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Jean-Martin Charcot (1825–1893), son of a Parisian craftsman, went on to a brilliant university career and worked his way to the top of the hospital hierarchy. Becoming a resident in 1858 at the women’s nursing home and asylum at La Salpêtrière Hospital, he returned there in 1868 as chief physician. Observing more than 2,000 elderly women, he first worked as a geriatrician–internist, leading him to describe thyroid pathology, cruoric pulmonary embolism, and so forth. To deal with the numerous nervous system pathologies, he applied the anatomoclinical method with the addition of microscopy. In less than around 10 years, his perspicacious clinical eye enabled him to describe Parkinson’s disease, multiple sclerosis, amyotrophic lateral sclerosis, and tabetic arthropathy and to identify medullary localizations, for example. Already aware of functional neurological disorders, at that time referred to as hysteria and frequent to this day, Charcot used hypnosis to try to decipher the pathophysiology. His thinking gradually evolved from looking for lesions to recognizing triggering psychological trauma. This prolonged search, misinterpreted for years, opened the way to fine, precise clinical semiology, specific to neurology and psychosomatic medicine. Charcot knew how to surround himself with a cohort of brilliant clinicians, who often became as famous as he was, notably Pierre Marie (1853–1940), Georges Gilles de la Tourette (1857–1904), Joseph Babiński (1857–1932), and Pierre Janet (1859–1947). This cohort and the breadth of Charcot’s innovative work define what is now classically called the “Salpêtrière School.”

Decreased ability to smell is common in older persons. Some demonstrable smell loss is present in more than 50% of those 65 to 80 years of age, with up to 10% having no smell at all (anosmia). Over the age of 80, 75% exhibit some loss with up to 20% being totally anosmic. The causes of these decrements appear multifactorial and likely include altered intranasal airflow patterns, cumulative damage to the olfactory receptor cells from viruses and other environmental insults, decrements in mucosal metabolizing enzymes, closure of the cribriform plate foramina through which olfactory receptor cells axons project to the brain, loss of selectivity of receptor cells to odorants, and altered neurotransmission, including that exacerbated in some age-related neurodegenerative diseases.