Does presbygeusia really exist? An updated narrative review

This review critically assessed the existence of presbygeusia, i.e., the impairment in taste perception occurring in the elderly, as a natural part of the aging process and its potential clinical implications. Several factors might contribute to age-related taste alterations (TAs), including structural changes in taste buds, alterations in saliva composition, central nervous system changes, and oral microbiota dysbiosis. A comprehensive literature review was conducted to disentangle the effects of age from those of the several age-related diseases or conditions promoting TAs. Most of the included studies reported TAs in healthy elderly people, suggesting that presbygeusia is a relatively frequent condition associated with age-related changes in the absence of pathological conditions. However, the impact of TAs on dietary preferences and food choices among the elderly seems to be less relevant when compared to other factors, such as cultural, psychological, and social influences. In conclusion, presbygeusia exists even in the absence of comorbidities or drug side effects, but its impact on dietary choices in the elderly is likely modest. Taste alterations (TAs) – defined as abnormalities or changes in the sense of taste involving a modification in the perception of flavours, which can result in a diminished, altered, or distorted sense of taste – are common in older people. TAs are probably a natural part of the aging process, so that the term presbygeusia may justifiably be used for defining abnormal taste perception of the elderly, in the absence of well recognized pathological or pharmacological conditions. The clinical implications of TAs on health status and dietary choices of the elderly are likely modest, as many other factors have been reported to be ultimately more relevant in influencing food intake of old people.