How Should Dysphagia Care of Older Adults Differ? Establishing Optimal Practice Patterns

Abstract

An unprecedented demographic transformation is occurring as our population ages. Those older than age 65 represent the fastest growing segment of the population. Within this older group, approximately 10% to 30% of adults are estimated to have dysphagia, but true incidence and prevalence are unknown. They make up a heterogeneous mix of both healthy and disabled individuals that reside across a spectrum of living settings. As clinicians approach older adults with dysphagia, general geriatric principles should be followed to optimize care for this diverse group. Likewise, practitioners need to appreciate the physiology that distinguishes a healthy old swallow from dysphagia and acknowledge the wide array of causes that contribute to dysphagia in older people. Clinicians need to recognize the heterogeneity in health, functional abilities, social supports, and resources among the elderly and understand how these factors may influence approaches to dysphagia in different care settings. Standard outcome measures of pneumonia, malnutrition, and mortality must be blended with other quality of life indices. Advanced directives are essential in caring for elderly patients with dysphagia irrespective of their health acuity or care setting. Ultimately, patient and family preferences should dictate the swallowing and feeding interventions offered.

Dysphagia in stroke: Development of a standard method to examine swallowing recovery

“…In addition, because our healthy control subjects were matched for age with our stroke group, the age range for our control group was fairly restricted (mean = 62 years, 62% were younger than age 65). Previous research has found that longer transit times and increased age are associated [19][20], and that in older populations, the point at which swallowing may differ notably from younger subjects is between the ages of 65 and 70 [21][22]. As such, a larger sample size that incorporates a greater number of healthy adults over the age of 65 may provide a more accurate range of normal transit times and better delineate dysphagia from normal variances in swallowing.…”

Understanding the Rheological Parameters of Thickened Fluids for Dysphagia Sufferers

“…Dysphagia can occur due to a range of medical conditions, including premature birth, cerebral palsy, Alzheimer's disease, cancer of the oesophagus, Parkinson's disease and stroke (Althaus, 2002, Vivanti et al, 2009). It affects individuals of all ages (Whelan, 2001, Saigal andDoyle, 2008), but commonly with the elderly where their swallowing difficulty arises due to illness, polypharmacy and weakened reserves (Barczi et al, 2000, Cabre et al, 2010.…”

Nurses' Perception and Experiences at Nursing Home Residents with Dysphagia: Focus Group Interviews

“…의 40~60%가 연하 장애를 갖고 있는 것으로 보고되고 있다 (Barczi, Sullivan, & Robbins, 2000). 우리나라의 경우 전국 적인 자료는 없으나 요양시설노인의 10~30% 정도가 연하장애 로 인한 건강문제를 가지고 있는 것으로 추정되었으며 (Choi, 2009), 2010년 대도시 소재 두 곳의 노인요양시설 거주 노인 전수를 대상으로 한 연구에서는 노인의 52.7%가 연하장애가 있는 것으로 보고되었다 .…”