Swallowing Disorders in the Older Population

Abstract

Swallowing problems, or dysphagia, are common as people age, and are associated with significant negative outcomes, including weight loss, pneumonia, dehydration, shortened life expectancy, reduced quality of life, and increased caregiver burden. In this article, we will discuss the complex process of swallowing in normal circumstances and with healthy aging, then review etiologies that contribute to dysphagia. We will discuss approaches to evaluating and treating dysphagia, providing relevant data where they are available. We highlight the desperate need for high‐quality research to guide best practices in treating dysphagia in older adults. J Am Geriatr Soc 67:2643–2649, 2019

Analysis of Quality of Life and Nutritional Status in Elderly Patients with Dysphagia in Order to Prevent Hospital Admissions in a COVID-19 Pandemic

“…Oropharyngeal dysphagia (OD), or difficulty swallowing, is a common clinical symptom among older people [ 1 , 2 ]. Although aging in itself is not a cause of clinically evident OD, there are age-related changes that can affect all phases of swallowing [ 1 , 2 , 3 , 4 ]. Indicators of OD in healthy older people include the lack of teeth, esophageal weakness, and decreased cognitive function [ 3 ].…”

“…Although the prevalence in elderly patients is high and has a great impact on functional quality and morbimortality, it is one of the least known and most underestimated geriatric syndromes [ 1 , 3 ]. Different authors [ 4 , 6 , 12 ] underscore that OD is underdiagnosed due to the tendency of older patients to underestimate their swallowing problems, and caregivers are thus often unable to detect them.…”

“…Different authors [ 4 , 6 , 12 ] underscore that OD is underdiagnosed due to the tendency of older patients to underestimate their swallowing problems, and caregivers are thus often unable to detect them. These factors contribute to the appearance of complications, reduced life expectancy, and increased healthcare costs [ 1 , 13 , 14 ].…”

“…Complications of OD include malnutrition [ 3 , 15 ], dehydration [ 3 , 15 ], functional impairment [ 15 , 16 ], and aspiration pneumonia [ 3 , 15 , 17 ]—the latter being a major cause of morbidity and mortality due to infection in older people [ 1 , 3 , 15 ]. Furthermore, two of the most prominent consequences of OD are its impact on the quality of life of older people [ 3 , 16 , 18 ] and the increased burden it places on the caregiver [ 1 , 19 ].…”

COVID-19 Infection-Related Weight Loss Decreases Eating/Swallowing Function in Schizophrenic Patients

“…While no measurements of skeletal muscle mass were conducted in the present study, weight loss during treatment for COVID-19 can be attributed to cachexia, which is believed to lead to a decrease in the strength of swallowing-related muscles and to have effects on swallowing function [ 29 ]. Malnutrition is associated with decreased eating/swallowing function and can lead to dysphagia, which is one cause of malnutrition, in turn contributing to further malnutrition [ 30 ]. Preventing malnutrition during treatment for COVID-19 infection is important to maintain eating/swallowing function.…”