Impact of age on laryngopharyngeal reflux disease presentation: a multi-center prospective study

Abstract

The objective is to assess the differences in the severity of symptoms, signs, voice quality, and quality of life before and after treatment according to age in suspected laryngopharyngeal reflux (LPR) patients. The design used in this paper is prospective multi-center study. Eighty clinically diagnosed LPR patients with a reflux finding score (RFS) >7 and a reflux symptom index (RSI) >13 were treated with pantoprazole and diet recommendations for 3 months. Patients were subdivided into three groups according their age: group 1 (18-39 years, N = 21), group 2 (40-59 years, N = 31), and group 3 (≥60 years, N = 28). RSI, RFS, Voice Handicap Index (VHI), Short Form 36 questionnaire (SF36), aerodynamic, and acoustic measurements were evaluated at baseline and after treatment. The response to the empiric treatment was also assessed. Significant improvements in RSI, RFS, and VHI were found in all patient groups. The elderly patients showed a significantly lower RSI score than younger subjects (p = 0.035) without RFS difference among groups. At baseline, the SF36 score was better in group 3 with respect to social functioning (p = 0.049). At the 3-month follow-up, we found significant improvement of acoustic parameters only in the younger age groups (group 1 and group 2). The rate of resistant patients to the empiric treatment was higher in the younger group than in the elderly patient group (42.9 versus 28.6%). Age appears to reduce the subjective LPR symptom perception, leading to a lower rate of uncured patients. The utilization of acoustic parameters as an indicator of treatment effectiveness seems less useful for elderly subjects, probably due to an overlap between an aging voice and LPR.

Laryngopharyngeal Reflux Disease in War-torn Syria and its Association with Smoking and other Risks.

“…Subjects aging 30 years and more had higher RSI scores than the younger subjects. However, it is suggested that elderly people might have a higher baseline RSI (29) but another study found that patients in the older groups had signi cantly lower RSI (30). However, we did not nd a clear association with LPR and age.…”

Change of signs, symptoms and voice quality evaluations throughout a 3‐ to 6‐month empirical treatment for laryngopharyngeal reflux disease

“…Our observations could enrich the disparate knowledge on the subject with a potential ‘suggestive effect’ as a concurrent hypothesis. Concerning the association between the elderly and the low rate of pyrosis complaints, we attributed this observation to the unusual clinical presentation related to ageing following the degeneration of the neurologic system …”

Validity and reliability of the reflux symptom score

“…As recommended, GI endoscopy was performed in patients with GERD symptoms. Because some studies have reported a reduction of GERD symptom perception in older people with LPR, GI endoscopy was also performed in patients age ≥60 years . Patients were excluded if they presented with one of the following conditions: smoking; alcohol dependence; pregnancy; neurological or psychiatric illness; upper respiratory tract infection within the last month; current use of antireflux treatment (e.g., PPI, antihistamine, alginate, magaldrate); previous history of neck surgery or trauma; benign vocal fold lesions; malignancy; history of ear, nose, and throat radiotherapy; and active seasonal allergies or asthma.…”