Imagine this: it’s a hot day, you’ve been working in the garden outside, and you’re feeling thirsty. A tall glass of cool, ice water sits on the table in front of you. You put the glass to your lips and take several long, big sips. It’s a refreshing moment with a skill that many of us often take for granted: swallowing.

Among the subtle shifts that occur with aging, changes in eating and swallowing often take a back seat in discussions about other top concerns such as mobility, vision, and hearing, or cognitive abilities. Yet changes in eating and swallowing can significantly impact one’s quality of life and overall health. Understanding the nuances of age-related shifts in eating and swallowing is critical for maintaining health and addressing potential concerns before major problems arise.

Body Changes as We Age

As readers already well know, various physiological changes occur in our bodies as we age, including those affecting the structures involved in the swallowing system. Normal aging can affect the structures and functions involved in how we eat and drink, such as:

• Reduced Muscle Strength: Muscles involved in chewing and swallowing may weaken over time, leading to slower and less efficient management, especially for more challenging textures like chewy meats and raw vegetables
• Decreased Salivary Production: Aging often results in reduced saliva production, which can make the mouth dry. This may be additionally impacted by certain medications with dry mouth listed as a side effect
• Changes related to teeth: Missing or damaged teeth can impact the ability to break down bigger pieces of food; dental work, including dentures, may result in temporary changes to chewing and swallowing
• Changes in Sensation: Older adults may experience diminished sensitivity in their mouth and throat, making it harder to detect and manage food textures; the timing of the older swallow is slower, making reaction times to unexpectedly large or quick-moving foods more difficult. Other sensory changes to taste, vision, and smell may also have an impact on the experience of eating
• Altered Esophageal Function: The muscular tube connecting the throat to the stomach is the esophagus; these muscles may become less coordinated, potentially causing difficulties in safely moving food through the digestive tract

Affects on Eating and Drinking

While these changes are part of the natural aging process, they can still affect the comfort and safety of eating and drinking; conditions that can temporarily make the normal aging swallow worse include any acute illnesses, new medications (especially those with side effects that impact the swallowing system), or the long-term impact of chronic medical conditions.

Other concerning signs may indicate a more serious issue, and require professional attention. These include:

Persistent Coughing or Choking: These are the body’s protective behaviors that may signal food or liquid is getting near or into the airway, a major risk factor for developing pneumonia

Voice Changes After Eating: Hoarseness or gurgling sounds in the voice after eating or drinking may indicate food or liquid entering the airway.

Recurrent Pneumonia: Unexplained or recurrent cases of pneumonia can be a red flag for dysphagia, a swallowing disorder.

Weight Loss or Malnutrition: Difficulty in eating and swallowing may lead to inadequate nutrient intake over time, resulting in unintended weight loss or malnutrition.

In the event of the above signs or concerns, talk to your doctor. Depending on the symptoms, a Speech Language Pathologist is a dedicated specialist with skills to evaluate all phases of the swallowing process and develop treatment plans to ensure comfort and safety.

Tips to Promote Healthy Swallowing

Maintaining healthy eating and swallowing habits is essential for overall well-being. Here are some action items to promote healthy swallowing:

Stay Hydrated: Adequate hydration helps maintain saliva production, making the anatomy throughout the digestive tract to move at its best. Encourage regular water intake throughout the day

Sit upright and stay focused: Sitting upright while eating and drinking facilitates proper swallowing mechanics and reduces the risk of aspiration. Removing distractions (including TV, cell phones, or other entertainment) can ensure proper attention to the act of eating

Modify Food Textures: Adjusting food textures to softer or more manageable consistencies can make swallowing safer and more comfortable for older adults with swallowing difficulties, whether temporarily to manage a brief change in status, or more permanently to avoid complications

As with all healthy aging habits, understanding normal swallowing changes, recognizing signs of concern, and taking proactive steps to promote healthy swallowing can significantly enhance the quality of life for older adults. Given the opportunity for social connection, stimulation, and enjoyment that comes from a delicious meal or drink, focusing on ensuring safe swallowing is certainly worth the effort.

Contributed by: Lauren Schwabish, MS, CCC-SLP

Lauren Schwabish MS, CCC-SLP is the owner of Neuro Speech Services, a private practice based in Northern Virginia, specializing in person-centered assessment and treatment of cognitive-communicative disorders related to stroke, brain injury, mild cognitive impairment, ADHD, and other neurologic and neurodegenerative conditions.

Lauren received her Bachelor of Science degree with Honors in Communicative Disorders from the University of Wisconsin-Madison. She  holds a master’s degree in Communication Sciences from Hunter College of the City University of New York. Licensed in the Commonwealth of Virginia and the state of Maryland, she is a certified member of the American Speech Language Hearing Association.

She has over 23 years of experience working in hospitals and acute rehabilitation centers. And she is passionate about providing meaningful and accessible health education about the brain to patients, families, and healthcare professionals. Lauren is committed to empowering communities with evidence-based information and best practices in brain health behaviors.

 

 

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