Oropharyngeal Dysphagia: Aetiology and Effects of Ageing

Abstract

Oropharyngeal dysphagia (OD) is a very prevalent swallowing disorder among older people that causes severe complications such as malnutrition and dehydration (due to impaired efficacy of swallow) and respiratory infections and pneumonia (caused by impaired safety of swallow) with detrimental outcomes such as high hospital readmission rates and mortality. In addition, these complications and poor outcomes have great economic and social impact. Older patients with OD should be diagnosed and treated early to prevent or minimize complications and economic and social costs. Management of patients with OD is of key importance and several screening and diagnostic tools and methods (EAT-10, volume-viscosity swallowing test, FEES and videofluoroscopy) are available. In addition, different types of treatments have been described and are being used and new ones are being studied and developed. There is a strong case for OD to be considered a geriatric syndrome because it is highly prevalent, has serious repercussion on the overall health status of the patient, is related to multiple risk factors, follows diverse aetiopathogenic pathways is a part of the aetiopathogenic cycle of frailty and is able to induce it. For these reasons, OD should be systematically integrated into the management of older patients. This chapter gives an overview of OD in older people, from prevalence to a general intervention strategy for correct diagnosis and treatment.