Swallowing disorders (or dysphagia) are common in the elderly and their prevalence is often underestimated. They may result in serious complications including dehydration, malnutrition, airway obstruction, aspiration pneumonia (infectious process) or pneumonitis (chemical injury caused by the inhalation of sterile gastric contents). Moreover the repercussions of dysphagia are not only physical but also emotional and social, leading to depression, altered quality of life, and social isolation. While some changes in swallowing may be a natural result of aging, dysphagia in the elderly is mainly due to central nervous system diseases such as stroke, parkinsonism, dementia, medications, local oral and oesophageal factors. To be effective, management requires a multidisciplinary team approach and a careful assessment of the patient’s oropharyngeal anatomy and physiology, medical and nutritional status, cognition, language and behaviour. Clinical evaluation can be completed by a videofluoroscopic study which enables observation of bolus movement and movements of the oral cavity, pharynx and larynx throughout the swallow. The treatment depends on the underlying cause, extent of dysphagia and prognosis. Various categories of treatment are available, including compensatory strategies (postural changes and dietary modification), direct or indirect therapy techniques (swallow manoeuvres, medication and surgical procedures).Le texte complet de cet article est disponible en PDF.
Keywords : Swallowing disorders, Elderly, Pneumonia, Dysphagia, Cough, Aspiration, Lower respiratory tract infectious disease
| Scientific committee: Louis-Jean Couderc, Bruno Crestani, Philippe Devillier, Françoise Forette, Alain Franco, Hervé Guenard, Philippe Godard, Maurice Hayot, Claude Jeandel, Élizabeth Orvoen-Frija, François Piette, Geneviève Pinganaud, Christophe Pison, François Puisieux, Benoît de Wazières.
| This article is the English translation of the following manuscript, which was originally published in French in Revue des Maladies Respiratoires. Please cite this article as: “Puisieux F, D’andrea C, Baconnier P, Bui-Dinh D, Castaings-Pelet S, Crestani B, Desrues B, Ferron C, Franco A, Gaillat J, Guenard H, Housset B, Jeandel C, Jebrak G, Leymarie-Selles A, Orvoen-Frija E, Piette F, Pinganaud G, Salle JY, Strubel D, Vernejoux JM, De Wazières B, Weil-Engerer S. Troubles de la déglutition du sujet âgé et pneumopathies en 14questions/réponses. Rev Mal Respir 2009;26:587–605”.