Dysphagia in Aging

Abstract

Dysphagia is a common problem in older patients and is becoming a larger health care problem as the populations of the United States and other developed countries rapidly age. Changes in physiology with aging are seen in the upper esophageal sphincter and pharyngeal region in both symptomatic and asymptomatic older individuals. Age related changes in the esophageal body and lower esophageal sphincter are more difficult to identify, while esophageal sensation certainly is blunted with age. Stroke, Parkinson's disease, amyotrophic lateral sclerosis, Zenker's diverticula, and several other motility and structural disorders may cause oropharyngeal dysphagia in an older patient. Esophageal dysphagia can also be caused by both disorders of motility (achalasia, diffuse esophageal spasm, scleroderma and others) and structure (malignancy, strictures, rings, external compression, and others). Many of these disorders have an increased prevalence in older patients and should be sought with an appropriate diagnostic evaluation in older patients. The treatment of dysphagia in older patients is similar to that in younger patients, but more invasive therapies such as surgery may not be possible in some older patients making less aggressive medical and endoscopic therapy more attractive.

Staple-assisted endoscopic management of Zenker’s diverticula: a role in the geriatric population

“…In the geriatric population, dysphagia is a frequently described symptom with prevalence rates ranging from 6.9% up to 40% in selected populations [1]. Zenker's diverticulum (ZD) has been found to be almost exclusively affecting this older aged cohort.…”

Dysphagia From Extrinsic Compression of Esophagus by Pericardial Effusion

“…Compression of the esophagus by an enlarged left atrium (e.g., from mitral stenosis) has been documented, however, compression by a pericardial effusion has not been reported. 1,2 A detailed history is essential to identify the cause of the dysphagia. Subsequent workup is directed by the initial assessment.…”

Análise da fisiologia da deglutição por meio da ultra-sonografia

“…Os indivíduos de 51-60 anos apresentaram força e tônus da musculatura supra e infra-hióidea e cursa com a deglutição senescente (5,35) .…”

“…Indivíduos idosos são mais susceptíveis a esta condição (35,36) . Para Costa (2000) (30), alguns indivíduos normais podem, ao ingerir alguns tipos de alimento e sob determinadas circunstâncias, apresentar deglutições com curso prejudicado de hióide e laringe, assim como…”

“…O envelhecimento é responsável por algumas alterações no sistema neuromuscular que levam a um decréscimo da força muscular (48) , ocorrendo também, mudanças estruturais e funcionais em todo o processo de deglutição (4,5,35,36) . Os nervos periféricos e centrais, bem como a função das estruturas da musculatura estriada, promovem redução da atividade funcional da musculatura orofaríngea e dos lábios (4) .…”