Swallowing dysfunction in healthy older people using pharyngeal pressure‐flow analysis. Issue 1 (9th September 2013)

• Record Type: Journal Article
• Authors: Omari, T. I.; Kritas, S.; Cock, C.; Besanko, L.; Burgstad, C.; Thompson, A.; Rommel, N.; Heddle, R.; Fraser, R. J. L.
• Is Part Of: Neurogastroenterology & motility. Volume 26:Issue 1(2014:Jan.)
• Page Start: 59
• Page End: 68
• Publication Date: 2013-09-09
• Subjects: Gastrointestinal system -- Motility -- Periodicals; Gastrointestinal system -- Innervation -- Periodicals; 616.33
• DOI: 10.1111/nmo.12224
• Languages: English
• ISSNs: 1350-1925

Abstract

<abstract abstract-type="main" id="nmo12224-abs-0001"> <title>Abstract</title> <sec id="nmo12224-sec-0001" sec-type="section"> <title>Background</title> <p>Age‐related loss of swallowing efficiency may occur for multiple reasons. Objective assessment of individual dysfunctions is difficult and may not clearly differentiate these from normal. Pharyngeal pressure‐flow analysis is a novel technique that allows quantification of swallow dysfunction predisposing to aspiration risk based on a swallow risk index (SRI). In this study, we examined the effect of ageing on swallow function.</p> </sec> <sec id="nmo12224-sec-0002" sec-type="section"> <title>Methods</title> <p>Studies were performed in 68 healthy subjects aged 20–91 years (mean 59 years; 29 male), asymptomatic for oropharyngeal disease. Swallowing of liquid and viscous boluses was recorded with a pressure‐impedance catheter. Indices of swallow function including the SRI, postswallow residues, upper esophageal sphincter opening and bolus transit time were derived using purpose designed software.</p> </sec> <sec id="nmo12224-sec-0003" sec-type="section"> <title>Key Results</title> <p>Swallow function worsened with increasing age with a significant decline after 80 years. Higher SRI correlated with increasing age (r = 0.257, p < 0.05 for liquids and r = 0.361, p < 0.005 viscous bolus). Subjects over 80 years were overrepresented amongst those with an SRI considered diagnostically relevant (SRI > 15). In addition, upper esophageal sphincter opening was reduced and postswallow residues increased in older subjects.</p> </sec> <sec id="nmo12224-sec-0004" sec-type="section"> <title>Conclusions & Inferences</title> <p>Pharyngeal pressure‐flow analysis reveals multiple functional abnormalities in older individuals. The higher SRI levels seen in asymptomatic elders possibly reflect a loss of functional reserve with ageing. Automated impedance manometry analysis of swallow function may allow the risk of developing disordered swallowing to be quantified numerically.</p> </sec> </abstract>