Among older adults, a decreased ability to identify scents is a strong indicator of death within five years, a new study suggests. The study, published October 1, 2014 in the journal PLOS ONE, indicates that 39 percent of participants who could not successfully complete a simple smelling test died within that time period, compared to 19 percent of individuals with moderate smell loss and 10 percent of those with a healthy sense of smell.

The researchers called the dangers of smell loss “strikingly robust,” moreso than most chronic diseases. Olfactory dysfunction had a better chance of predicting mortality than a diagnosis of heart failure, lung disease or cancer. Severe liver damage was the only indicator of death that was more powerful. High-risk individuals who lacked a sense of smell had over twice the probability of death.

The study’s lead author, Jayant M. Pinto, MD, associate professor of surgery at the University of Chicago who specializes in the genetics and treatment of olfactory and sinus disease, said in a statement, “We think loss of the sense of smell is like the canary in the coal mine.” He continued, “It doesn’t directly cause death, but it’s a harbinger, an early warning that something has gone badly wrong, that damage has been done. Our findings could provide a useful clinical test, a quick and inexpensive way to identify patients most at risk.”

According to NIH Senior Health, issues with smell increase as people age, and are more common among men than women.