14 August, 2017
Swallowing problems, or dysphagia, are caused by a number of problems and are quite prevalent in the elderly. Swallowing problems in the elderly can result from gastrointestinal reflux disease, problems in the stomach with digestion and esophageal cancer. Neurological diseases that plague the elderly such as Parkinson's and Alzheimer's also can cause swallowing problems.
The Mayo Clinic reports that many swallowing problems in the elderly originate from neurological problems before the food even hits the esophagus. Patients often choke on their food and cause it to go down the windpipe instead of the esophagus. Sometimes swallowed food starts a coughing fit that interferes with swallowing. Poor nutrition and dehydration, common among the elderly, can cause this reaction. When elderly people have had swallowing problems in the past, they often are embarrassed to eat in public, which can cause a bout of dysphagia due to the stress of the situation. Other diseases that can cause swallowing problems for the elderly include stroke, brain injury and dementia. Drug therapies are available to treat many of the causes of dysphagia, while many elderly people find relief from botulinum toxin injections that numb the areas causing the difficulties.
Older adults often develop bony protrusions on the inside of their spinal column that are called osteophytes. As they enlarge, the bumps can push against the esophagus and create swallowing difficulties. The National Institute of Neurological Disorders and Stroke recommends thickening the food and encouraging the older patient to chew his food longer to alleviate swallowing problems.
Saliva production reduces with aging, yet remains vital to proper swallowing functions. Impaired saliva production also is a common side effect of many medications. While many causes of dysphagia can be treated with diet changes and adding more liquids to each meal, patients getting progressively worse may need a feeding tube to deliver proper nutrition if they are not able to swallow and keep food down.
As the muscles atrophy during the aging process and from lack of exercise, facial muscles also become affected. A speech-language pathologist typically treats patients with dysphagia due to muscle weakness. According to the National Institute on Deafness and Other Communication Disorders, patients are provided with muscle strengthening exercises that also help with coordination problems. Many elderly patients must be retrained to eat and follow new patterns, such as turning their head to the side when swallowing or looking straight ahead.
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