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Clin Interv Aging. 2016 Feb 23;11:189-208. doi: 10.2147/CIA.S97481. eCollection 2016.

Oropharyngeal dysphagia in older persons - from pathophysiology to adequate intervention: a review and summary of an international expert meeting.

Author information

1
Department for Internal Medicine and Geriatrics, St Marien-Hospital Borken, Borken, Germany; Institute for Biomedicine of Aging, Friedrich-Alexander-Universität Erlangen-Nürnberg, Nürnberg, Germany.
2
Department of Neurology, University Hospital Münster, Münster, Germany.
3
Department of Nutrition and Health, Faculty of Health and Technology, Metropolitan University College, Copenhagen, Denmark.
4
Centro de Investigación Biomédica en Red de enfermadades Hepáticas y Digestivas (CIBERehd), Hospital de Mataró, Universitat Autònoma de Barcelona, Mataró, Spain.
5
Centre for Gastrointestinal Sciences, Institute of Inflammation and Repair, University of Manchester, Salford Royal Hospital, Salford, UK.
6
Department of Geriatrics, Witten- Herdecke University, Schwelm, Germany; Helios Clinic Schwelm, Schwelm, Germany.
7
Department of Speech, Language and Hearing Sciences, Boston University School of Medicine, Boston, MA, USA.
8
Department of Geriatrics, Alexianer Hospital Krefeld, Krefeld, Germany.
9
Department of Speech-Language Pathology, University of Toronto, Toronto, Canada.
10
Department of Phoniatrics and Pediatric Audiology, University of Marburg, Marburg, Germany.
11
Department of Geriatrics, Marien Hospital Hamburg, Hamburg, Germany.
12
Division of Gastroenterology and Hepatology, Medical College of Wisconsin, Milwaukee, WI, USA.
13
Institute for Biomedicine of Aging, Friedrich-Alexander-Universität Erlangen-Nürnberg, Nürnberg, Germany; Department of General Internal Medicine and Geriatrics, St John of God Hospital Regensburg, Regensburg, Germany.
14
Institute for Biomedicine of Aging, Friedrich-Alexander-Universität Erlangen-Nürnberg, Nürnberg, Germany.

Abstract

Oropharyngeal dysphagia (OD) is a highly prevalent and growing condition in the older population. Although OD may cause very severe complications, it is often not detected, explored, and treated. Older patients are frequently unaware of their swallowing dysfunction which is one of the reasons why the consequences of OD, ie, aspiration, dehydration, and malnutrition, are regularly not attributed to dysphagia. Older patients are particularly vulnerable to dysphagia because multiple age-related changes increase the risk of dysphagia. Physicians in charge of older patients should be aware that malnutrition, dehydration, and pneumonia are frequently caused by (unrecognized) dysphagia. The diagnosis is particularly difficult in the case of silent aspiration. In addition to numerous screening tools, videofluoroscopy was the traditional gold standard of diagnosing OD. Recently, the fiberoptic endoscopic evaluation of swallowing is increasingly utilized because it has several advantages. Besides making a diagnosis, fiberoptic endoscopic evaluation of swallowing is applied to evaluate the effectiveness of therapeutic maneuvers and texture modification of food and liquids. In addition to swallowing training and nutritional interventions, newer rehabilitation approaches of stimulation techniques are showing promise and may significantly impact future treatment strategies.

KEYWORDS:

aspiration; dehydration; dysphagia; geriatric; malnutrition; older

PMID:
26966356
PMCID:
PMC4770066
DOI:
10.2147/CIA.S97481
[Indexed for MEDLINE]
Free PMC Article

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