Effect of aging and bolus variables on pharyngeal and upper esophageal sphincter motor function

1993 ◽  
Vol 264 (3) ◽  
pp. G427-G432 ◽  
Author(s):  
R. Shaker ◽  
J. Ren ◽  
B. Podvrsan ◽  
W. J. Dodds ◽  
W. J. Hogan ◽  
...  
Keyword(s):  
Pressure Wave ◽  
Wave Amplitude ◽  
Age Groups ◽  
The Elderly ◽  
Young Group ◽  
Upper Esophageal Sphincter ◽  
Healthy Elderly ◽  
Pressure Wave Amplitude ◽  
Resting Pressure ◽  
Esophageal Sphincter

Effect of aging, bolus volume, temperature, and consistency on the pharyngeal peristalsis, as well as the effect of aging on the upper esophageal sphincter (UES) resting pressure and its response to esophageal distension by air and balloon, were studied in 14 young and 12 healthy elderly volunteers. In both age groups there was no significant volume or temperature effect on amplitude, duration, or velocity of the pharyngeal peristalsis. Compared with water swallows, mashed potato swallows resulted in a significant increase in the amplitude and duration of the hypopharyngeal peristaltic pressure wave (P < 0.05). For water swallows, the amplitude and duration of the peristaltic pressure wave in the hypopharynx were significantly increased in the elderly compared with the young group (P < 0.01). UES resting pressure in the elderly measured 43 +/- 5 (SE) mmHg and was significantly less than that of the young (71 +/- 8 mmHg; P < 0.01). Magnitude of the UES pressure decrease because of esophageal distension by air, as well as magnitude of its pressure increase because of esophageal balloon distension, was similar among young and elderly. 1) Contrary to common expectations, the parameters of the pharyngeal peristaltic pressure wave do not deteriorate in the elderly in their seventh and eighth decade. 2) Compared with the young, hypopharyngeal pressure wave amplitude and duration are significantly increased in the elderly. This increase could be caused by an adaptation response to a pharyngeal outflow compromise. 3) Pharyngeal peristaltic pressure wave amplitude and duration, but not its velocity, are modulated by the bolus consistency. This modulatory mechanism is preserved in the elderly. 4) Although UES resting pressure is significantly decreased in the elderly, its pressure response to esophageal distension by air and balloon is preserved.

Augmentation of deglutitive upper esophageal sphincter opening in the elderly by exercise

1997 ◽  
Vol 272 (6) ◽  
pp. G1518-G1522 ◽  
Author(s):  
R. Shaker ◽  
M. Kern ◽  
E. Bardan ◽  
A. Taylor ◽  
E. T. Stewart ◽  
...  
Keyword(s):  
The Elderly ◽  
Upper Esophageal Sphincter ◽  
Cross Sectional Area ◽  
Elderly Subjects ◽  
Sectional Area ◽  
Cross Sectional ◽  
Healthy Elderly ◽  
Esophageal Sphincter ◽  
The Cross ◽  
Ues Opening

Earlier studies have shown that the cross-sectional area of the deglutitive upper esophageal sphincter (UES) opening in healthy asymptomatic elderly individuals is reduced compared with healthy young volunteers. The aim of this study was to determine the effect of a head-raising exercise on swallow-induced UES opening and hypopharyngeal intrabolus pressure in the elderly. We studied a total of 31 asymptomatic healthy elderly subjects by videofluoroscopy and manometry before and after real (19 subjects) and sham (12 subjects) exercises. A significant increase was found in the magnitude of the anterior excursion of the larynx, the maximum anteroposterior diameter, and the cross-sectional area of the UES opening after the real exercise (P < 0.05). These changes were associated with a significant decrease in the hypopharyngeal intrabolus pressure studied in 12 (real-exercise) and 6 (sham-exercise) subjects (P < 0.05). A similar effect was not found in the sham-exercise group. In normal elderly subjects, deglutitive UES opening is amenable to augmentation by exercise aimed at strengthening the UES opening muscles. This augmentation is accompanied by a significant decrease in hypopharyngeal intrabolus pressure, indicating a decrease in pharyngeal outflow resistance. This approach may be helpful in some patients with dysphagia due to disorders of deglutitive UES opening.

The influence of dynamic visual environments on postural sway in the elderly

1999 ◽  
Vol 9 (3) ◽  
pp. 197-205
Author(s):  
L.L. Borger ◽  
S.L. Whitney ◽  
M.S. Redfern ◽  
J.M. Furman
Keyword(s):  
Visual Information ◽  
Postural Sway ◽  
Center Of Pressure ◽  
Age Groups ◽  
The Elderly ◽  
Visual Scene ◽  
Elderly Subjects ◽  
Mean Velocity ◽  
Healthy Elderly ◽  
Young Subjects

