How do the elderly swallow? An investigation using high-resolution impedance manometry

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Abstract

Background
Swallowing is a complex and intricate process that changes as we age. Changes in sensory and motor function modify the biomechanics of swallowing and may in some cases increase the risk of developing dysphagia (impaired swallowing). The aim of this research was to identify the characteristics of swallowing function in a group of healthy older individuals. We investigated the effect of bolus volume on the biomechanics of swallowing, using high-resolution impedance manometry (HRIM). A comparison was conducted between pre-measured bolus amounts, administered via syringe and self-guided bolus volume.

Method
This study is part of the Speech Pathology Honours project of R Francis. Data collection is currently underway using HRIM to assess the swallowing of 14 healthy +65yr old healthy participants. Each participant swallows three trials of 3ml, 5ml, 10ml and 20ml of thin and puree thick liquid. In addition, each participant consumes “mouthfuls” of thin liquid from a cup. Biomechanical swallowing data of the self-guided swallows will be compared to that recorded during the pre-measured bolus volumes administered via syringe. Data will be analysed using Swallow Gateway software, a customized analysis platform for HRIM data. Key outcome measures will include pharyngeal peak pressure, intra-bolus pressure, upper oesophageal sphincter (UES) opening duration, and bolus clearance across the UES.

Results
Preliminary data analysis of N=7 suggests that the volume of a self-guided mouthful of liquid is on average 26ml. This does not closely align with the bolus volumes presented via syringe and indicates pre-measured bolus volumes may not be a true representation of bolus volumes ingested naturally. Analysis of the HRIM data will commence as soon as data collection is complete.

Clinical Implications
The findings of this research will provide insights into the characteristics of healthy elderly swallowing physiology and how function changes to accommodate different bolus volumes. This information will be valuable in providing more individualized and specific assessment and consequent management of dysphagia.
Original languageEnglish
Publication statusPublished - 6 Jun 2018
EventASMR Medical Research Week: South Australian Scientific Meeting - National Wine Centre, Adelaide, Australia
Duration: 6 Jun 2018 → …

Conference

ConferenceASMR Medical Research Week
Abbreviated titleASMR
Country/TerritoryAustralia
CityAdelaide
Period6/06/18 → …

Keywords

  • Swallowing
  • Dysphagia
  • Older people
  • Manometry

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