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Changes in etiology and severity of dysphagia with aging

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Key summary points

AbstractSection Aim

This study aimed to investigate the characteristics of dysphagia in the oldest-old population and the effect of aging on swallowing physiology.

AbstractSection Findings

Dysphagia in the oldest-old was more severe than in older persons. The etiology of dysphagia showed a lower proportion of CNS disorder ratio and a higher proportion of other diseases not related to dysphagia in the oldest-old. Additionally, lower BMI and a higher frailty index were found among the oldest old, compared to older persons.

AbstractSection Message

Dysphagia can be caused by health conditions unrelated to swallowing, and tends to be more severe in the oldest-old than in the older population; malnutrition and frailty are positively correlated with dysphagia severity in older-aged people.

Abstract

Purpose

To investigate characteristics of dysphagia in the oldest-old population and the effect of aging on swallowing physiology.

Methods

418 (364 men, 54 women) patients who underwent videofluoroscopic swallow study (VFSS) for dysphagia were included. The patients were divided into an older group, group I (60–79 years old, n = 275) and the oldest-old group, group II (80–96 years old, n = 143). Sex, cognition, duration of symptoms, BMI (body mass index), frailty index derived from comprehensive geriatric assessment (FI-CGA), penetration aspiration scale (PAS), and videofluoroscopic dysphagia scale (VDS) scores and the etiologies of dysphagia were compared between the groups. The correlation analysis of BMI and FI-CGA with dysphagia severity and age was performed.

Results

The proportion of males, K-MMSE scores, the duration of symptoms, BMI scores and FI-CGA were significantly greater in group I than II. The PAS and VDS scores were significantly higher in group II than I. The proportion of CNS disorders was significantly higher in group I than in group II. The proportion of poor general medical condition was significantly higher in group II than in group I. A negative correlation between BMI and dysphagia severity and a positive correlation between FI-CGA and dysphagia severity were observed.

Conclusion

Dysphagia tends to be more severe in the oldest-old, and can be caused by health conditions unrelated to swallowing. Malnutrition and frailty correlated positively with dysphagia severity, irrespective of age.

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Acknowledgements

This study was supported by a VHS Medical Center Research Grant, Republic of Korea (Grant No: VHSMC19009). We would like to acknowledge and thank VHS Medical Center Research Grant.

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Authors and Affiliations

  1. Department of Rehabilitation Medicine, Veterans Health Service Medical Center Seoul, 53, Jinhwangdo-ro 61-gil, Gangdong-gu, Seoul, 05368, Republic of Korea

    Da Hyun Ahn, Hea Eun Yang, Hyo Jung Kang, Kyung Hee Do, Seok Cheol Han, Soo Woong Jang & Jang Ho Lee

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Correspondence to Hea Eun Yang.

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The authors declare that they have no conflict of interest.

Ethical approval

This study was approved by the Ethics Committees of the Veterans Health Service Medical Center Institutional Review Board (No. 2018-12-017). All procedures performed in studies involving human participants were in accordance with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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All study participants provided informed consent.

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Ahn, D.H., Yang, H.E., Kang, H.J. et al. Changes in etiology and severity of dysphagia with aging. Eur Geriatr Med 11, 139–145 (2020). https://doi.org/10.1007/s41999-019-00259-0

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  • DOI: https://doi.org/10.1007/s41999-019-00259-0

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