Dysphagia pp 165-174 | Cite as

The Geriatric Pharynx and Esophagus

  • Olle Ekberg
Part of the Medical Radiology book series (MEDRAD)


Dysphagia is common in the elderly. This is mainly due to neurodegenerative abnormalities in the central nervous system. The elderly may be able to compensate, to a certain degree, for deterioration of function but the reserve capacity is much less than in younger. Understanding of the normal aging process as well as disease processes common in the elderly is important for diagnosis and treatment of dysphagia in the elderly.


Hyoid Bone Esophageal Dysmotility Diffuse Esophageal Spasm Laryngeal Closure Nutcracker Esophagus 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


  1. Baum BJ, Bodner L (1983) Aging and oral motor function: evidence for altered performance among older persons. J Dent Res 62:2–6PubMedCrossRefGoogle Scholar
  2. Borgström PS, Ekberg O (1988a) Pharyngeal dysfunction in the elderly. J Med Imaging 2:74–81Google Scholar
  3. Borgström PS, Ekberg O (1988b) Speed of peristalsis in pharyngeal, constrictor musculature: correlation to age. Dysphagia 2:140–144PubMedCrossRefGoogle Scholar
  4. Buchholz D (1992) Editorial. Dysphagia 7:148–149Google Scholar
  5. Castell DO (1990) Esophageal disorders in the elderly. Gastroenterol Clin North Am 19:235PubMedGoogle Scholar
  6. Colodny N (2001) Effects of age, gender, disease, and multisystem involvement on oxygen saturation levels in dysphagic persons. Dysphagia 16:48–57PubMedCrossRefGoogle Scholar
  7. Cook IJ, Dent J, Collins SM (1989) Upper esophageal sphincter tone and reactivity to stress in patients with a history of globus sensation. Dig Dis Sci 34:672–676PubMedCrossRefGoogle Scholar
  8. Dodds WJ, Logemann JA, Stewart ET (1990) Radiologic assessment of abnormal oral and pharyngeal phases of swallowing. Am J Roentgenol 154:965–974Google Scholar
  9. Doggett DL, Tappe KA, Mitchell MD, Chapell R, Coates V, Turkelson CM (2001) Prevention of pneumonia in elderly stroke patients by systematic diagnosis and treatment of dysphagia: an evidence-based comprehensive analysis of the literature. Dysphagia 16:279–295PubMedCrossRefGoogle Scholar
  10. Donner MW, Jones B (1991) Aging and neurological disease. In: Jones B, Donner MW (eds) Normal and abnormal swallowing: imaging in diagnosis and therapy. Springer, New YorkGoogle Scholar
  11. Ekberg O, Feinberg MJ (1991) Altered swallowing function in elderly patients with dysphagia: radiographic findings in 56 patients. Am J Roentgenol 156:1181–1184Google Scholar
  12. Ekberg O, Hamdy S, Woisard V, Wuttge-Hannig A, Ortega P (2002) Social and mental burden of dysphagia: Its impact on diagnosis and treatment. Dysphagia 17:139–146PubMedCrossRefGoogle Scholar
  13. Feinberg MJ, Ekberg O (1991) Videofluoroscopy in elderly patients with aspiration: importance of evaluating both oral and pharyngeal stages of deglutition. Am J Roentgenol 156:293–296Google Scholar
  14. Feinberg MJ, Ekberg O, Segall L, Tully J (1992) Deglutition in elderly patients with dementia: findings of videofluorographic evaluation and impact on staging and management. Radiology 183:811–814PubMedGoogle Scholar
  15. Feinberg MJ, Knebl J, Tully J (1996) Prandial aspiration and pneumonia in an elderly population followed over 3 years. Dysphagia 11:104–109PubMedCrossRefGoogle Scholar
  16. Fulp SR, Dalton CB, Castell JA, Castell DO (1990) Aging-related alterations in human upper esophageal sphincter function. Am J Gastroenterol 85:1569–1572PubMedGoogle Scholar
