Presbyphagia Versus Dysphagia

Abstract

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.

Main Disorders of Gastrointestinal Tract in Older People: An Overview

“…The reasons for the higher incidence and severity of dysphagia in the elderly take place not only in the increased burden of age-related diseases affecting the swallowing muscles but also in changes in structure, physiology, and innervation of the swallowing system occurring with healthy aging [10,11]. These alterations, so-called presbyphagia, are predisposed to the development of dysphagia when a superimposed stressor occurs (i.e., delirium, dementia, adverse effect of medication, or hospitalization) [11,24,25]. However, in clinical practice, dysphagia should never be attributed to the normal aging process without an appropriate diagnostic work up.…”

Reinventing Speech-Language Pathologists’ Approach to Psychosocial Barriers and Dysphagia Management

“…In a study performed to gain a better understanding of dysphagia patient emotions regarding their experience of symptoms, Barrera and O'Connor Wells [1] reviewed the results of completed Swallow Related Quality of Life questionnaires from individuals with PD and dysphagia prior to and after therapy. Findings demonstrated "a difference between the [SLP] clinical evaluation of dysphagia and a patient's self-assessment" with participants sharing that dysphagia had "a strong negative impact on their overall quality of life" [1]. Evidence from the findings suggests the need for increased SLP recognition of emotional and psychological symptoms considering the lack of SLP awareness concerning participants' negative experiences connected to their symptoms.…”

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Dysphagia, known as difficulty swallowing, is "a symptom of an underlying disease or disorder" that "affects individuals across the lifespan, may be transient or chronic, and may arise from congenital abnormalities, acquired neurologic or physical dysfunction, progressive degeneration, and/or psychiatric disorders" [1,2]. Difficulty in one or more of the stages of swallowing, including the oral preparatory, oral transit, pharyngeal, and esophageal stages, signals the presence of dysphagia.

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Swallowing Function and Oral Care in Older Adults

“…Ayrıca iştahı, diyet seçimini ve oral alım miktarını etkileyebilir. Bir kısım sağlıklı yaşlı yetişkinler bile presbifaji ile ilgili sorunlar yaşayabilirler (6,(22)(23)(24). Sarkopeninin (ilerleyen yaşla birlikte kas kütlesi ve kalitesinin azalması), yutma için kullanılan kasları etkilediği ifade edilmektedir (25,26).…”

“…Yaşlı bireylerde faringeal bölgede yutma refleksinin başlamasında bir gecikme oluşabilir (6,27). Yemek borusu bölgesinde gıda transferi normal zamanlaması uzayabilir (24). Daha yaşlı bireylerde yaşlanma sürecinin diğer etkileri arasında yemek borusunun düz kaslarının kasılmasında azalma (27), peristaltik olmayan kasılmaların ortaya çıkması, özofagus boşalmasının gecikmesi ve üst özofagus sfinkterinin esnekliğinde azalma yaşanabilir (24,27).…”