Postural sway during stance has been found to be sensitive to moving visual scenes in young adults, children, and those with vestibular disease. The effect of visual environments on balance in elderly individuals is relatively unknown. The purpose of this study was to compare postural sway responses of healthy elderly to those of young subjects when both groups were exposed to a moving visual scene. Peak to peak, root mean squared, and mean velocity of the center of pressure were analyzed under conditions combining four moving scene amplitudes ( 2 . 5 ∘ , 5 ∘ , 7 . 5 ∘ , 10 ∘ ) and two frequencies of scene movement (0.1 Hz, 0.25 Hz). Each visual condition was tested with a fixed floor and sway referenced platform. Results showed that elderly subjects swayed more than younger subjects when experiencing a moving visual scene under all conditions. The elderly were affected more than the young by sway referencing the platform. The differences between the two age groups were greater at increased amplitudes of scene movement. These results suggest that elderly are more influenced by dynamic visual information for balance than the young, particularly when cues from the ankles are altered.

scholarly journals Normative data for healthy elderly on the phonemic verbal fluency task - FAS

2009 ◽  
Vol 3 (1) ◽  
pp. 55-60 ◽  
Author(s):  
Thais Helena Machado ◽  
Helenice Charchat Fichman ◽  
Etelvina Lucas Santos ◽  
Viviane Amaral Carvalho ◽  
Patrícia Paes Fialho ◽  
...  
Keyword(s):  
Test Performance ◽  
Educational Level ◽  
Verbal Fluency ◽  
Normative Data ◽  
Age Groups ◽  
The Elderly ◽  
Verbal Fluency Task ◽  
Healthy Elderly ◽  
Phonemic Verbal Fluency ◽  
Student’S T

Abstract Phonemic verbal fluency tests assess the production of words beginning with specific letters. Of these letters, the most frequently used are F, A and S. It is a sensitive test for assessing frontal lobe functions. Objective: To provide normative data for the elderly Brazilian population on the FAS test and to investigate the effects of age and schooling on test performance. Methods: The individuals were divided into three age groups (60-69, 70-79 and ³80 years), and into four groups according to education (1-3, 4-7, 8-11 and ³12 years). All subjects were assessed by the Mini Mental State Examination and the FAS. Data were analyzed with Student's t test, ANOVA, simple linear regression and Spearman's correlation. Results: We evaluated 345 cognitively healthy volunteers, 66.66% being female, aged 60 to 93 years, with an educational level ranging from one to 24 years. The average (number of items) ±SD for the whole sample was 28.28±11.53. No significant effect of gender was observed (p=0.5). Performance on the MMSE and education exerted a direct influence on FAS scores (p<0.001), with education being the most significant factor. A positive correlation was found between FAS and the MMSE (r=0.404; p<0.001). Conclusion: The performance of Brazilian elderly on the phonemic verbal fluency tests-FAS is significantly influenced by education, where individuals with higher educational level present better performance than those with fewer years of schooling. Age and gender did not prove significant with the FAS.

Pharyngeal swallowing mechanics associated with upper esophageal sphincter pressure wave

Head & Neck ◽  
2019 ◽  
Vol 42 (3) ◽  
pp. 467-475 ◽  
Author(s):  
Nelson H. May ◽  
Kate W. Davidson ◽  
William G. Pearson ◽  
Ashli K. O'Rourke
Keyword(s):  
Pressure Wave ◽  
Upper Esophageal Sphincter ◽  
Sphincter Pressure ◽  
Esophageal Sphincter ◽  
Pharyngeal Swallowing

Effect of aging on bolus kinematics during the pharyngeal phase of swallowing

2006 ◽  
Vol 290 (3) ◽  
pp. G458-G465 ◽  
Author(s):  
Eytan Bardan ◽  
Mark Kern ◽  
Ronald C. Arndorfer ◽  
Candy Hofmann ◽  
Reza Shaker
Keyword(s):  
Pressure Gradient ◽  
The Elderly ◽  
Upper Esophageal Sphincter ◽  
Elderly Subjects ◽  
Kinematics And Dynamics ◽  
Pressure Gradients ◽  
Swallowing Difficulty ◽  
Esophageal Sphincter ◽  
Young Subjects ◽  
Liquid Bolus

Swallowing difficulty is a common complaint in the elderly and, although there are data for the biomechanics of liquid swallows, little is known about solid bolus motion, or kinematics, in the elderly. The aims of this study were as follows: 1) to characterize and compare solid and liquid bolus kinematics in the elderly and compare the findings with those in young subjects and 2) to correlate bolus kinematics and dynamics. Concurrent manometric-fluoroscopic techniques were used to study eight young and eight elderly subjects. The subjects performed four swallows each of 0.2-cm-diameter solid barium pellets and 5 ml of liquid barium during sagittal fluoroscopy and six-channel pharyngoesophageal manometry. Images were digitized for analysis of kinematic properties such as velocity and acceleration. Dynamic pressures were recorded and coordinated with kinematic events. Image analysis showed that velocity varied as the pellet passed through the hypopharynx, pharynx, and upper esophageal sphincter. In young subjects, pellet kinematics were characterized by two zones of pellet acceleration: one over the tongue base and another as the pellet passed through the upper esophageal sphincter. Although the elderly showed a similar zone of acceleration over the base of the tongue, the second zone of pellet acceleration was not seen. Decreasing pressure gradients immediately distal to the position of the solid pellet and liquid bolus characterized dynamics for all subjects. This decreasing pressure gradient was significantly larger in elderly than in young subjects. Bolus kinematics and dynamics were significantly altered among elderly compared with young subjects. Among these differences were the absence of hypopharyngeal bolus acceleration and a significant increase in the transsphincteric pressure gradient in the elderly.

