2005 Fiscal Year Final Research Report Summary
Quantitative evaluation for swallowing disturbance due to aging
| Project/Area Number |
16591713
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| Research Category |
Grant-in-Aid for Scientific Research (C)
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| Allocation Type | Single-year Grants |
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| Section | 一般 |
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| Research Field |
Otorhinolaryngology
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| Research Institution | Ehime University |
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Principal Investigator |
HYODO Masamitsu Ehime University, School of Medicine, Associate Professor, 医学部, 助教授 (00181123)
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| Co-Investigator(Kenkyū-buntansha) |
WAKISAKA Hiroyuki Ehime University, University Hospital, Lecturer, 医学部附属病院, 講師 (30304611)
MOTOYOSHI Kazumi Ehime University, School of Medicine, Lecturer, 医学部, 講師 (70322279)
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| Project Period (FY) |
2004 – 2005
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| Keywords | dysphagia / aging / self-reported questionnaire / videoendoscopy in swallowing / videofluorography / swallowing manometry / aspiration / delay of swallowing reflex |
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| Research Abstract |
Methods
Forty-seven healthy aged volunteers (10 males and 37 females, 60-87 years old with an average of 68.9 years) participated in this study. None of them had a past history of cerebrovascular or neuromuscular diseases. Multilaterall analyses (the self-reported questionnaire, videoendoscopy in swallowing, videofluorography, and swallowing manometry) were conducted, and their swallowing functions were objectively assessed.
Results
The self-reported questionnaire showed 23% of the participants stated "aspiration before swallow", 30% of "aspiration during swallow", and 13% of "recent increase of dysphagia", indicating potential subclinical swallowing disturbance in aged population. These complaints were more frequent in participants over 70-year-old than in those 60-69 years. By videoendoscopic observation, salivary pooling in the vallecula and piriform sinuses, glottal-closure reflex and pharyngeal clearance after drinking 3ml of blue-dye water were scored into 0-3. Percentages of distur
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bed swallowing function, with score 2 or 3, were 19%, 13% and 25%, respectively. Videofluorography showed insignificant changes of distances of hyoid and laryngeal movement during swallow, but significant prolongations of pharyngeal transition time and laryngeal elevation delay time with an increase of ages. Manometric examination showed sustained tonic pressure at the upper esophageal sphincter zone in 6% during pharyngeal swallowing phase, and widened upper esophageal sphincter zone in 15%.
Discussion and Conclusion
The present study revealed that swallowing disturbance possibly exists in aged persons resulting in an increasing risk of aspiration. Videoendoscopy also showed age-related swallowing dysfunction with a great individual variation. Videofluorography indicated a decrease of bolus driving force and a delay of laryngeal elevation during pharyngeal swallowing phase. Manometric study suggested functional alteration of the thyropharyngeal or upper esophageal muscles to cricopharyngeal muscle leading to dysfunction of upper esophageal constrictor muscle. Less
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