The Swallowing Profile of Healthy Aging Adults: Comparing Noninvasive Swallow Tests to Videofluoroscopic Measures of Safety and Efficiency

Molfenter, Sonja M.; Brates, Danielle; Herzberg, Erica G.; Noorani, Mehak; Lazarus, Cathy L.

doi:10.1044/2018_jslhr-s-17-0471

Cited by 29 publications

(22 citation statements)

References 56 publications

(56 reference statements)

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“…Of these, six of the boluses were extracted for this analysis: three trials of 22% w/v 5 ml thin liquid barium and three trials of 20 ml 22% w/v thin liquid barium (BraccoPolibar barium suspension diluted with water). The data set of older healthy adults included VF studies from 44 participants (21 men, 23 women) 65 years old and older (M age = 76.9 years, SD = 7.1 years), originally collected for separate analyses (Molfenter, Brates, Herzberg, Noorani, & Lazarus, 2018;Molfenter, Lenell, & Lazarus, 2019). Participants were healthy, community-dwelling volunteers with no history of neurological disease, head and neck cancer, or self-reported swallowing difficulties.…”

Section: Participantsmentioning

confidence: 99%

Measuring Hyoid Excursion Across the Life Span: Anatomical Scaling to Control for Variation

Brates

Steele

Molfenter

2020

J Speech Lang Hear Res

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Purpose A method for controlling for sex-based differences in measures of hyoid movement using an internal anatomical scalar has been validated in young healthy individuals. Known anatomical changes with aging necessitate validation of this methodology in a mixed-age sample. The primary aim of this study was to validate a method for controlling for sex-based differences in measures of hyoid movement across the life span. Measurement error as a potential source of variability was addressed to inform best practice recommendations. Method Two distinct data sets previously collected using identical protocols were combined for this study to achieve a data set of young (< 40 years) and older (> 65 years) healthy adults. Data included videofluoroscopic swallow studies with three swallow trials each of 5 and 20 ml thin liquid barium. Previously reported methodology was replicated to validate the use of an anatomical scalar for measuring hyoid excursion in this sample. Hyoid movement was measured using 2 methods (rest-to-peak displacement and peak only) in 3 planes of movement (anterior, superior, and hypotenuse), was expressed in millimeters and individually scaled units relative to C4, and normalized using the C2–C4 vertebral distance. Mixed-model repeated-measures analyses of variance were run with each of the 6 hyoid measures as the dependent variable (in both millimeters and C2–C4 units), within-subject factors of sex and bolus volume, and a between-subjects factor of age group. We predicted that the C2–C4 scalar would adequately control for sex-based differences across age groups. Results Significant differences in absolute hyoid movements (millimeters) were observed by sex, bolus volume, and age group. When measured in %C2–C4 units, all differences between males and females were neutralized. Significant differences between 5- and 20-ml boluses were found for all peak position measures. Significant differences between young and older individuals were found for all peak position measures. Conclusion Expressing hyoid excursion as a percentage of the C2–C4 distance appears valid for use across the life span. Peak position is preferable over displacement measures for quantifying hyoid excursion for research and clinical purposes.

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Section: Participantsmentioning

confidence: 99%

Measuring Hyoid Excursion Across the Life Span: Anatomical Scaling to Control for Variation

Brates

Steele

Molfenter

2020

J Speech Lang Hear Res

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“…Regarding the implementation of EAT-10 to screen dysphagia; EAT-10 is simple, fast, and can be applied by most of the health professionals, and an increased score of EAT-10 may indicate a self-perception of severe dysphagia (15). In a recent study comparing noninvasive swallow tests to videofluoroscopic methods; though none of the swallowing measures were shown to be different regarding safety, several variables such as age, EAT-10, and 3-oz water swallow challenge trended to distinguish efficiency of swallows (41). So, further studies are needed regarding the association of dysphagia with sarcopenia defined by EWGSOP2 criteria.…”

Section: Discussionmentioning

confidence: 99%

Self Reported Dysphagia is not Associated with Sarcopenia Defined by the Revised EWGSOP2 Criteria and Regional Thresholds at the Hospital Among Ambulatory Older Patients

