, Volume 33, Issue 6, pp 848–856 | Cite as

Swallowing Changes in Community-Dwelling Older Adults

  • Rachel W. MulherenEmail author
  • Alba M. Azola
  • Stephanie Kwiatkowski
  • Eleni Karagiorgos
  • Ianessa Humbert
  • Jeffrey B. Palmer
  • Marlís González-Fernández
Original Article


Older adults may evidence changes in swallowing physiology. Our goals were to identify dysphagia risk in community-dwelling older adults with no history of dysphagia, and to compare swallowing physiology and safety between older and younger adults. Thirty-two older adults with no history of dysphagia were prospectively recruited and completed the Dysphagia Handicap Index (DHI), two trials of a 3 oz. swallow screen, and videofluoroscopy (VFSS). Self-ratings of swallowing function were compared to published norms by paired t tests, and multivariate logistic regression models were generated to determine whether these ratings and VFSS analysis of swallowing function were associated with failure of one or both swallow screen trials. Archived VFSS of 33 younger adults were compared to older adults with Wilcoxon rank-sum tests. The DHI scores of older adults were higher than published non-dysphagic adults but lower than dysphagic adults. Older participants with greater Oral Residue scores were more likely to fail both swallow screen trials. Older adults received higher median MBSImP™© scores for select pharyngeal components than younger adults. The two age groups did not differ on Penetration-Aspiration Scale scores, and no aspiration was observed. Measures of swallowing in older individuals may reflect age-related sensory and motor changes in the context of functional swallowing and adequate airway protection.


Dysphagia Presbyphagia Aging swallow MBSImP Swallow screen Dysphagia Handicap Index 



The research reported in this paper was supported by the National Institutes of Health through Awards K23DC011056 (National Institute on Deafness and Other Communication Disorders) and T32HD007414 (National Center for Medical Rehabilitation Research). The content is solely the responsibility of the authors and does not necessarily represent the views of the National Institutes of Health.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Rachel W. Mulheren
    • 1
    • 2
    • 3
    Email author
  • Alba M. Azola
    • 1
  • Stephanie Kwiatkowski
    • 1
  • Eleni Karagiorgos
    • 1
  • Ianessa Humbert
    • 4
    • 5
    • 6
  • Jeffrey B. Palmer
    • 1
  • Marlís González-Fernández
    • 1
  1. 1.Department of Physical Medicine and RehabilitationJohns Hopkins University School of MedicineBaltimoreUSA
  2. 2.Department of NeuroscienceJohns Hopkins University School of MedicineBaltimoreUSA
  3. 3.Kennedy Krieger InstituteBaltimoreUSA
  4. 4.Swallowing Systems Core, Department of Speech, Language, Hearing SciencesUniversity of FloridaGainesvilleUSA
  5. 5.Department of NeurologyUniversity of FloridaGainesvilleUSA
  6. 6.Rehabilitation Sciences, College of Health and Health ProfessionsUniversity of FloridaGainesvilleUSA

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