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Swallowing and Aging


Swallowing is a complex process that changes over time, and sometimes swallowing difficulties can be associated with aging. It is estimated that 40% of adults aged 60 and older currently suffer from swallowing difficulties. Advancing age notoriously comes with reductions in muscle mass and strength. All muscles of the body are affected, including those involved in chewing and swallowing. The medical term used to describe these changes in the swallowing mechanism of otherwise healthy older adults is Presbyphagia.

Presbyphagia is not a pathology or a disease itself but it can be considered rather the change in normal swallowing function due to age-related changes. It is true though that if these swallowing difficulties are ignored or underestimated, they can lead to major health problems like dehydration, malnutrition, choking or aspiration pneumonia (food or liquid entering the airway and introducing bacteria), with serious consequences for independence and quality of life.



What are the signs of Presbyphagia?


When you have difficulty swallowing, you may be experiencing one or more of the following situations:

  • Difficulty chewing

  • Increased effort to move food and liquids from the mouth into the upper throat (pharynx)

  • Increased effort or resistance moving food from the upper throat (pharynx) into the lower throat (esophagus)

  • Food getting stuck

  • Pills getting stuck

  • Regurgitation of food

  • Coughing and/or choking with eating and drinking

  • Recurrent lung infections

  • Weight loss due to food avoidance

These conditions can be associated with physiological changes happening with aging. The most common ones are:

  • Missing teeth

  • Dry mouth and throat

  • Reduced tongue size and strength

  • Reduced strength in the upper throat (pharynx)

  • Reduced size and strength of the vocal cords and voice box (larynx)

  • A narrower entrance into the lower throat (esophagus)

  • Poor ability of the lower throat (esophagus) to move food into the stomach



What can you do if you realize you are experiencing Presbyphagia?


Often, an older person is able to accommodate these changes in swallowing functions. They can recognize these modifications and assume they are typical of the ageing process, or they adapt to them so gradually that they aren’t even aware that they are making compensations.

It is important to acknowledge that questions about, or changes in swallowing ability should be addressed with a professional familiar with the swallowing process, such as a Speech-Language Pathologist who specializes in swallowing problems.



How can a Speech-Language Pathologist help if you are experiencing swallowing difficulties?


The Speech-Language Pathologist will recommend exercises or functional activities to ensure the swallowing mechanism is optimally maintained.

The exercises are aimed to strengthen the muscles involved in the swallowing mechanism and to improve general force-generating capacity. The Speech-Language Pathologist can also suggest postural adjustments while eating or diet modifications in order to avoid certain textures or food that are more difficult to swallow. This will allow easier oral consumption and thus maintain a safe and adequate oral intake.


Some recommendations given by the Speech-Language Pathologist might sound obvious. For instance, taking good care of your teeth and practicing good oral hygiene are excellent first steps. Ensuring that you chew your food completely and taking small bites and sips can help food move through the swallowing process. Make sure you hydrate properly, such as drinking water, especially when swallowing drier foods like bread or crackers. Minimizing the use of medications and drinks that dry your mouth and throat, such as coffee and other caffeinated beverages, can also be helpful.


Presbyphagia requires collaboration between you, the clinician and your family or caregiver in order to ensure meal time can be a safe yet still enjoyable experience.

Take care of your swallowing and enjoy your meals 😊


Written By: Francesca Brambilla

Registered Speech-Language Pathologist







References:

Taeok Park, Youngsun Kim (2019) Enhancing swallowing quality of life in older individuals after the oropharyngeal strengthening exercise. Clinical Archives of Communication disorders 4(2) : 90-97


https://www.medbridgeeducation.com/blog/2017/01/treating-aging-swallow-one-size-not-fit/


https://www.melbswallow.com.au/resources/presbyphagia-or-swallowing-and-ageing/

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