🧠 SWALLOWING & AGING (PRESBYPHAGIA) (SLP Grad Student Study Set)

🔹 GENERAL PHYSIOLOGICAL CHANGES WITH AGING

Q1. What general physiological changes occur in swallowing with normal aging?

Reduction in muscle mass, decreased range of motion, speed, and strength, diminished sensory abilities, and some degree of respiratory compromise.

Q2. How do sensory changes with aging affect swallowing?

They reduce sensory awareness, which can delay swallow initiation and impair bolus control.

Q3. Why does reduced respiratory support matter for swallowing in older adults?

Because swallowing and breathing coordination is less efficient, increasing vulnerability to airway compromise.

🔹 ORAL STAGE CHANGES

Q4. How does tongue hypertrophy affect swallowing in aging?

Despite increased tongue size, tongue pressure is reduced, leading to inefficient bolus manipulation and propulsion.

Q5. What happens to tongue strength and pressure with aging?

Tongue pressure decreases, which can prolong oral transit and contribute to residue.

Q6. How do sensory impairments affect oral-stage swallowing in older adults?

Older adults have reduced ability to discriminate bolus viscosity, which can impair oral control and timing.

Q7. What oral-stage timing change is commonly seen with aging?

Prolonged mastication due to reduced strength, coordination, or dentition issues.

Q8. How does poor dentition impact swallowing in aging?

It reduces chewing efficiency, contributing to prolonged mastication and larger, poorly formed boluses.

🔹 PHARYNGEAL STAGE CHANGES

Q9. How does aging affect initiation of the pharyngeal swallow?

Swallow initiation may be mildly delayed but is typically still functional.

Q10. What happens to hyolaryngeal excursion with normal aging?

Hyolaryngeal excursion may be reduced, affecting airway protection and bolus clearance.

Q11. How does aging affect cricopharyngeal function?

There may be impairments in cricopharyngeal contraction and relaxation, affecting bolus passage through the UES.

Q12. What airway findings are common during swallowing in older adults?

Increased instances of laryngeal penetration without aspiration.

Q13. Why is penetration more common than aspiration in normal aging?

Because airway protective mechanisms are usually sufficient to prevent material from passing below the vocal folds.

Q14. What does FEES commonly show regarding laryngeal reflexes in aging?

A poor or diminished laryngeal adductor reflex (LAR).

Q15. How do sensory and motor changes contribute to pharyngeal residue in aging?

Reduced sensation and weakened motor function decrease bolus clearance, leading to residue in the pharynx.

🔹 ESOPHAGEAL STAGE CHANGES

Q16. How does aging affect esophageal motility overall?

Motility of the UES, LES, and esophageal body is decreased.

Q17. What happens to UES resting pressure with aging?

UES resting pressure is reduced, which may affect bolus control entering the esophagus.

Q18. How is esophageal peristalsis affected in older adults?

Peristalsis is weaker overall, with greater impairment seen in secondary peristalsis.

Q19. Why is impaired secondary peristalsis clinically relevant?

Because it reduces clearance of residual material in the esophagus, increasing discomfort and reflux risk.

🧠 CLINICAL PEARLS (EXAM FAVORITES)

Normal aging (presbyphagia):

• Mild delays

• Reduced strength

• Penetration without aspiration

• Increased residue

🧠 CLINICAL PEARLS (EXAM FAVORITES)

NOT normal aging:

• Frequent aspiration

• Severe delays

• Significant weight loss

• Recurrent pneumonia