Engstrom, Gabriella

Chronic pain is highly prevalent in older adults and often negatively
associated with health-related quality of life (HRQoL). This study
compared HRQoL, including physical health and mental health, in
persons of differing ethnicities, and identified factors associated with
pain intensity and HRQoL in ethnically diverse older adults. Older
adults with chronic pain from four ethnic groups (African Americans,
Afro-Caribbeans, Hispanics, and European Americans) were recruited
from the Florida Atlantic University Healthy Aging Research Initiative
(HARI) registry. The Medical Outcomes Study Short Form-36
(SF-36) was used to evaluate HRQoL, including functional status,
emotional well-being, and social functioning. Of 593 persons in the
four ethnic groups in the registry, 174 met the inclusion criteria (pain
level of four or higher on an 11-point scale, lasting 3 months or
longer). Among these 174, African Americans reported the highest
level of pain intensity, followed by Afro-Caribbeans, Hispanics, and
European Americans. Hispanics reported the highest physical health
scores and the lowest mental health scores. In contrast, African
Americans reported the highest mental health scores and the lowest
physical health scores. Multivariate linear regression analysis revealed
that ethnicity, lower physical health scores, and lower mental
health scores were significantly (p # .01) associated with pain intensity.
Understanding ethnic variations in response to pain intensity
may address gaps in knowledge about HRQoL to reduce disparities in
optimal care. Health care providers should consider ethnic norms and
cultural diversity to provide optimal interventions for this population.

With large numbers of Americans over 65 years of age, millions of elderly individuals
could be at risk for swallowing disorders or dysphagia. These disorders can greatly affect
a person’s quality of life and health. While the aging process in a healthy individual does
not necessarily lead to impaired swallowing, aging can lead to changes in the swallowing
process, known as presbyphagia (Robbins, et al., 1992). Further data is needed regarding
prevalence, effects of lifestyle, and relationship with fatigue and swallowing abilities in healthy aging
individuals. The purpose of this study was to: investigate the prevalence of self-reported swallowing
difficulties in a healthy aging population; determine if age, ethnicity, or gender impact whether healthy
aging individuals perceive swallowing problems; and, if individuals reporting swallowing difficulties
experience avoidance of social situations or if fatigue relates as a factor in presbyphagia. A significantly
greater proportion of Hispanic Americans indicated swallowing difficulties than expected by chance,
18.8% "No" vs. 40.5% "Yes" (p = .0035). Further analysis indicated those who self-reported swallowing
difficulties were less socially engaged (t = 1.75, p = .048) and, for people who self-reported swallowing
difficulties a significant correlation between reduced social aspects of life and increased level of fatigue
(r = -.473, p = .003).Previous studies have reported mealtime anxiety and avoidance of eating with
other people in elderly individuals (Ekberg, 2002). Overall, the negative social impact from
presbyphagia can seriously affect an individual’s quality of life, however, early identification of
swallowing difficulties and remediation may be beneficial.