Assessing Taste and Smell Dysfunction in Acute and Chronic Stroke Patients: Insights From an Adapted Bedside Questionnaire

Abstract

Introduction: Taste and smell dysfunctions are underinvestigated stroke symptoms. The lack of awareness and standardized assessment may contribute to the underrecognition of these dysfunctions, despite their clinical relevance. We aimed to assess their frequency after stroke, associated factors, and impact on health and quality of life.

Methods: With a cross-sectional design, we included stroke patients at the acute (Stroke Unit) and chronic stroke phases (Stroke Outpatient Clinic) between September 2020 and December 2022. We collected patients characteristics, conducted a structured interview to evaluate taste and smell dysfunction, and applied an adaptation of the "Taste and Smell Survey" (TSS) to the stroke context.

Results: We included 128 patients, 57 in the acute and 71 in the chronic phase. Forty-nine patients (38%) reported taste dysfunction, not significantly different in the two settings (24.4% vs. 25.3%, p = 0.425). In patients with supratentorial stroke (n = 112), taste dysfunction was significantly associated with insula involvement (OR = 3.5, 95% CI 1.5-8.3, p = 0.004), left hemisphere lesion (OR = 2.4, 95% CI 1.0-5.5, p = 0.048), and dyslipidemia (OR = 2.3, 95% CI 1.01-5.4, p = 0.047). Smell dysfunction was reported in 12% of patients. Chronic taste dysfunction was associated with more severe quality-of-life impacts, including weight loss.

Conclusion: This study highlights the frequency and impact of taste and smell dysfunctions after stroke. Routine assessment is essential for early identification and management. The questionnaire to explore taste and smell dysfunction was simple and easy to apply, and could be a useful tool in this setting. Future research should validate these findings with objective taste and smell testing.

Keywords: smell dysfunction; stroke; taste and smell survey; taste dysfunction.