The relationship between metacognitive awareness of olfactory ability and age in people reporting chemosensory disturbances

THERESA L. WHITE and DANIEL B. KURTZ
Clinical Olfactory Research Center, SUNY Upstate Medical University

When determining how much to rely on olfactory information, accurate estimates of olfactory ability are important. Nevertheless, metacognitive errors regarding olfactory ability are common in the normal population. Are older adults less accurate at estimating olfactory ability, or do they simply tend to make a particular type of estimation error? We examined data from 203 patients, all of whom self-rated olfactory ability and then were tested with the Odorant Confusion Matrix. The patients' self-reports did not match the objective measure of olfactory ability in 42% of the cases, thus demonstrating a high level of impairment in metacognitive knowledge. Neither the cause of loss nor the patient's age was related to the inability to accurately estimate olfactory loss, but both contributed to the type of metacognitive errors patients made. Younger patients tended to underestimate their olfactory ability, thus behaving similarly to patients with "blindsight" who demonstrate residual visual function in the absence of awareness. Older patients tended to overestimate their olfactory ability, thus making the metacognitive error of deficit unawareness that is observed in a number of other clinical syndromes. These findings indicate that older patients are not necessarily more likely to make errors in estimating their olfactory ability; rather, they are more prone to a particular type of metacognitive error than are younger patients.