  17. Groher ME (1983) Mechanical disorders of swallowing. In: Groher ME (ed) Dysphagia: diagnosis and management. Butterworth, Worburn, pp 61–84Google Scholar
  18. Groher ME, Bukatman R (1986) The prevalence of swallowing disorders in two teaching hospitals. Dysphagia 1:3–6CrossRefGoogle Scholar
  19. Hey H, Jorgensen F, Sorensen K et al (1982) Esophageal transit of six commonly used tablets and capsules. Br Med J 285:717CrossRefGoogle Scholar
  20. Hirst LJ, Ford GA, Gibson GJ, Wilson JA (2002) Swallow-induced alterations in breathing in normal older people. Dysphagia 17:152–161PubMedCrossRefGoogle Scholar
  21. Jones B, Donner MW (1991) Adaptation, compensation, and decompensation. In: Jones B, Donner MW (eds) Normal and abnormal swallowing: imaging in diagnosis and therapy. Springer, New YorkGoogle Scholar
  22. Kendall KA, Leonard RJ (2001) Pharyngeal constriction in elderly dysphagic patients compared with young and elderly nondysphagic controls. Dysphagia 16:272–278PubMedCrossRefGoogle Scholar
  23. Kikendall JW, Friedman AC, Oyewole MA et al (1983) Pill-induced esophageal injury: case reports and review of the medical literature. Dig Dis Sci 28:174PubMedCrossRefGoogle Scholar
  24. Kirkwood TBL (2000) Biological origins of ageing. In: Grimley Evans J, Franklin Williams F et al (eds) Oxford textbook of geriatric medicine, 2nd edn. Oxford University Press, Oxford, pp 35–42Google Scholar
  25. Langmore SE, Terpenning MS, Schork A, Chen YM, Murray JT, Lopatin D, Loeshe WJ (1998) Predictors of aspiration pneumonia: how important is dysphagia?. Dysphagia 13:69–81PubMedCrossRefGoogle Scholar
  26. Levine R, Robbins JA, Maser A (1992) Periventricular white matter changes and oropharyngeal swallowing in normal individuals. Dysphagia 7:142–147PubMedCrossRefGoogle Scholar
  27. Logemann JA (1983) Evaluation and treatment of swallowing disorders. College Hill Press, San Diego, pp 64–69Google Scholar
  28. Logemann JA (1990) Effects of aging on the swallowing mechanism. Otolaryngol Clin North Am 23:1045–1056PubMedGoogle Scholar
  29. McCord GS, Clouse RE (1990) Pill-induced esophageal strictures: clinical features and risk factors for development. Am J Med 88:512PubMedCrossRefGoogle Scholar
  30. Nilsson H, Ekberg O, Bülow M, Hindfelt B (1997) Assessment of respiration during video fluoroscopy of dysphagic patients. Acad Radiol 4:503–507PubMedCrossRefGoogle Scholar
  31. Ohmae Y, Inouye T, Kitahara S (1993) Relationship between cervical osteophytes and globus sensation: a study based on altered swallowing function. Nippon Jibiinkoka Gakkai Kaiho 96:379–386PubMedCrossRefGoogle Scholar
  32. Perlman AL, Guthmiller Schultz J, VanDaele DJ (1993) Effects of age, gender, bolus volume, and bolus viscosity on oropharyngeal pressure during swallowing. J Appl Physiol 75:33–37PubMedGoogle Scholar
  33. Pontoppidan H, Beecher HK (1960) Progressive loss of protective reflexes in the airway with advance of age. JAMA 174:2209–2213PubMedCrossRefGoogle Scholar
  34. Richter JE, Wu WC, Johns DN, Blackwell JN, Nelson JL, Castell JA, Castell DO (1987) Esophageal manometry in 95 healthy adults volunteers. Dig Dis Sci 32:583–592PubMedCrossRefGoogle Scholar
  35. Robbins J, Hamilton JW, Lof GL, Kempster GB (1992) Oropharyngeal swallowing in normal adults of different ages:. Gastroenterology 103:823–829PubMedGoogle Scholar
