Deterioration of the pharyngo-UES contractile reflex in the elderly

Objectives/Hypothesis: Deterioration of aerodigestive tract reflexes such a s the esophagoglottal and pharyngoglottal closure reflexes and pharyngeal s wallow has been documented in the elderly. However, the effect of aging on the contractile response of the upper esophageal sphincter (UES) to pharyng eal water stimulation has not been studied. The aim of this study was to ch aracterize the pharyngo-UES reflex in the healthy elderly, Methods: We stud ied nine healthy elderly (77 +/- 1 y [SD]; four men, five women) and nine h ealthy young volunteers (26 +/- 2 y [SD]; four men, five women). A UES slee ve sensor was used to measure the pressure. We tested pharyngeal stimulatio n induced by rapid pulse and slow continuous injection of water. Results: T he volume of water required to stimulate the pharyngo-UES contractile refle x by rapid pulse injection in the elderly (0.5 +/- 34 0.1 mL) was significa ntly higher than that in the young (0.1 +/- 0.02 mL) (P < .05). In contrast to young subjects, there was no pressure increase in resting UES pressure observed in the elderly for continuous pharyngeal water infusion. In both y oung and elderly, the threshold volume for the pharyngo UES contractile ref lex was significantly lower than that for pharyngeal swallows. Conclusions: The pharyngo-UES contractile reflex deteriorates with aging, This deterior ation is primarily due to abnormalities of the afferent limb of the reflex.