Dysphagia and pharmacotherapy in older adults

The review summarizes current knowledge and recent findings about how to practically apply medication in patients with dysphagia and how swallowing function may be positively or negatively affected by drugs.

Oropharyngeal dysphagia is a major health problem in older persons and was recently classified as a geriatric syndrome. Although the knowledge about an effective diagnostic approach increased during the last years, comparatively little is known about how to effectively manage and treat dysphagia and hardly anything is implemented in clinical routine. Studies have shown a considerable lack of knowledge about the adequate modification of medication and demonstrated an increased rate of practical medication errors in patients with dysphagia. With regard to dysphagia therapy, two systematic reviews have identified neuroleptics as potentially harmful for swallowing function. The role of other candidates is controversial. Contrary to this, some pharmacological approaches may be future options for the treatment of dysphagia, with capsaicin currently being the most evaluated and potential one.

More professional training and advice about the adequate management of medication in dysphagic patients is necessary for all healthcare professionals. Large observational and interventional studies are needed to identify and confirm the influence of pharmacological substances on the swallowing function.