Dysphagia (swallowing difficulty) is a growing health concern in our aging population. Age-related changes in swallowing physiology as well as age-related diseases are predisposing factors for dysphagia in the elderly. In the US, dysphagia affects 300,000–600,000 persons yearly.1 Although the exact prevalence of dysphagia across different settings is unclear, conservative estimates suggest that 15% of the elderly population is affected by dysphagia.2 Furthermore, according to a single study, dysphagia referral rates among the elderly in a single tertiary teaching hospital increased 20% from 2002–2007; with 70% of referrals for persons above the age of 60.3 The US Census Bureau indicates that in 2010, the population of persons above the age of 65 was 40 million. Taken together, this suggests that up to 6 million older adults could be considered at risk for dysphagia.
Any disruption in the swallowing process may be defined as dysphagia.4 Persons with anatomical or physiologic deficits in the mouth, pharynx, larynx, and esophagus may demonstrate signs and symptoms of dysphagia.4 In addition, dysphagia contributes to a variety of negative health status changes; most notably, increased risk of malnutrition and pneumonia. In this review, we will discuss how aging and disease impact swallowing physiology with a focus on nutritional status and pneumonia. We will conclude with a brief overview of dysphagia management approaches and consequences of dysphagia management on nutritional status and pneumonia in the elderly.