Temmel and colleagues ¹¹ reported that almost all of the investigated patients (n=278) reported difficulties in daily life due to their olfactory disorder. Specifically, 73% complained of difficulties with cooking, 68% of mood changes, 56% of decreased appetite, 50% eating of rotten food, 41% to little perception of own body odor, 30% of burning food, but only 8% of problems at work. Similar figures were reported by Miwa et al. ⁷⁶ who investigated 345 patients with persisting olfactory dysfunction. The most commonly cited impairments were ability to detect spoiled food (75%), gas leaks (61%), or smoke (50%); eating (53%); and cooking (49%). Thus, problems in quality-of-life issues were reported primarily in the areas of safety and eating. Overall satisfaction with life was reported to be reduced to only 50% of the impaired group. Approximately 25% of their patients indicated that they enjoyed life less. Interestingly, in both studies ^{11, 76} relatively few patients (< 15%) complained of work-related problems due to olfactory loss which maintains the idea that even for anosmic people social functioning is still possible. In fact, in our clinic we have seen chefs who continue their jobs without attracting attention in their professional environments - which is largely due to the fact that most of the cooking is done according to specific recipes or through the processing of pre-prepared foods.

Nevertheless, areas most affected through olfactory loss appear to be eating and safety. This corresponds to observations made by Tennen et al. ⁵⁴, that a "feeling of vulnerability" is the single most stressful aspect of olfactory dysfunction. This complaint was reported by 28% of 66 investigated patients with smell disorders.

Both age and gender seem to have a significant effect on difficulties in daily life due to olfactory dysfunction ¹¹. Specifically, the youngest patients had the highest degree of difficulties (²40 years: 54%; 41-60 years: 53%; >60 years: 38%) (compare ⁷⁷), and women mentioned more complaints than men (women: 53%, men: 42%) (see also ^{78, 79}). Gender effects have also been reported such that olfactory dysfunction appears to be more likely change eating habits in female than in male patients ⁷⁷. This may be interpreted such that olfaction is more important to women than to men. This idea is also supported by the rule that, if gender differences are found, female subjects score higher on olfactory tasks than do men ^80-83. In other words, the world seems to smell different to men and women. In turn, the total or partial loss of this odorous environment is much more meaningful to women than it is for men.

In a study of 72 patients with anosmia (46%) and hyposmia (54%), 77% considered that quality of life in general had deteriorated after the onset of their dysfunction. Based on a retrospective question, olfaction was considered by 90% to be of more importance after than before the dysfunction started. Seventy-five percent experienced risks caused by their dysfunction, 63% found their daily routines to be negatively affected and 34% experienced that their dysfunction affected health. Fifty percent of these latter patients reported depression, and psychological well-being was compromised, which was assessed with the General Well-Being Schedule. Reduced food appreciation and appetite was reported by 53% and 32%, respectively. Physical health, financial security, profession, partnership, friendship, emotional stability and leisure were all rated as important for life quality and rated as negatively affected by their olfactory dysfunction ⁸⁴.

Interestingly, neither duration of disease, nor etiology of the olfactory dysfunction had significant effects on the patients' complaints - other than what has been reported by Tennen et al. ⁵⁴.

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