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Gastroenterology Research and Practice
Volume 2011, Article ID 818979, 13 pages
http://dx.doi.org/10.1155/2011/818979
Review Article

Diagnosis and Management of Oropharyngeal Dysphagia and Its Nutritional and Respiratory Complications in the Elderly

1Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (Ciberehd), Instituto de Salud Carlos III, 08036 Barcelona, Spain
2Unidad de Exploraciones Funcionales Digestivas, Hospital de Mataró, 08304 Mataró, Spain
3Unidad de Cuidados Intensivos, Hospital de Mataró, 08304 Mataró, Spain
4Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (Ciberes), Instituto de Salud Carlos III, 07110 Mallorca, Spain
5Unidad Geriátrica de Adultos, Hospital de Mataró, 08304 Mataró, Spain
6Servicio de Farmacia, Hospital de Mataró, 08304 Mataró, Spain
7Nutrition Unit, Hospital General Universitario Gregorio Marañón, 28007 Madrid, Spain
8Department of Otorhinolaryngology and Head and Neck Surgery, Maastricht University Medical Centre, 6200 MD Maastricht, The Netherlands
9Comprehensive Cancer Centre West, 2316 XB Leiden, The Netherlands

Received 15 February 2010; Accepted 13 April 2010

Academic Editor: Rémy Meier

Copyright © 2011 Laia Rofes et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Oropharyngeal dysphagia is a major complaint among older people. Dysphagia may cause two types of complications in these patients: (a) a decrease in the efficacy of deglutition leading to malnutrition and dehydration, (b) a decrease in deglutition safety, leading to tracheobronchial aspiration which results in aspiration pneumonia and can lead to death. Clinical screening methods should be used to identify older people with oropharyngeal dysphagia and to identify those patients who are at risk of aspiration. Videofluoroscopy (VFS) is the gold standard to study the oral and pharyngeal mechanisms of dysphagia in older patients. Up to 30% of older patients with dysphagia present aspiration—half of them without cough, and 45%, oropharyngeal residue; and 55% older patients with dysphagia are at risk of malnutrition. Treatment with dietetic changes in bolus volume and viscosity, as well as rehabilitation procedures can improve deglutition and prevent nutritional and respiratory complications in older patients. Diagnosis and management of oropharyngeal dysphagia need a multidisciplinary approach.