Savaş

Yılmaz

2019

Mater Sociomed

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Introduction: Dysphagia and sarcopenia are geriatric syndromes, and they are shown to be related. There is no study on dysphagia and sarcopenia with the revised European Working Group on Sarcopenia in Older People (EWGSOP)2 criteria. Aim: We aimed to evaluate dysphagia and sarcopenia with the revised criteria implementing regional thresholds for skeletal muscle mass (SMM) in hospitalized older patients. Methods: Ambulatory patients ≥60 years of age from the Internal Medicine Department of our hospital were taken into the study. Grip strength, SMM via bioelectrical impedance analysis, nutritional status, dysphagia screening with Eating Assessment Tool-10, prior hospitalizations and diet were evaluated. Sarcopenia was defined by EWGSOP2 criteria using regional SMM thresholds adjusted to body mass index (BMI) (SMMI (BMI)). Results: Out of 112, 61 patients were enrolled. Sarcopenia, nutritional risk, and dysphagia were shown in 36.1%, 88.5%, and 14.8% of the patients. The risk of dysphagia was not associated with sarcopenia (p=0.263). Hospitalizations (≥1) in one year with pneumonia, modified diet, malnutrition, and low SMMI (BMI) were more common in patients with dysphagia risk than in the patients without (p=0.001, p<0.01, p=0.011, p=0.008, respectively). The median age and BMI were higher where SMMI (BMI) was lower in the group with dysphagia risk than in the group without (p=0.016, p=0.034, p=0.032), respectively. Conclusion: We found that self-reported dysphagia was not associated with sarcopenia defined by the EWGSOP2 criteria in ambulatory hospitalized patients over 60 years of age. Further studies using revised criteria, different adjustments and thresholds are needed to reveal possible differences.

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“…Extant research [33][34][35] suggests that the swallowing function declines with age and a majority of age-related changes in swallowing occur after the age of 60 years [36]. Understanding agerelated change in swallowing is important for several reasons.…”

Section: Aging Effects On Swallowing and Swallowing Related Lateralitymentioning

confidence: 99%

Effects of dual-task interference on swallowing in healthy aging adults

Krishnamurthy

Philip²,

Balasubramanium

et al. 2021

PLoS ONE

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A wide body of literature has demonstrated that the neural representation of healthy swallowing is mostly bilateral, with one hemisphere dominant over the other. While several studies have demonstrated the presence of laterality for swallowing related functions among young adults, the data on older adults are still growing. The purpose of this paper is to investigate potential changes in hemispheric dominance in healthy aging adults for swallowing related tasks using a behavioral dual-task paradigm. A modified dual-task paradigm was designed to investigate the potential reduction in hemispherical specialization for swallowing function. Eighty healthy right-handed participants in the study were divided into two groups [Group 1: young adults (18–40 years) and Group 2: older adults (65 and above)]. All the participants performed a timed water swallow test at baseline and with two interference conditions (silent word repetition, and facial recognition). The results of the study revealed the following 1) a statistically significant effect of age on swallow performance; 2) statistically significant effect of each of the interference tasks on two of the swallow measures (VPS and VPT) in younger adults; and 3) no significant effect of the interference tasks on the swallowing performance of older adults. These findings suggest that aging substantially affects swallowing in older individuals, and this potentially accompanies a reduction in the hemispheric specialization for swallowing related tasks.

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The Swallowing Profile of Healthy Aging Adults: Comparing Noninvasive Swallow Tests to Videofluoroscopic Measures of Safety and Efficiency

Abstract: Our findings support the notion that larger pharyngeal volumes (measured using acoustic pharyngometry) are associated with worse swallowing efficiency, a finding we attribute to atrophy of the pharyngeal musculature in healthy aging.

Cited by 29 publications

References 56 publications

Measuring Hyoid Excursion Across the Life Span: Anatomical Scaling to Control for Variation

Measuring Hyoid Excursion Across the Life Span: Anatomical Scaling to Control for Variation

Self Reported Dysphagia is not Associated with Sarcopenia Defined by the Revised EWGSOP2 Criteria and Regional Thresholds at the Hospital Among Ambulatory Older Patients

Effects of dual-task interference on swallowing in healthy aging adults

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