Changes in etiology and severity of dysphagia with aging

  • Da Hyun Ahn
  • Hea Eun YangEmail author
  • Hyo Jung Kang
  • Kyung Hee Do
  • Seok Cheol Han
  • Soo Woong Jang
  • Jang Ho Lee
Research Paper

Key summary points


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


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.


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.



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


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.


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.


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.


Age Dysphagia Frailty Malnutrition Severity 



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.

Compliance with ethical standards

Conflict of interest

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.

Informed consent

All study participants provided informed consent.


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Copyright information

© European Geriatric Medicine Society 2019

Authors and Affiliations

  • Da Hyun Ahn
    • 1
  • Hea Eun Yang
    • 1
    Email author
  • Hyo Jung Kang
    • 1
  • Kyung Hee Do
    • 1
  • Seok Cheol Han
    • 1
  • Soo Woong Jang
    • 1
  • Jang Ho Lee
    • 1
  1. 1.Department of Rehabilitation MedicineVeterans Health Service Medical Center SeoulGangdong-guRepublic of Korea

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