European society for swallowing disorders - European union geriatric medicine society white paper: Oropharyngeal dysphagia as a geriatric syndrome

Research output: Contribution to journalReview article

Abstract

This position document has been developed by the Dysphagia Working Group, a committee of members from the European Society for Swallowing Disorders and the European Union Geriatric Medicine Society, and invited experts. It consists of 12 sections that cover all aspects of clinical management of oropharyngeal dysphagia (OD) related to geriatric medicine and discusses prevalence, quality of life, and legal and ethical issues, as well as health economics and social burden. OD constitutes impaired or uncomfortable transit of food or liquids from the oral cavity to the esophagus, and it is included in the World Health Organization’s classification of diseases. It can cause severe complications such as malnutrition, dehydration, respiratory infections, aspiration pneumonia, and increased readmissions, institutionalization, and morbimortality. OD is a prevalent and serious problem among all phenotypes of older patients as oropharyngeal swallow response is impaired in older people and can cause aspiration. Despite its prevalence and severity, OD is still underdiagnosed and untreated in many medical centers. There are several validated clinical and instrumental methods (videofluoroscopy and fiberoptic endoscopic evaluation of swallowing) to diagnose OD, and treatment is mainly based on compensatory measures, although new treatments to stimulate the oropharyngeal swallow response are under research. OD matches the definition of a geriatric syndrome as it is highly prevalent among older people, is caused by multiple factors, is associated with several comorbidities and poor prognosis, and needs a multidimensional approach to be treated. OD should be given more importance and attention and thus be included in all standard screening protocols, treated, and regularly monitored to prevent its main complications. More research is needed to develop and standardize new treatments and management protocols for older patients with OD, which is a challenging mission for our societies.

Details

Authors
  • Laura W J Baijens
  • Pere Clavé
  • Patrick Cras
  • Olle Ekberg
  • Alexandre Forster
  • Gerald F. Kolb
  • Jean Claude Leners
  • Stefano Masiero
  • Jesús Mateos-Nozal
  • Omar Ortega
  • David G. Smithard
  • Renée Speyer
  • Margaret Walshe
Organisations
External organisations
  • Skåne University Hospital
  • Clinique Bois-Bougy
  • University of Padova
  • Long Term Care and Hospice, Ettelbruck
  • Maastricht University
  • Autonomous University of Barcelona
  • University of Antwerp
  • Bonifatius Hospital
  • King's College London
  • Hospital Ramón Y Cajal
Research areas and keywords

Subject classification (UKÄ) – MANDATORY

  • Geriatrics

Keywords

  • Aged, Frail elderly, Healthy aging, Malnutrition, Quality of life, Sarcopenia, Swallowing disorders
Original languageEnglish
Pages (from-to)1403-1428
Number of pages26
JournalClinical Interventions in Aging
Volume11
Publication statusPublished - 2016 Oct 7
Publication categoryResearch
Peer-reviewedYes