The ageing swallow

Question 1

What is Presbyphagia?

Answer 1

This is a term used for age-related changes in the oro-pharyngeal and oesophageal stages of swallowing for healthy adults

Question 2

Give some examples of where the swallow breaks down at each stage

Answer 2

Pre-oral: Intensity of smell and taste are reduced. This can lead to a reduced appetite

Oral Preparatory and Oral Stage:

• Tongue hypertrophy (reduced tongue mobility and strength)
• Weakness of the muscles of mastication
• Osteoporosis of the jaw - unable to chew certain textures
• Reduced sensation taste, temperature, tactile sensation

Pharyngeal Stage:

• Larynx may not be be able to lift as much which may lead to ossification of the thyroid + cricoid cartilages
• Arthritis of the temporomandibular joint and larynx = can cause pain
• Decrease in the connective tissue supporting the suprahyoid so the airway may not be protected sufficiently + limits the opening of the UES
• Changes in reflexes - coughing

Oesophageal Stage:

• Increased duration of oesophageal peristalsis - movement of the oesophagus moving the food downward takes longer
• Increased reflux
• Potential reduced sensation in the oesophagus