Dysphagia in the elderly: A multidisciplinary approach

Abstract

The process of eating and swallowing is a complex physiologic process requiring volitional as well as reflexive activities and involving multiple structural and functional elements. Dysphagia is a geriatric syndrome resulting in multiple negative health consequences. Dysphagia can have profound adverse influences, including malnutrition, dehydration, aspiration pneumonia, and depression poor quality of life in the elderly. With the aging of the population across the globe, health-care providers are encountering older patients with dysphagia either due to oropharyngeal or esophageal disease. Barium swallow remains a low-cost initial alternative for luminal and esophageal motility assessment. A variety of emerging modalities can help detect anatomical and functional deficits. These include fiberoptic endoscopic evaluation of swallowing, videofluoroscopic swallow study, high-resolution pharyngeal manometry, and esophagogastroduodenoscopy. This review provides a comprehensive review of diagnostic modalities and addresses several issues regarding the collaborative management of elderly persons with dysphagia, including a brief discussion on how swallowing mechanisms are affected by the aging process.