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Continuum theory: presbyphagia to dysphagia? Functional assessment of swallowing in the elderly

  • Laryngology
  • Published:
European Archives of Oto-Rhino-Laryngology Aims and scope Submit manuscript

Abstract

Objectives

To investigate whether disclosed symptoms (coughing, choking and throat clearing) can be used as early predictors of swallowing disorders in non-hospitalized elderly population. In addition, to determine the presence of early findings of swallowing disorders through fiber optic endoscopic evaluation of swallowing (FEES).

Materials and methods

One hundred subjects older than 60 years were recruited from local community social meetings for seniors, they fulfilled inclusion criteria, and were given an oral interview and underwent FEES, with findings classified as: (1) saliva stasis; (2) pharyngeal residue; (3) penetration; (4) aspiration; (5) laryngeal sensitivity.

Results

Twenty-one percent of subjects declared previous choking, 10% coughing, and 7% throat clearing, 39% had pharyngeal residue; 6% saliva stasis; 9% penetration; 2% aspiration; and 92% laryngeal sensitivity present. Thirty-three percent showed pharyngeal residue without saliva stasis, while only 6% showed positivity for both (p = 0.003).

Conclusions

Our data suggest that health care professionals should be aware that among an apparently healthy population, some subjects may have swallowing disorders without clinical complaints and that a nasolaryngoscopy exam may not be enough to predict dysphagia. We suggest that FEES should be performed to look for surrogate of dysphagia such as pharyngeal residue, laryngeal penetration, and aspiration.

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Authors and Affiliations

  1. Department of Otolaryngology, Head and Neck Surgery, School of Medicine, Federal University of São Paulo, Rua Conselheiro Brotero 1539, cj33, São Paulo, São Paulo, CEP 01232-011, Brazil

    Eliézia Helena de Lima Alvarenga, Giovana Piovesan Dall’Oglio & Márcio Abrahão

  2. Department of Otolaryngology, Head and Neck Surgery, School of Medicine, University of São Paulo, São Paulo, Brazil

    Emi Zuiki Murano

Authors
  1. Eliézia Helena de Lima Alvarenga
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  2. Giovana Piovesan Dall’Oglio
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Correspondence to Eliézia Helena de Lima Alvarenga.

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Funding

The authors received no financial support for this study.

Conflict of interest

All author and co-authors declare that they do not have conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional, CAAE 08674612.2.0000.5505 and it was approved (152.28) by UNIFESP-EPM.

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Informed consent was obtained from all individual participants included in the study.

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de Lima Alvarenga, E.H., Dall’Oglio, G.P., Murano, E.Z. et al. Continuum theory: presbyphagia to dysphagia? Functional assessment of swallowing in the elderly. Eur Arch Otorhinolaryngol 275, 443–449 (2018). https://doi.org/10.1007/s00405-017-4801-7

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  • DOI: https://doi.org/10.1007/s00405-017-4801-7

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