Dysphagia Diagnoses in Older Adults Often Neuromuscular, Esophageal

The most common causes of dysphagia in patients age 65 and older presenting at a tertiary care swallowing center over a 2-year period were neurologic and esophageal in nature, according to a study published online in OTO Open. 

“These etiologies also result in significant quality-of-life burden, thereby pointing to the need for further research in the evaluation and treatment of dysphagia in older age,” wrote researchers from the departments of otolaryngology-head and neck surgery at Johns Hopkins University and Emory University. 

The study was a retrospective chart review of 109 older adults with a chief complaint of dysphagia who were new patients at the Johns Hopkins Voice Center between April 2015 and March 2017.  

In addition to identifying neurologic and esophageal as the most common dysphagia etiologies, the review identified the most common diagnoses in the population: diverticular disease (15.6%), reflux-related disease (13.8%), and radiation-induced fibrosis (8.3%).

Men were more likely to present with oropharyngeal disease, researchers reported. Women were more likely to present with esophageal disease.

The greatest quality-of-life impact, reflected in higher Eating Assessment Tool (EAT-10) scores, occurred with diverticular disease, cricopharyngeal hypertonicity, and radiation-induced changes, the study found. 

“Our study did not identify a difference in etiology of dysphagia or EAT-10 scores among the 3 subgroups analyzed (young-old, 65-74 years; middle old, 75-84; and old-old, ≥85),” researchers reported, “consistent with a prior study analyzing self-perceived dysphagia in these age groups.” 

—Jolynn Tumolo

Reference:

Applebaum J, Lee E, Harun A, et al. Characterization of Geriatric Dysphagia Diagnoses in Age-Based Cohorts. OTO Open. 2020;4(3):2473974X20939543. Published 2020 Jul 8. doi:10.1177/2473974X20939543