Volumetric Changes to the Pharynx in Healthy Aging: Consequence for Pharyngeal Swallow Mechanics and Function
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ORIGINAL ARTICLE
Volumetric Changes to the Pharynx in Healthy Aging: Consequence for Pharyngeal Swallow Mechanics and Function Sonja M. Molfenter1
•
Charles Lenell1 • Cathy L. Lazarus2,3
Received: 15 March 2018 / Accepted: 11 July 2018 Ó Springer Science+Business Media, LLC, part of Springer Nature 2018
Abstract Pharyngeal lumen volume is prone to increase as a consequence of pharyngeal muscle atrophy in aging. Yet, the impact of this on swallowing mechanics and function is poorly understood. We examined the relationship between pharyngeal volume and pharyngeal swallowing mechanics and function in a sample of healthy community-dwelling seniors. Data were collected from 44 healthy seniors (21 male, mean age = 76.9, SD = 7.1). Each participant swallowed 9 boluses of barium (3 9 5 ml thin, 3 9 20 ml thin, 3 9 5 ml nectar). Pharyngeal shortening, pharyngeal constriction, pyriform sinus and vallecular residue were quantified from lateral view videofluorosopic swallowing studies. Pharyngeal lumen volume was captured during an oral breathing task with acoustic pharyngometry. In addition, within-participant measures of strength and anthropometrics were collected. Four linear mixed effects regression models were run to study the relationship between pharyngeal volume and pharyngeal constriction, pharyngeal shortening, pyriform sinus residue, and vallecular residue while controlling for bolus condition, age, sex, and posterior tongue strength. Increasing pharyngeal lumen volume was significantly related to worse constriction and vallecular residue. In general, larger and thicker boluses resulted in worse pharyngeal constriction and residue. Pharyngeal shortening was only significantly related to posterior tongue strength. Our work establishes the utility of acoustic pharyngometry to monitor pharyngeal lumen volume. Increasing pharyngeal lumen volume appears to impact both pharyngeal swallowing mechanics and function in a sample of healthy, functional seniors. Keywords Swallowing Deglutition Dysphagia Deglutition disorders Aging Pharynx Sarcopenia Atrophy Acoustic pharyngometry Pharyngeal constriction Pharyngeal shortening Residue
Introduction The proportion of seniors in the US is projected to dramatically increase from 13% (2010) to over 20% (2030) [1]. The literature suggests that between 11 and 38% of healthy, community-dwelling seniors experience disruption to swallowing function [2–8] which can potentially disrupt their nutrition, hydration, pulmonary health, and quality-of& Sonja M. Molfenter [email protected] 1
Department of Communicative Sciences & Disorders, NYU Steinhardt, New York, NY, USA
2
Department of Otolaryngology Head & Neck Surgery, Mount Sinai Beth Israel, THANC Foundation, New York, NY, USA
3
Department of Otolaryngology Head & Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA
life. When patients with dysphagia are admitted to the hospital, they experience a 40% longer length-of-stay than those without dyspha
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