AGE EFFECTS ON LINGUAL PRESSURE GENERATION AS A RISK FACTOR FOR DYSPHAGIA

Background. Tongue activity plays a crucial role in both oral and phar yngeal phases of swallowing. In this study, maximum lingual isometric and swallowing pressures were quantified in two groups of healthy men to investigate possible age effects on performance. Magnetic resonance images of the brain were also obtained to examine the relationship be tween age-related anatomical changes and swallowing function. Methods. Pressures were recorded at three lingual sites (tip, blade, and dorsu m) during a maximal isometric task and during saliva swallows. Task or der was randomized, and subjects performed three trials per placement site. Additionally, t2-weighted MRIs were obtained on 9 of the 10 youn g subjects (mean age = 25 years) and all 15 older subjects (mean age = 75 years). Results. Maximal isometric pressures were significantly gr eater for younger subjects at the tongue blade site (p = .002), wherea s peak swallowing pressures remained similar across both age groups. W ithin-subject comparisons of maximum isometric to swallowing pressures , a measure of reserve capacity, revealed reduced difference scores at the tongue blade in the older group (p = .02). Older subjects exhibit ed significantly more cerebral atrophy (p = .001) and greater incidenc e of periventricular white matter lesions (p = .0001) than did younger subjects. Conclusions. While swallowing pressures remain similar acro ss the life span, overall pressure reserve declines with age. The impl ications are: (a) older people may be working harder to produce adequa te swallowing pressures, and (b) age-related illness may put geriatric patients at higher risk for dysphagia, thus further complicating reco very.