Treatment for Swallowing Dysfunction in Elderly Person

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Dysphagia with frequent aspiration is associated with an increased risk for subsequent pneumonia. Aspiration pneumonia in the elderly may be caused by a decrease in the swallowing function. The aim of this study was to discuss the influence of body position on swallowing function.Following informed consent, 10 healthy, fully dentate males (average age : 29.5 3.6 years old) were selected as subjects. Tongue movements and swallowing sounds were observed and recorded using general-purpose ultra-sound diagnostic system. Tongue movement and swallowing sounds were analyzed by plotting five inflection points (T1, T2, T3, T4 and T5) of the tongue movement curve and two beginning points of swallowing sounds (S1 and S2) using a digitizer. The test food was made by dissolving Mousse Up (Food Care Ltd. Japan) of 6 g into 30 ml water. Subjects were directed to swallow a test food under 3 body positions ; sitting position, 30^o lying position, lying position. Statistical analysis was performed by one-way analysis of variance (ANOVA) and the Duncan test.The times from the beginning point of the swallowing to T3, T4, S1 and S2 were significant extended (p < 0.05). The time from S1 to T4 was significant extended (p < 0.005). There was a significant correlation between T4 and S1, T4 and S2 statistically (p < 0.05).In the "lingual stage", the lingual edges appose the hard plate anteriorly and laterally as tongue contact. In our study, we judged T4 to be the end of this stage and the bolus would be squeezed toward the oropharynx. In the "pharyngeal stage", the tongue approximates the posterior pharyngeal wall resulting in a tight velopharyngeal seal. The epiglottis will be shut in anticipation of the bolus. In our study, we judged S1 to be the beginning of this sound.From this study, it was suggested that the body positions influence on swallowing function, and also suggested that our analyzing method could be useful for evaluation of the swallowing function.