Effects of Aging on Correlation of Striated Esophageal and Pharyngeal Deglutitive Motor Function

Effects of aging on the relationship of striated esophagus (StEso) motor function with pharyngeal deglutitive biomechanics has not been systematically studied.

The aim of this study is to characterize the effects of aging on the correlation of deglutitive StEso with pharyngeal function.

We studied 33 healthy subjects. Fifteen elderly (age: 75 ± 7 years, 8 female) and 18 nonelderly (age: 50 ± 14 years, 9 F) were evaluated using high resolution manometry/impedance. Nine elderly (73 ± 7 years, 5 F) and eight young (24 ± 3 years, 4 F) were further evaluated by digital videofluoroscopy.

Duration of StEso excursion averaged 2.56 ± 0.65 s in elderly and 2.33 ± 0.41 in young. We identified four periods in StEso motor function during deglutitive excursion: (a) anterosuperior ascent without bolus/peristaltic activity, (b) nonperistaltic bolus receiving function at apogee of StEso excursion during UES opening and pharyngeal peristalsis, (c) peristaltic bolus transport as StEso descends, (d) continued peristalsis in resting position. Apart from the final period described, the periods are significantly different in the elderly compared with the young subjects (p < 0.04). Furthermore, the interaction of striated esophageal flow dynamics and peristaltic contractile vigor showed that a significant correlation (r = -0.71, p = 0.0009) was found when comparing the average bolus injection length to the average SECI in young subjects. This correlation was muted in the elderly and did not reach statistical significance (r = -0.41, p = 0.13).

Sequencing of StEso/pharyngeal deglutitive motor function is preserved in the elderly. The differences observed in early stages of spatiotemporal mapping of StEso deglutitive motor function when comparing healthy elderly to young populations may be due to age-related suprahyoid muscle weakness since the affected periods are those associated with the active StEso ascent and descent. Like young individuals, elderly pressure signatures currently attributed to the StEso deglutitive motor activity do not represent the entirety of StEso peristalsis.