  36. Schoenen J (1991) Clinical anatomy of the spinal cord. Neurol Clin 9:503–532PubMedGoogle Scholar
  37. Semble EL, Wu WC, Castell DO (1989) Nonsteroidal antiinflammatory drugs and esophageal injury. Semin Arth Rheum 19:99CrossRefGoogle Scholar
  38. Shaker R (1993) Effect of aging on the deglutitive oral, pharyngeal and esophageal motor function. DRS, 2nd annual scientific meeting, DRS, Lake Geneva, Wisconsin, Oct 22–24, 1993Google Scholar
  39. Shaker R, Cook IJS, Dodds WJ, Hogan WJ (1988) Pressure-flow dynamics of the oral phase of swallowing. Dysphagia 3:79–84PubMedCrossRefGoogle Scholar
  40. Shaker R, Dodds WJ, Podursan MC et al (1990) Effect of aging on pharynx and upper esophageal sphincter (UES). Gastroenterology 98:A432 (abstract)Google Scholar
  41. Shaker R, Ren J, Podvrsan B, Dodds WJ, Hogan WJ, Kern M, Hoffmann R, Hintz J (1993) Effect of aging and bolus variables on pharyngeal and upper esophageal sphincter motor function. Am J Physiol 264:G427–G432PubMedGoogle Scholar
  42. Shaw DW, Cook IJ, Dent J, Simula ME, Panagopoulos V, Gabb M, Shearman DJ (1990) Age influences oropharyngeal and upper esophageal sphincter function during swallowing. Gastroenterology 98:A390Google Scholar
  43. Sheth N, Diner WC (1988) Swallowing problems in the elderly. Dysphagia 2:209–215PubMedCrossRefGoogle Scholar
  44. Siebens H, Trupe E, Siebens A et al (1986) Correlates and consequences of eating dependency in institutionalised elderly. J Am Geriatr Soc 34:192PubMedGoogle Scholar
  45. Soergel KH, Zboralske FF, Amberg JR (1964) Presbyesophagus: esophageal motility in nonagenarians. J Clin Invest 43:1472–1479PubMedCrossRefGoogle Scholar
  46. Sonies BC, Tone M, Shawker T (1984) Speech and swallowing in the elderly. Gerodontology 3:115–123PubMedCrossRefGoogle Scholar
  47. Sonies B, Parent L, Morrish K et al (1988) Durational aspects of the oropharyngeal phase in normal adults. Dysphagia 3:1–10PubMedCrossRefGoogle Scholar
  48. Strasser G, Schima W, Schober E, Pokieser P, Kaider A, Denk DM (2000) Cervical osteophytes impinging on the pharynx: importance of size and concurrent disorders for development of aspiration. Am J Roentgenol 174:449–453Google Scholar
  49. Tracy JF, Logemann JA, Kahrilas PJ, Jacob P, Kobara M, Krugler C (1989) Preliminary observations on the effects of age on oropharyngeal deglutition. Dysphagia 4:90–94PubMedCrossRefGoogle Scholar
  50. Tucker HJ, Snape WJ, Cohen S (1978) Achalasia secondary to carcinoma: manometric and clinical features. Ann Intern Med 89:315PubMedGoogle Scholar
  51. Vijayashankar N, Brody H (1979) A quantitativ estudy of the pigmented neurons in the neuclei locus coeruleus and subcoeruleus in man as related to aging. J Neuropathol Exp Neurol 38:490–497PubMedCrossRefGoogle Scholar
  52. Volicer L, Seltzer B, Rheaume Y et al (1989) Eating difficulties in patients with probable dementia of the Alzheimer type. J Geriatr Psychiatry Neurol 2:188–195PubMedCrossRefGoogle Scholar
  53. Wilson JA, Pryde A, Macintyre CCA (1989) Normal pharyngoesophageal motility: a study of 50 healthy volunteers. Dig Sis Sci 34:1590–1599Google Scholar
  54. Zboralske FF, Amberg JR, Soergel KH (1964) Presbyesophagus: cineradiographic manifestations. Radiology 82:463–467PubMedGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2011

Authors and Affiliations

  1. 1.Diagnostic Centre of Imaging and Functional MedicineSkåne University HospitalMalmöSweden

Personalised recommendations