DYSPHAGIA IN THE ELDERLY

OBJECTIVE To review the problem of dysphagia in the elderly so that pr imary care physicians are better able to recognize and manage it. QUAL ITY OF EVIDENCE Dysphagia, a prevalent problem in the elderly, causes significant morbidity and even mortality. Age-related deterioration of the oropharyngeal phase of swallowing is well documented. Diagnosis a nd treatment of dysphagia in the elderly is based mainly on clinical e xperience with large groups of patients. Few controlled clinical trial s have been conducted. MAIN FINDINGS Oropharyngeal dysphagia in the el derly is often due to irreversible neuromuscular disease. These patien ts benefit from swallowing therapy performed by speech pathologists. E sophageal causes of dysphagia are similar in the elderly and younger p atients, and the approach to treatment is also similar, although nonin vasive forms of therapy play a larger role for elderly patients. CONCL USIONS Dysphagia is a common problem that lowers quality of life for t he elderly. Primary care physicians must be aware of causes of dysphag ia for which specific treatments are available, as well as of the role of nonspecific treatments offered by ancillary health professionals.