Yoshikawa Mineka, Yoshida Mitsuyoshi, Nagasaki Toshikazu, Tanimoto Keiji, Tsuga Kazuhiro, Akagawa Yasumasa, Komatsu Teruki
Hiroshima University, Graduate School of Biomedical Sciences, Minami-ku, Hiroshima 734-8553, Japan.
J Gerontol A Biol Sci Med Sci. 2005 Apr;60(4):506-9. doi: 10.1093/gerona/60.4.506.
Although age-related changes resulting in slowing of the swallowing reflex and a decline in the neuromuscular control system have been reported, there have been few reports on swallowing function in dentate elderly persons. The purpose of this study was to clarify the primary influence of aging on swallowing in healthy dentate elderly persons older than 80 years who have more than 20 teeth.
Dentate elderly persons (12 male, 7 female; mean age: 81.2 years) and dentate young participants (9 male, 5 female; mean age: 26.8 years) as a control group participated voluntarily. Participants reported no clinical symptoms relating to dysphagia, neurologic impairments, or degenerative diseases, and were asked to swallow 10 ml of barium sulfate solution (10% w/v) three times. Functional swallowing was recorded on 35 mm cinefilm at 30 frames per second with a digital subtraction angiography system. Lateral images of cinefluorography of seated participants' mouth, pharynx, and larynx were obtained. Visual image analysis for qualitative and quantitative evaluation was made with a cine projector.
No participants exhibited aspiration during three trials. Occurrence and frequencies of piecemeal deglutition, premature loss of liquid, oral and pharyngeal residues, and laryngeal penetration were significantly greater in dentate elderly persons (p <.05) than in the dentate young participants. Oral transit time, pharyngeal delay time, and pharyngeal transit time in dentate elderly persons were prolonged significantly compared with those in dentate young participants (p <.01).
Physiological swallowing functions deteriorate even in healthy dentate elderly persons. This deterioration may be explained primarily by the influence of aging on swallowing.
尽管已有报道称与年龄相关的变化会导致吞咽反射减慢以及神经肌肉控制系统功能下降，但关于有牙老年人吞咽功能的报道却很少。本研究的目的是阐明衰老对80岁以上拥有20颗以上牙齿的健康有牙老年人吞咽功能的主要影响。
有牙老年人（12名男性，7名女性；平均年龄：81.2岁）和作为对照组的有牙年轻参与者（9名男性，5名女性；平均年龄：26.8岁）自愿参与。参与者均未报告有吞咽困难、神经功能障碍或退行性疾病的临床症状，并被要求分三次吞咽10毫升硫酸钡溶液（10% w/v）。使用数字减影血管造影系统以每秒30帧的速度在35毫米电影胶片上记录功能性吞咽情况。获取了坐着的参与者口腔、咽部和喉部的电影荧光造影侧位图像。使用电影放映机进行视觉图像分析以进行定性和定量评估。
在三次试验中，没有参与者出现误吸。有牙老年人中逐口吞咽、液体过早流失、口腔和咽部残留以及喉部穿透的发生率和频率显著高于有牙年轻参与者（p <.05）。与有牙年轻参与者相比，有牙老年人的口腔通过时间、咽部延迟时间和咽部通过时间显著延长（p <.01）。
即使在健康的有牙老年人中，生理吞咽功能也会恶化。这种恶化可能主要是由衰老对吞咽的影响所解释。
