As early as 50 years of age, individuals may begin to experience sensory and motor changes related to the swallow as a result of the natural aging process and continue to progress with age (Daggett, et al., 2006). These changes, which will be described in detail throughout this resource, are generally slow and mild; however, they may significantly reduce the efficiency of the swallow (Logemann et al., 2013). According to the 2012-2016 National Outcomes Measurement System (NOMS) report, 89.73 % of the speech-language pathologist’s (SLP) caseload across the acute, inpatient, outpatient, and skilled nursing settings consistent of patients 50 years of age and older and 60% of the SLPs caseload alone were individuals 70 years and older (ASHA, 2019). 59% of clinicians treating adults indicated that swallowing disorders were in the top five most common diagnoses they treat (ASHA, 2021). Given the prevalence of older adults treated by SLPs and the prevalence of swallowing conditions, clinicians should understand how to differentiate abnormal versus typical age-related changes in the swallow to ensure appropriate diagnostic and treatment interventions.
The content of this resource will focus on motor and sensory changes impacting the swallow in the aging population and aid clinicians in determining whether these changes are truly a disorder or instead, presbyphagia.
Part one of this resource discussed the specifics of presbyphagia and the normal aging process, expected changes to anatomy, physiology and sensation that may impact swallowing. Part two of this resource will discuss factors that may result in the progression of presbyphagia to a clinical diagnosis of dysphagia.
Part one of this resource focused on sensory and motor changes related to the swallow as a result of the natural aging process while part two discussed how to differentiate between presbyphagia and dysphagia. Part three will help guide the clinician on how to apply their knowledge about normal age-related swallow changes and dysphagia into clinical practice; including the use of screenings to guide differential diagnosis and, if indicated, assessment and treatment options. Strategies and interventions that may be useful to address changes in swallow function and/or disordered swallow function will be introduced. In addition, strategies to improve the sensorimotor experience to optimize swallow efficiency and safety, nutrition and hydration status, pleasure, and quality of life in the aging population will be summarized.