evaluate whether sensory-targeted interventions can improve nutritional status and patient-reported outcomes in ILD. This abstract is funded by: None
Emery et al. (Fri,) studied this question.