Effects of Head Rotation on Pharyngeal Function during Normal Swallow

1998 ◽  
Vol 107 (4) ◽  
pp. 344-348 ◽  
Author(s):  
Yukio Ohmae ◽  
Masami Ogura ◽  
Satoshi Kitahara ◽  
Takehiro Karaho ◽  
Tetsuzo Inouye
Keyword(s):  
Healthy Subjects ◽  
Head Rotation ◽  
Normal Subjects ◽  
Upper Esophageal Sphincter ◽  
Resting Pressure ◽  
Esophageal Sphincter ◽  
Pharyngeal Clearance ◽  
Pharyngeal Swallowing ◽  
Peak Pressures ◽  
Pharyngeal Function

This study quantified the effects of head rotation on pharyngeal swallowing in healthy subjects. Videofluoroscopic and oropharyngeal manometric examinations of pharyngeal swallowing were performed on seven volunteers with the head in neutral and rotated positions. Videofluoroscopic study revealed that head rotation swallow causes the bolus to lateralize away from the direction of head rotation. Pharyngeal manometric study indicated that the pharyngeal peak pressures toward the side of head rotation were significantly increased, whereas the pharyngeal pressures opposite the side of head rotation were not affected. Head rotation swallow produced a significant fall in upper esophageal sphincter (UES) resting pressure and a delay in UES closing. We concluded that the head rotation swallow in normal subjects not only alters the bolus pathway, but also has a useful effect on both pharyngeal clearance and UES dynamics.

Nutritional supplements in the Ambulatory Elderly Population: Patterns of Use and Requirements

DICP ◽  
1989 ◽  
Vol 23 (6) ◽  
pp. 490-495 ◽  
Keyword(s):  
Age Groups ◽  
National Research Council ◽  
Nutritional Supplements ◽  
The Elderly ◽  
World Health ◽  
Nutritional Deficiencies ◽  
Elderly Persons ◽  
National Academy Of Sciences ◽  
Supplement Use ◽  
Healthy Elderly

Older persons are thought to be the most frequent consumers of vitamin and mineral supplements. In this review, the use of nutritional supplements by the elderly was found to be common but was not greatly different from other age groups. Elderly persons living in Dunedin, Florida, reported nutritional supplement use less frequently than a random sample of registered nurses. Neither the Food and Nutrition Board of the National Academy of Sciences/National Research Council nor the World Health Organization has recognized the need for increasing the vitamin and mineral allowances for healthy elderly adults above those recommended for healthy young adults. It is important to recognize, however, that the elderly are at greater risk of developing nutritional deficiencies as a result of acute and chronic diseases, drug use, and social isolation, and they require careful monitoring.

scholarly journals Esophageal Peristalsis Disorders in ALS Patients with Dysphagia

2020 ◽  
Vol 10 (11) ◽  
pp. 820
Author(s):  
Jerzy Tomik ◽  
Klaudia Sowula ◽  
Mateusz Dworak ◽  
Kamila Stolcman ◽  
Małgorzata Maraj ◽  
...  
Keyword(s):  
Esophageal Manometry ◽  
Clinical Presentation ◽  
Upper Esophageal Sphincter ◽  
Esophageal Peristalsis ◽  
Resting Pressure ◽  
Esophageal Sphincter ◽  
Risk Of Aspiration ◽  
Als Patients ◽  
Low Amplitude ◽  
Lateral Sclerosis

To detect the variations of esophageal peristalsis in amyotrophic lateral sclerosis (ALS) patients with predominantly bulbar or predominantly pseudobulbar clinical presentation by using esophageal manometry (EM). Fifteen ALS patients with pseudobulbar clinical presentation (PBP) and 13 patients with bulbar presentation (BP), fulfilling WFN Criteria, were studied. EM was performed in all subjects using a flexible catheter with solid-state transducers. Swallowing was initiated with 5 to 10 mL of water (wet swallows) and saliva (dry swallows) and repeated at 30 s intervals. The manometric parameters were measured automatically and visualized by the computer system. The tracings were analyzed using Synectics software. In PBP patients, an increase of resting pressure value in the upper esophageal sphincter (UES) >45 mmHg, a wave-like course of resting pressure, and toothed peristaltic waves were observed. In BP patients, a low amplitude of peristaltic waves <30 mmHg (mean: 17 ± 5) was recorded, without signs of esophageal motility disturbance at onset or during progression. EM procedure allows objectively distinguishing dysphagia in ALS patients due to bulbar syndrome from the dysphagia due to pseudobulbar syndrome. It is important to identify PBP patients because of their high risk of aspiration.

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