Dysphagia in the Elderly

Abstract

Dysphagia is a common problem in the elderly population with an especially high prevalence in hospitalized and institutionalized patients. If inadequately addressed, dysphagia leads to significant morbidity and contributes to decreased quality of life. Dysphagia can be categorized as emanating from either an oropharyngeal or esophageal process. A disproportionate number of elderly patients suffer from oropharyngeal dysphagia with a multifactorial etiology. Historically, treatment options have been limited and included mostly supportive care with a focus on dietary modification, food avoidance, and swallow rehabilitation. Nascent technologies such as the functional luminal imaging probe (FLIP) and advances in esophageal manometry are improving our understanding of the pathophysiology of oropharyngeal dysphagia. Recent developments in the treatment of specific causes of oropharyngeal dysphagia, including endoscopic balloon dilations for upper esophageal sphincter (UES) dysfunction, show promise and are expected to enhance with further research. Esophageal dysphagia is also common in the elderly and more commonly due to an identifiable cause. The full breadth of treatment options is frequently unavailable to elderly patients due to comorbidities and overall functional status. However, the increasing availability of less invasive solutions to specific esophageal pathologies has augmented the number of treatment options available to this population, where an individualized approach to patient care is paramount. This review focuses on the evaluation and management of dysphagia in the elderly and delineates how standard and novel therapeutics are contributing to more nuanced and personalized management.

Water Ingestion Dynamics in Patients With Achalasia: Influence of Sex and Age

“…Aging process has a clear influence on swallowing (19)(20)(21)(22)(23) . Swallowing capacity decreases as the individual gets older, with altered oral, pharyngeal and esophageal function (19) , manifested by prolongation of oral and pharyngeal phases (23) , esophageal motility abnormalities (23) , and reduction in the cross-sectional area of the upper esophageal sphincter opening during swallows (19) .…”

Composição corporal por meio da absortometria radiológica de dupla energia em idosos institucionalizados do Hospital Santo Antônio

“…Um planejamento de assistência multifacetada dentro das ILPI possibilita auxílio no retardo da progressão da sarcopenia e da obesidade sarcopênica. Já existem evidências que a adoção de exercícios físicos resistidos, uso de suplementos nutricionais e dietoterapia individualizada, protocolos de triagem para disfagia, atividades que estimulem a convivência social, devem fazer parte do plano de cuidados do idoso institucionalizado (OLIVEIRA et al, 2021;SMUKALLA et al, 2017;STRASSER et al, 2018).…”

Diagnosis and treatments for oropharyngeal dysphagia: effects of capsaicin evaluated by newly developed ultrasonographic method

“…Several studies have shown that rehabilitation and training can have significant positive effects in OD patients, and are recommended as supportive treatments (19,20,40). Swallowing intervention with exercise, such as rehabilitation and swallowing training, was also reported to improve swallowing dysfunction and ODrelated comorbidities (41,42).…”