Age and dysphagia correlate closely. In fact, patients who are 90 years old are twice as likely to aspirate their food than patients in their 70s.
What’s happening physiologically to create such a stark difference?
Well, the pharyngeal muscles atrophy over time. When these muscles weaken, the pharyngeal wall thins and the pharyngeal lumen widens.
Similarly, lingual strength weakens with age. This is why we notice a difference in the amount of food our patients consume across the lifespan. Less lingual strength means a person’s intake is reduced. The reduced intake applies to liquids too, of course. Adults under the age of 50 can sip twice the volume someone over 50 can consume.
Understanding the impacts aging has on swallowing is critical in order to diagnose dysphagia correctly. Some swallows that may seem to be problematic are actually functional – just altered a bit due to age. As Stephen and colleagues found:
“Older adults commonly initiate thin-liquid swallows with the bolus head well below the tongue base and mandibular ramus intersection without associated penetration or aspiration. Thus, bolus position alone does not differentiate between normal and pathologic swallowing within the healthy elderly.”
The only way to know for sure if a swallow is impaired? Schedule a FEES! Instrumentation and visualization of the larynx will provide the diagnostic criteria you need.