The purpose of this article is to describe normal, age-related changes in the swallowing mechanism, clinically referred to as “presbyphagia.” The authors compare presbyphagia in the oral, pharyngeal, and esophageal phases of the swallow to abnormal, or impaired swallowing, termed “dysphagia.” This article focuses on how older persons with Parkinson disease and multiple sclerosis frequently have dysphagia symptoms, such as food residue, delayed swallow trigger, penetration, and/or aspiration, superimposed over presbyphagia. Information on the psychosocial and emotional impacts of dysphagia on persons with Parkinson disease and/or multiple sclerosis, along with common treatment approaches to alleviate swallowing difficulties, has also been discussed.

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