Dysphagia in the elderly: management and nutritional considerations

• Published in: Clinical interventions in aging Vol. 7; pp. 287 - 298
• Main Authors: Sura, Livia, Madhavan, Aarthi, Carnaby, Giselle, Crary, Michael A
• Format: Journal Article
• Language: English
• Published: New Zealand Dove Medical Press Limited 01.01.2012; Taylor & Francis Ltd; Dove Press; Dove Medical Press
• Subjects: Aged; Aged, 80 and over; aging; Aging - physiology; Bacterial pneumonia; Deglutition - physiology; Deglutition disorders; Deglutition Disorders - complications; Deglutition Disorders - epidemiology; Deglutition Disorders - etiology; Deglutition Disorders - therapy; Dementia; Dementia - complications; Dysphagia; Enteral Nutrition - adverse effects; Enteral Nutrition - methods; Humans; malnutrition; Malnutrition - etiology; Malnutrition - prevention & control; Malnutrition - therapy; Pneumonia; Pneumonia, Aspiration - etiology; Pneumonia, Aspiration - prevention & control; Pneumonia, Aspiration - therapy; Posture - physiology; rehabilitation; Review; Stroke - complications; dysphagia; malnutrition; rehabilitation; aging; pneumonia
• ISSN: 1178-1998; 1176-9092; 1178-1998
• DOI: 10.2147/cia.s23404

Dysphagia is a prevalent difficulty among aging adults. Though increasing age facilitates subtle physiologic changes in swallow function, age-related diseases are significant factors in the presence and severity of dysphagia. Among elderly diseases and health complications, stroke and dementia reflect high rates of dysphagia. In both conditions, dysphagia is associated with nutritional deficits and increased risk of pneumonia. Recent efforts have suggested that elderly community dwellers are also at risk for dysphagia and associated deficits in nutritional status and increased pneumonia risk. Swallowing rehabilitation is an effective approach to increase safe oral intake in these populations and recent research has demonstrated extended benefits related to improved nutritional status and reduced pneumonia rates. In this manuscript, we review data describing age related changes in swallowing and discuss the relationship of dysphagia in patients following stroke, those with dementia, and in community dwelling elderly. Subsequently, we review basic approaches to dysphagia intervention including both compensatory and rehabilitative approaches. We conclude with a discussion on the positive impact of swallowing rehabilitation on malnutrition and pneumonia in elderly who either present with dysphagia or are at risk for dysphagia.