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Review
. 2025 Apr 7:6:1510257.
doi: 10.3389/fragi.2025.1510257. eCollection 2025.

Age-defying swallowing

María-Itatí Palacio  1 , Rosa-María Bermejo  1 , Ana-María Lucas-Ochoa  1 , Ana-María González-Cuello  1 , Emiliano Fernández-Villalba  1 , María-Trinidad Herrero  1
Affiliations
Review

Age-defying swallowing

María-Itatí Palacio et al. Front Aging. .

Abstract

Swallowing disorders, which are generally underdiagnosed, affect the elderly, leading to a decreased quality of life and complications, including aspiration pneumonia and death. Understanding the neurophysiology of swallowing and the causes of its dysfunction is a fundamental tool for the prevention, early diagnosis, and treatment of dysphagia. New technologies open a wide range of possibilities for the implementation of new care protocols for this disorder.

Keywords: ageing; dysphagia; new technologies; presbyphagia; prevention; swallowing.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The author(s) declared that they were an editorial board member of Frontiers, at the time of submission. This had no impact on the peer review process and the final decision.

Figures

FIGURE 1
FIGURE 1
Relevant processes in the development of swallowing during gestation and the first few months of life. The swallowing reflex is preserved throughout life.
FIGURE 2
FIGURE 2
Lateral view of the left hemisphere showing the cortical areas involved in swallowing: The precentral gyrus, the swallowing motor cortex (located within the primary motor cortex), the premotor cortex, the supplementary motor area, the anterior cingulate cortex, the anterior insula, and the lateral postcentral gyrus.
FIGURE 3
FIGURE 3
Motor control of swallowing in the central nervous system. The ideation of voluntary swallowing begins in the frontal cortex. Planning takes place in the prefrontal and somatosensory association cortices; planning is a joint effort between the cerebellum, motor cortex, and basal ganglia; for execution, the supplementary motor area, swallowing cortex, and insula send signals through the corticobulbar tract that will be received by the pattern generators (A) located in the medulla oblongata whose motor and sensory neurons will initiate and moderate swallowing.
FIGURE 4
FIGURE 4
Cranial nerve nuclei which are involved in swallowing. Motor nuclei: nucleus ambiguus (cranial nerves IX, X, and XI, the latter not involved in swallowing), trigeminal motor nucleus (for V), facial motor nucleus (cranial nerve VII), and hypoglossal nucleus. Sensory nuclei: nucleus of the solitary tract (cranial nerves VII, IX, and X) and specific regions of the trigeminal nucleus (cranial nerve V).
FIGURE 5
FIGURE 5
Causes of dysphagia. Causes of dysphagia can be divided into neurological, structural, other etiologies, and age-related changes, although the latter may not be a cause of dysphagia but rather an early symptom.
FIGURE 6
FIGURE 6
Changes during aging. Affected system, structures and functions affected, improvement or worsening, and impact on swallowing.
FIGURE 7
FIGURE 7
Age-related changes affecting swallowing. The combination of skeletal, muscular, sensory, and respiratory changes, along with decreased reflexes, salivation, laryngeal constriction and sensation, and increased medication use in this stage of life contributes to the onset of presbyphagia.
FIGURE 8
FIGURE 8
Swallowing treatments: a range of compensatory strategies, rehabilitation exercises, and neurostimulation techniques can be used alone or in combination.
FIGURE 9
FIGURE 9
Neuroplasticity-driven principles of neurorehabilitation for achieving rehabilitation treatment goals.
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