Cook Ian J
Department of Gastroenterology, St George Hospital, Gray Street, Kogarah, NSW 2217, Australia.
Gastroenterol Clin North Am. 2009 Sep;38(3):411-31. doi: 10.1016/j.gtc.2009.06.003.
Although the aging process per se can produce measurable changes in the normal oropharyngeal swallow, these changes alone are rarely sufficient to cause clinically apparent dysphagia. The causes of oropharyngeal dysphagia in the elderly are predominantly neuromyogenic, with the most common cause being stroke. The evaluation of oropharyngeal dysphagia in the elderly involves early exclusion of structural abnormalities, detection of aspiration by videofluoroscopy which might dictate early introduction of nonoral feeding, and exclusion of underlying systemic and neuromyogenic causes that have specific therapies in their own right. Such conditions include Parkinson disease, myositis, myasthenia, and thyrotoxicosis. Management is best delivered by a multidisciplinary team involving physician, speech pathologist, nutritionist and, at times, a surgeon.
尽管衰老过程本身会在正常口咽吞咽中产生可测量的变化，但仅这些变化很少足以导致临床上明显的吞咽困难。老年人口咽吞咽困难的原因主要是神经肌肉性的，最常见的原因是中风。对老年人口咽吞咽困难的评估包括早期排除结构异常、通过视频荧光透视检查检测误吸（这可能决定早期采用非经口喂养），以及排除本身有特定治疗方法的潜在全身性和神经肌肉性病因。这些病症包括帕金森病、肌炎、重症肌无力和甲状腺毒症。最好由包括医生、言语病理学家、营养师，有时还有外科医生在内的多学科团队进行管理。
