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

Authors
  • de Lima Alvarenga, Eliézia Helena1
  • Dall’Oglio, Giovana Piovesan1
  • Murano, Emi Zuiki2
  • Abrahão, Márcio1
  • 1 Federal University of São Paulo, Department of Otolaryngology, Head and Neck Surgery, School of Medicine, Rua Conselheiro Brotero 1539, cj33, São Paulo, São Paulo, CEP 01232-011, Brazil , São Paulo (Brazil)
  • 2 University of São Paulo, Department of Otolaryngology, Head and Neck Surgery, School of Medicine, São Paulo, Brazil , São Paulo (Brazil)
Type
Published Article
Journal
European Archives of Oto-Rhino-Laryngology
Publisher
Springer Berlin Heidelberg
Publication Date
Nov 09, 2017
Volume
275
Issue
2
Pages
443–449
Identifiers
DOI: 10.1007/s00405-017-4801-7
Source
Springer Nature
Keywords
License
Yellow

Abstract

ObjectivesTo 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 methodsOne 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.ResultsTwenty-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).ConclusionsOur 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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