Which Physiological Swallowing Parameters Change with Healthy Aging?

Area of Science:

• Gerontology
• Swallowing physiology
• Deglutition biomechanics

Background:

• Age-related swallowing changes, termed presbyphagia, are distinct from pathological impairment.
• Understanding these normal changes is crucial for accurate clinical assessment.
• Previous research has not fully delineated specific kinematic and timing alterations associated with healthy aging.

Purpose of the Study:

• To investigate the influence of age on quantitative measures of healthy swallowing.
• To differentiate specific characteristics of presbyphagia from dysphagia.
• To control for sex and sip volume effects on swallowing parameters.

Main Methods:

• Videofluoroscopy of thin liquid swallows in 76 healthy adults (21-82 years).
• Analysis using the ASPEKT method for safety, efficiency, kinematics, and timing.
• Hierarchical regression models to assess age, sex, and sip volume effects.

Main Results:

• No age-related changes in penetration-aspiration, hyoid-burst (HYB)-to-upper-esophageal-sphincter (UES) opening interval, or pharyngeal residue.
• Increased age correlated with longer swallow reaction time, UES opening duration, and laryngeal vestibule closure (LVC) duration.
• Older adults exhibited larger resting and maximum pharyngeal area and wider UES diameter.

Conclusions:

• Identified specific age-related changes in swallowing kinematics and timing (presbyphagia) in healthy adults up to 80 years.
• Observed changes like longer UES opening and LVC duration may represent compensatory mechanisms for slower bolus transit.
• Distinguishes normal aging swallowing characteristics from pathological impairment, aiding clinical differentiation.