Dysphagia in Older Adults and Its Management
K. Rao Poduri in Geriatric Rehabilitation, 2017
Oropharyngeal dysphagia is a swallowing disorder that results in difficulties with the passage of food, liquids, and secretions from the mouth to the esophagus. Symptoms of dysphagia include drooling, difficulty chewing, manipulating the bolus, and propelling it to the posterior aspect of the oral cavity, coughing before, during, or after swallowing, and moving the bolus through the pharynx. The term oropharyngeal dysphagia is sometimes used interchangeably with deglutition disorder and dysphagia. In this chapter, we will use the term dysphagia to mean oropharyngeal dysphagia. As the word suggests, oropharyngeal refers primarily to the oral (mouth) region and the pharynx, and is different from esophageal dysphagia. Speech-language pathologists (SLPs) diagnose and treat persons with oropharyngeal dysphagia, while gastroenterologists usually diagnose and treat persons with esophageal dysphagia.
Instrumental assessment and skill-based dysphagia rehabilitation following stroke
Margaret Walshe, Maggie-Lee Huckabee in Clinical Cases in Dysphagia, 2018
VFSS had been undertaken two months previously. This was not initially repeated because there had been limited symptomatic improvement and no reported clinical change in swallowing performance on FEES one month later, and swallowing elicitation frequency was low. Although his CN exam and behavioural assessment were not inconsistent with weakness as an underlying aetiology, strength-based rehabilitation had not been effective. In addition, a presentation of nasal redirection, paired with a site of lesion in the brainstem, raised concerns that the primary deficit may not be weakness, but rather a deficit of motor planning for swallowing. Importantly, adverse effects have been reported with strengthening exercises, such as effortful swallowing (Garcia et al. 2004) and current research is highlighting improvements based on skill, rather than strength, training (Athukorala et al. 2014; Humbert & German 2013). Thus, skill-based rehabilitation for oropharyngeal dysphagia was undertaken to improve volitional control of swallowing elicitation and improve precision in motor control of timing and relative strength of swallowing.
Swallowing disorders
Declan Costello, Guri Sandhu in Practical Laryngology, 2015
Dysphagia is a symptom. It may be caused by multiple different disorders or insults and has far-reaching consequences. The prevalence of dysphagia is increasing rapidly worldwide and will continue to rise as society ages. In the United States, more than 15 million people were estimated to be affected by dysphagia in 2010.1 Hospital stays for dysphagic patients are twice as long as non-dysphagic patients and are estimated to cost $547 billion annually.2 Data from the United States demonstrates that a diagnosis of oropharyngeal dysphagia (OPD) is associated with an adjusted mortality rate of 13.7.2 Epidemiological studies suggest that dysphagia impacts 22% of adults 50 years or older, 50% adults 65 years and older and most individuals by 80 years of age.3–5 Dysphagia is the most common symptom following stroke and is associated with increased mortality in rest home residents and people in long-term residential care.1
The Test of Masticating and Swallowing Solids (TOMASS): Normative data for two crackers available in the Scandinavian and international markets
Published in International Journal of Speech-Language Pathology, 2021
Patricia Hägglund, Sandra Blom, Patrik Thoden, Fredrik Karlsson
Oropharyngeal dysphagia refers to swallowing dysfunction in the oral cavity or the pharynx. Accurate identification of dysfunction is crucial for minimising dysphagia-related complications such as malnutrition and aspiration pneumonia (Altman, Yu, & Schaefer, 2010; Martino et al., 2005; Serra-Prat et al., 2012). Oropharyngeal dysphagia is commonly assessed in one of three ways: screening, clinical assessment or instrumental assessment, or in a three-step approach where all three ways are included (Baijens et al., 2016). Although instrumental swallowing assessment techniques (e.g. videofluoroscopic or videoendoscopic assessments) are considered to have the highest diagnostic value (Baijens et al., 2016; Langmore, 2003), the availability of these techniques varies across countries due to both social and economic conditions as well as the existing health policies. In addition, most screening tools and clinical assessments use liquid when assessing the oropharyngeal swallowing, whereas there is a lack of objective and quantifiable clinical measures for assessing the oral preparatory and oral transit part of swallowing when ingesting solid food.
The prevalence of oropharyngeal dysphagia in patients with chronic obstructive pulmonary disease: a systematic review and meta-analysis
Published in Expert Review of Respiratory Medicine, 2022
Wenyan Li, Mingjing Gao, Jin Liu, Fengwa Zhang, Rongjing Yuan, Qingling Su, Yetong Wang, Yanhong Wang
Observational study (cross-sectional studies, case-control studies, and cohort studies).The subjects were patients with COPD (Diagnostic criteria for the GOLD guidelines [11]: the presence of progressive dyspnea, chronic cough, and expectoration; A history of exposure to risk factors; Pulmonary function tests: FEV1/FVC < 0.7 after inhalation of bronchodilators suggests continued airflow limitation, among other conditions that can cause continued airflow limitation.Assess for oropharyngeal dysphagia.
Development of a swallowing risk screening tool and best practice recommendations for the management of oropharyngeal dysphagia following acute cervical spinal cord injury: an international multi-professional Delphi consensus
Published in Disability and Rehabilitation, 2022
Jackie McRae, Christina Smith, Suzanne Beeke, Anton Emmanuel
Statements were developed following a review of the literature on clinical factors linked to oropharyngeal dysphagia in cSCI. MeSh search terms were used to generate papers through PubMed (Supplemental Data 1), specifically on dysphagia identification and management, nutritional management, respiratory impairment, mouth care and associated clinical complications in acute SCI. A total of seven topic areas were generated related to the clinical pathway of dysphagia care post-SCI, namely co-morbid status, the definition of dysphagia, screening for dysphagia, assessment, identification, management and therapeutic intervention. Each topic had further subcategories resulting in a total of 90 statements for inclusion in the Delphi questionnaire. The steering group reviewed the statements for content and construct and merged similar items reducing the questionnaire to 85 statements (Table 1).
Related Knowledge Centers
- Aspiration Pneumonia
- Cough
- Dysphagia
- Malnutrition
- Pharynx
- Pneumonia
- Weight Loss
- Esophagus
- Choking
- Regurgitation