Oropharyngeal dysphagia in the elderly

Abstract

Considerable evidence exists to suggest that normal aging alone does not cause significant impairment to the ability to swallow. Although there are changes in muscular tension, speed of responses, taste sensitivity, and smell, the physiology of swallowing remains relatively intact. There is evidence suggesting that the duration of the oropharyngeal swallow is longer in older females and that esophageal motility slows in normal aging. Elderly persons do produce multiple lingual gestures and may eat softer and less spicy foods. These changes are subtle and subclinical but do not indicate oropharyngeal dysphagia. Oropharyngeal dysphagia in the elderly is the specific result of a pathologic condition or illness that may occur more commonly in elderly persons. These conditions are neurologic, neuromuscular, systemic, immunologic, psychiatric, environmental, or societal in nature. Oropharyngeal dysphagia is commonly found in institutionalized elderly populations and presents an ethical dilemma in treatment.