Aging and Swallowing

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Swallowing is a complex process that changes over time, and swallowing difficulty (dysphagia) can be associated with aging. Changes in the tongue, upper throat (pharynx), vocal cords and voice box (larynx), and lower throat (esophagus) occur with aging. It has been estimated that more than 20 percent of individuals over the age of 50 experience dysphagia.1 Since the aging population is increasing, a significant number of individuals will experience changes in swallowing over time. By understanding normal, as well as abnormal, age-related changes, doctors and speech-language pathologists (SLPs) who specialize in swallowing disorders can better counsel patients, and target treatment strategies.

What Are the Symptoms of Swallowing Difficulty?

When you have difficulty swallowing, you may be experiencing one or more of the following symptoms:

  • Difficulty chewing
  • Increased effort to move food and liquids from the mouth into the upper throat (pharynx)
  • Increased effort or resistance moving food from the upper throat (pharynx) into the lower throat (esophagus)
  • Food getting stuck
  • Pills getting stuck
  • Regurgitation of food (can be right away with swallowing or delayed)
  • Coughing and/or choking with eating and drinking
  • Recurrent lung infections 
  • Weight loss due to food avoidance

What Causes Swallowing Difficulty?

Several issues can lead to swallowing difficulties, especially as people grow older, including:

  • Missing teeth
  • Dry mouth and throat
  • Reduced tongue size and strength
  • Reduced strength in the upper throat (pharynx)
  • Reduced size and strength of the vocal cords and voice box (larynx)
  • A longer, more dilated throat
  • A narrower entrance into the lower throat (esophagus)
  • Poor ability of the lower throat (esophagus) to move food into the stomach
  • Overall increase in the time it takes for swallowing to occur
  • Overall decrease in the feeling or sensitivity of the throat and voice box2

What Are the Treatment Options?

This website has numerous resources covering specific swallowing disorders, but when age-related changes alone are suspected, you can use these helpful strategies. Taking good care of your teeth and practicing good oral hygiene are excellent first steps. Ensuring that you chew your food completely and taking small bites and sips can help food move through the swallowing process. Make sure you hydrate properly, such as drinking water, when swallowing drier foods like bread or crackers. Minimizing the use of medications and drinks that dry your mouth and throat, such as coffee and other caffeinated beverages, can be helpful.

You may also consider working with a speech pathologist to learn strategies for eating properly and strengthening your throat using specific exercises. In some instances, further testing by your doctor or swallowing therapist may help identify underlying problems and individual treatment options.

What Questions Should I Ask My Doctor?

  1. How can I get my pills down more easily?
  2. I have trouble chewing my food. What can I do?
  3. Food gets stuck in my throat and is hard to get down. What can I do?
  4. Is coughing with swallowing okay?
  5. Since there is “normal aging” with swallowing, is it a problem?

 

References
1: Howden CW. Management of acid-related disorders in patients with dysphagia. Am J Med. 2004;117:44S-8.
2: Leonard RL and Shaker S. Effect of aging of the pharynx and UES.  In: Principles of Deglutition. Eds: Shaker R, Belafsky PC, Postma GN, et al. Springer 2013.

 

Copyright 2021. American Academy of Otolaryngology–Head and Neck Surgery Foundation. Last reviewed April 2020.