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Aspects of Swallowing in Healthy Dentate Elderly Persons Older Than 80 Years

¹ Graduate School of Biomedical Sciences, Hiroshima University, Japan.
² Hiroshima City Dental Association, Japan.

Address correspondence to Mitsuyoshi Yoshida, DDS, PhD, Department of Advanced Prosthodontics, Hiroshima University, Graduate School of Biomedical Sciences, Kasumi 1-2-3, Minami-ku, Hiroshima 734-8553, Japan. E-mail: mitsu{at}hiroshima-u.ac.jp

Background. Although age-related changes resulting in slowing of the swallowing reflex and a decline in the neuromuscular control system have been reported, there have been few reports on swallowing function in dentate elderly persons. The purpose of this study was to clarify the primary influence of aging on swallowing in healthy dentate elderly persons older than 80 years who have more than 20 teeth.

Methods. Dentate elderly persons (12 male, 7 female; mean age: 81.2 years) and dentate young participants (9 male, 5 female; mean age: 26.8 years) as a control group participated voluntarily. Participants reported no clinical symptoms relating to dysphagia, neurologic impairments, or degenerative diseases, and were asked to swallow 10 ml of barium sulfate solution (10% w/v) three times. Functional swallowing was recorded on 35 mm cinefilm at 30 frames per second with a digital subtraction angiography system. Lateral images of cinefluorography of seated participants' mouth, pharynx, and larynx were obtained. Visual image analysis for qualitative and quantitative evaluation was made with a cine projector.

Results. No participants exhibited aspiration during three trials. Occurrence and frequencies of piecemeal deglutition, premature loss of liquid, oral and pharyngeal residues, and laryngeal penetration were significantly greater in dentate elderly persons (p <.05) than in the dentate young participants. Oral transit time, pharyngeal delay time, and pharyngeal transit time in dentate elderly persons were prolonged significantly compared with those in dentate young participants (p <.01).

Conclusion. Physiological swallowing functions deteriorate even in healthy dentate elderly persons. This deterioration may be explained primarily by the influence of aging on swallowing.