title: Racial disparities in olfactory loss among older adults in the United States.
abstract: BACKGROUND
  Age-related olfactory loss (presbyosmia) substantially decreases quality of life, presages neurodegenerative disease, impairs nutrition, and predicts mortality. We sought to determine how race is associated with olfactory loss in older American adults in order to inform both health care and policy.
  
  
  METHODS
  The National Social Life, Health and Aging Project interviewed a cross-sectional nationally representative probability sample of older adults in the United States. African Americans and Hispanics were oversampled, providing power to detect disparities for these subgroups. As part of an omnibus survey of demographic, social, psychological, and biological measures, National Social Life, Health and Aging Project assessed the ability to verbally identify odors by presenting five odor pens. Multivariate ordinal logistic regression quantified racial differences in odor identification, and then tested potential confounders.
  
  
  RESULTS
  African Americans and Hispanics had markedly worse olfactory function (controlling for gender and age) compared with whites (p < .001), twice the magnitude of gender differences, and comparable to aging 9 years. Cognition, household assets, and education accounted for the disparity found among Hispanics but not among African Americans. Moreover, other potential confounders, such as physical or mental health, including tobacco and alcohol use, did not account for the African American health disparity, which remained significant (p = .001) after including these factors.
  
  
  CONCLUSIONS
  African Americans are more likely to suffer from presbyosmia, a health disparity not explained by gender, education, cognition, physical or mental health, and health behaviors. This novel health disparity may result from lifetime environmental exposures, diet, or genetic susceptibility. Dissecting the interactions among these putative mechanisms will provide insight into ameliorating this decline in critical human sensory function.
authors.affiliation: Section of Otolaryngology-Head and Neck Surgery, Department of Surgery, The University of Chicago Medicine and Biological Sciences, 5841 South Maryland Avenue, MC1035, Chicago, IL 60637. jpinto@surgery.bsd.uchicago.edu.
authors.forename: Jayant M
authors.initials: JM
authors.lastname: Pinto
authors.forename: Ludwig Philip
authors.initials: LP
authors.lastname: Schumm
authors.forename: Kristen E
authors.initials: KE
authors.lastname: Wroblewski
authors.forename: David W
authors.initials: DW
authors.lastname: Kern
authors.forename: Martha K
authors.initials: MK
authors.lastname: McClintock
mesh_terms: D001741:Black or African American / Q000706:statistics & numerical data*; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000428:Alcohol Drinking / Q000453:epidemiology; D001007:Anxiety / Q000453:epidemiology; D003071:Cognition / Q000502:physiology; D015897:Comorbidity; D015986:Confounding Factors, Epidemiologic; D003430:Cross-Sectional Studies; D003863:Depression / Q000453:epidemiology; D004522:Educational Status; D005260:Female; D015438:Health Behavior; D006304:Health Status; D006630:Hispanic or Latino / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D000857:Olfaction Disorders / Q000453:epidemiology*; D012737:Sex Factors; D012907:Smoking / Q000453:epidemiology; D012923:Social Class; D014481:United States / Q000453:epidemiology; D044465:White People / Q000706:statistics & numerical data*
keywords: Aging; Gender.; Olfaction; Race disparity