Logemann J A, Pauloski B R, Rademaker A W, Colangelo L A, Kahrilas P J, Smith C H
Department of Communication Sciences and Disorders, Northwestern University, Evanston, IL 60208-3570, USA.
J Speech Lang Hear Res. 2000 Oct;43(5):1264-74. doi: 10.1044/jslhr.4305.1264.
As the U.S. population ages, there is increasing need for data on the effects of aging in healthy elderly individuals over age 80. This investigation compared the swallowing ability of 8 healthy younger men between the ages of 21 and 29 and 8 healthy older men between the ages of 80 and 94 during two swallows each of 1 ml and 10 ml liquid. Videofluoroscopic studies of these swallows were analyzed to confirm the absence of swallowing disorders. Biomechanical analysis of each swallow was completed, from which data on temporal, range of motion, and coordination characteristics of the oropharyngeal swallow were taken. Position of the larynx at rest, length of neck, and pattern of hyoid bone movement were also compared between the two groups. None of the younger or older men exhibited any swallowing disorders. The C2 to C4 distance of older men was significantly shorter than that of younger men, and laryngeal position at rest was lower than in younger men but not significantly so. Older men had a significantly longer pharyngeal delay than younger men and significantly faster onset of posterior pharyngeal wall movement in relation to first cricopharyngeal opening. The older men exhibited significantly reduced maximum vertical and anterior hyoid movement as compared to the younger men even when accounting for the difference in C2 to C4 distance in older men. These data support the hypothesis of reduced muscular reserve in the swallows of older men as compared to younger men. Older men also exhibited less width of cricopharyngeal opening than younger men at 10 ml volume, indicating less upper esophageal sphincter flexibility in the swallows of older men. The potential for exercise to improve reserve is discussed. Significant changes in extent of hyoid elevation and duration of cricopharyngeal opening were seen as liquid bolus volume increased.
随着美国人口老龄化，对于80岁以上健康老年人衰老影响的数据需求日益增加。本研究比较了8名年龄在21至29岁之间的健康年轻男性和8名年龄在80至94岁之间的健康老年男性在分别吞咽1毫升和10毫升液体各两次时的吞咽能力。对这些吞咽过程进行了视频荧光透视研究，以确认不存在吞咽障碍。完成了对每次吞咽的生物力学分析，从中获取了口咽吞咽的时间、运动范围和协调特征的数据。还比较了两组之间静息时喉部的位置、颈部长度和舌骨运动模式。年轻男性和老年男性均未表现出任何吞咽障碍。老年男性的C2至C4距离明显短于年轻男性，静息时喉部位置低于年轻男性，但差异不显著。老年男性的咽部延迟明显长于年轻男性，相对于环咽肌首次开放，咽后壁运动的起始明显更快。即使考虑到老年男性C2至C4距离的差异，与年轻男性相比，老年男性的舌骨最大垂直和向前运动仍明显减少。这些数据支持了与年轻男性相比老年男性吞咽时肌肉储备减少的假设。在吞咽10毫升液体时，老年男性的环咽肌开口宽度也小于年轻男性，表明老年男性吞咽时食管上括约肌的灵活性较低。文中讨论了通过锻炼改善储备的可能性。随着液体团块体积增加，可以看到舌骨抬高程度和环咽肌开放持续时间有显著变化。
