At least one in three US adults will have difficulty swallowing as they grow older, researchers warn.
After patients are diagnosed with dysphagia, or trouble swallowing, a quarter of them die within 30 days, and approximately 50 percent die within a year.
Researchers at Johns Hopkins University conducted a study to examine the changes that occur in the swallowing process as people age.
As more people are diagnosed with this condition, and the population ages, they hope their findings will help slow the progression of the condition to prevent millions of preventable deaths.
Approximately one in four adults will have difficulties swallowing food and drink as they age
About 33 to 84 percent of adults will have a swallowing disorder in their lifetime, according to lead study author Dr Alba Azola, resident in the Department of Physical Medicine and Rehabilitation.
‘We’ve always known people have difficulties swallowing when they grow older,’ Dr Azola said. ‘What we wanted to know was what changes occur and when do they become a problem.’
She and her colleagues recruited 31 adults, between the ages of 62 and 91 years old, without a history of swallowing disorders.
The participants underwent a videofluoroscopic swallow study – a test that examines how well a person swallows food and liquid.
They compared the results to those of a group of 33 people, between the ages of 18 and 28 years old, who underwent the same test.
While examining both sets of X-ray footage, researchers analyzed the movements of the anatomic structures involved in swallowing, such as how long the windpipe was closed off during the swallow, how long it took to close the airway and which swallowing activities were used to prevent food from getting into the lungs.
Researchers saw that it took longer for older adults to initiate the act of swallowing and they were more likely to have food get stuck in their throat.
This means there was a delay in the food was getting to the throat, and it took longer for the person to block off and protect their airway – the larynx usually closes tightly and breathing stops to prevent food or liquid from entering the airway and lungs.
‘As people grow older their muscles become weaker and smaller,’ said Dr Azola, adding that this also applies to muscles in the mouth.
Not only is this disorder uncomfortable, it can result in serious health complications.
For instance, the slowed ability to protect the airways means that older adults have a higher risk of having food going into their lungs, which increases the risk of aspiration pneumonia, a lung infection that can lead to death.
It can also cause malnutrition, weight loss, dehydration and choking.
Signs and symptoms of the disorder includes, pain while swallowing, drooling, having frequent heartburn, unexpectedly losing weight, being unable to swallow and having to cut food into smaller pieces because of trouble swallowing.
People are at risk of developing a swallowing disorder if they have conditions that weaken or damage the nerves and 50 pairs of muscles – including the tongue, and those of the esophagus, according to the National Institute of Deafness and Other Communication Disorders.
HOW TO SPOT IF A LOVED-ON HAS A SWALLOWING ISSUE
Dysphagia can be caused by a number of conditions that weaken or damage the muscles and nerves involved with swallowing.
Symptoms of the disorder include:
- Being unable to swallow
- Food getting stuck in your throat or chest
- Regurgitating food
- Having frequent heartburn
- Having food or stomach acid back up into your throat
- Coughing or gagging when swallowing
- Having to cut food into smaller pieces or avoiding certain foods because of trouble swallowing
For instance, people who have suffered from a stroke or head injury may have a weakened coordination of swallowing muscles. People with nervous system diseases like Parkinson’s disease also have issues swallowing because their illness impacts the nerves.
There’s been an increased rate of people being diagnosed with this condition.
However, Dr Azola said this is due to a growing geriatric population and better technology.
‘We just got better at picking them up and detecting them more,’ Dr Azola said. ‘And the geriatric population is growing rapidly so we have more people with the same issues.’
Dr Azola said to prevent or slow down the prevalence of this disorder, doctors should find ways for at-risk adults to increase the strength in the muscles involved in swallowing.
Treatment for this condition is administered based on whether the dysphagia is primarily caused by the mouth or the throat.
If the issue is caused by the mouth – or if people have difficulty initiating a swallow – doctors usually prescribe speech or swallowing therapy, according to Mayo Clinic.
In these therapies, people will learn how to coordinate the muscles involved in swallowing and restimulate the nerves that initiate the process. People with conditions like Alzheimer’s disease or Parkinson’s may be taught new swallowing techniques to compensate for the condition.
If a swallowing issue is caused by the throat – or if food gets stuck in the base of their throat or chest after they swallow – doctors may prescribe medication, surgery or a sphincter insertion.
People with a severe form of the condition are prescribed a special liquid diet or a feeding tube.
However, Dr Azola said he hope his findings will help clinicians develop ways people can screen and identify people with dysphagia before they develop any life-threatening complications associated with the disorder.