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Pharyngeal swallowing in older adults: Kinematic analysis using three‐dimensional dynamic computed tomography
Author(s) -
Pongpipatpaiboon Kannit,
Inamoto Yoko,
Saitoh Eiichi,
Kagaya Hitoshi,
Shibata Seiko,
Aoyagi Yoichiro,
Fujii Naoko,
Palmer Jeffrey B.,
Fernández Marlís G.
Publication year - 2018
Publication title -
journal of oral rehabilitation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.991
H-Index - 93
eISSN - 1365-2842
pISSN - 0305-182X
DOI - 10.1111/joor.12703
Subject(s) - swallowing , epiglottis , medicine , age groups , pharynx , hyoid bone , audiology , rehabilitation , larynx , orthodontics , dentistry , surgery , physical therapy , sociology , demography
Summary Objectives To assess the effect of age on swallowing with a focus on structural movement, timing and duration of physiologic events. Design Cross‐sectional study. Setting Tertiary University Medical Center. Participants Community‐dwelling adults (3 age groups): younger 20 to 39 (n = 23; mean 32 ± 5), middle‐aged 40 to 59 (n = 29; mean 49 ± 5) and older adults 60 to 74 (n = 15; mean 67 ± 5). Intervention One 10‐ mL honey‐thick liquid (1700 mP a) swallow was studied using 320‐row area detector computed tomography scanning. Measurements Kinematic analysis was performed for each swallow including temporal characteristics and structural movements. Results The duration of velopharyngeal closure and laryngeal closure (including epiglottis inversion, laryngeal vestibule closure, true vocal cord closure) was significantly different by age group ( P = 0.002, P < 0.001, P = 0.017, P = 0.041, respectively). Events were prolonged in older adults compared with middle‐aged and younger adults. The pharyngeal phase was longer for older adults. Velopharyngeal closure started earlier and continued until after complete UES opening. In younger adults, velopharyngeal and laryngeal opening occurred before complete UES opening. No differences were found in bolus movement through the oropharynx by group. Conclusion During swallowing, older adults had a longer pharyngeal phase characterised by prolonged velopharyngeal and laryngeal closure. This difference may be a protective mechanism to compensate for age‐related weakness. A better understanding of the mechanism by which this adaptation occurs is needed to tailor rehabilitation strategies and to maintain swallowing function during the lifespan.