Profile of oropharyngeal swallowing in healthy Brazilian adults and older adults

• Published in: Brazilian journal of otorhinolaryngology Vol. 91; no. 1; p. 101494
• Main Authors: Dall'Oglio, Giovana Piovesan, De Lima Alvarenga, Eliézia Helena, Haddad, Leonardo, Aires, Mateus Morais, Abrahão, Márcio
• Format: Journal Article
• Language: English
• Published: Brazil Elsevier España S.L.U 01.01.2025; Elsevier; Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial
• Subjects: Adult; Age Factors; Aged; Aged, 80 and over; Brazil; Cross-Sectional Studies; Deglutition - physiology; Deglutition disorders; Deglutition Disorders - diagnosis; Deglutition Disorders - physiopathology; Dysphagia; Female; Fiber Optic Technology; Fiberoptic endoscopic evaluation of swallowing; Humans; Male; Middle Aged; Original; Oropharynx - physiology; Oropharynx - physiopathology; OTORHINOLARYNGOLOGY; Prospective Studies; Surveys and Questionnaires; Swallowing physiology; Young Adult; Brazil; Fiberoptic endoscopic evaluation of swallowing; Dysphagia; Deglutition disorders; Swallowing physiology; Age factors
• ISSN: 1808-8694; 1808-8686; 1808-8686
• DOI: 10.1016/j.bjorl.2024.101494

•Age ≥80 years linked to higher salivary stasis and residue.•FEES reveals no age impact on penetration and aspiration.•Number of swallows to clear bolus was two during lifespan.•The swallowing reflex was triggered up to the vallecula in 99% in all consistencies.•Presence of residue and penetration indicate impaired swallowing efficiency and safety. To describe the findings of Fiberoptic Endoscopic Examination of Swallowing (FEES) in asymptomatic young and older adults, comparing results across different age groups. Additionally, this study aims to test the Eating Assessment Tool (EAT-10) as an instrument to identify dysphagia risk. A prospective cross-sectional observational analysis was conducted on a sample of individuals aged 20 and above, asymptomatic for dysphagia, stratified by age groups. The EAT-10 questionnaire was completed, and the FEES was employed to assess oropharyngeal swallowing function. Various parameters, including salivary stasis, swallowing reflex trigger, swallowing sequence, residue, penetration, and aspiration were blindly analyzed by two otolaryngologists. A total of 184 participants were included, with a mean age of 44.7 ± 18.5 years. There was good to excellent agreement between examiners for FEES parameters. The EAT-10 score ≥3 suggested dysphagia risk in 7.6% (n = 14) of the sample, with no association with age or any FEES parameter. Individuals aged ≥80 years presented more residue (50%; n = 5/10) compared to younger individuals (11.5%; n = 20/174; p =  0.039). Salivary stasis was found exclusively in individuals aged ≥60 years (n = 5/39; 12.8%; p = 0.027). Age did not influence on the swallowing reflex trigger, swallowing sequence, penetration, and aspiration. Penetration was observed in 4.9% (n = 9) of subjects and aspiration occurred in 0.5% (n = 1) of subjects, with no statistical significance in age groups. Age does not have a linear influence on swallowing in healthy adults and elderly people. However, individuals aged ≥80 years showed a higher prevalence of residue, and individuals aged ≥60 years showed a higher prevalence of salivary stasis, suggesting an increased risk or presence of dysphagia. Other FEES parameters were not influenced by age. These findings provide valuable insights into the nuanced dynamics of swallowing across different age groups, emphasizing the importance of age-specific considerations in dysphagia assessment. 4.