Muhle P, Wirth R, Glahn J, Dziewas R
Klinik für Allgemeine Neurologie, Universitätsklinikum Münster, Albert-Schweitzer-Campus 1, 48149, Münster, Deutschland,
Nervenarzt. 2015 Apr;86(4):440-51. doi: 10.1007/s00115-014-4183-7.
The term presbyphagia refers to all changes of swallowing physiology that are manifested with increasing age. Alterations in the pattern of deglutition that are part of healthy aging are called primary presbyphagia. Primary presbyphagia is not an illness in itself but contributes to a more pervasive naturally diminished functional reserve, making older adults more susceptible to dysphagia. If disorders in swallowing occur in the elderly as a comorbidity of a specific disease, for example stroke or neurodegenerative disorders, this is called secondary presbyphagia. Increasing age has an impact on each stage of deglutition. In the oral preparatory phase a diminished input for smell and taste as well as a usually multifactorial cause of dry mouth are the most important influencing factors. Sarcopenia, the degenerative loss of skeletal muscle mass, strength and quality associated with aging, interferes in particular with the oropharyngeal phase. A decreased sensory feedback from the oropharyngeal mucosa leads to a delayed triggering of the swallowing reflex. Finally, a reduction in connective tissue elasticity and changes of the axial skeleton lead to various modifications of the swallowing pattern with advanced age.
术语“老年吞咽困难”指随着年龄增长而出现的吞咽生理的所有变化。作为健康衰老一部分的吞咽模式改变称为原发性老年吞咽困难。原发性老年吞咽困难本身并非一种疾病，但会导致更普遍的自然功能储备下降，使老年人更容易出现吞咽困难。如果老年人因特定疾病（如中风或神经退行性疾病）的合并症而出现吞咽障碍，则称为继发性老年吞咽困难。年龄增长会影响吞咽的各个阶段。在口腔准备期，嗅觉和味觉输入减少以及通常由多种因素导致的口干是最重要的影响因素。肌肉减少症，即与衰老相关的骨骼肌质量、力量和质量的退行性丧失，尤其会干扰口咽期。口咽黏膜感觉反馈减少会导致吞咽反射触发延迟。最后，结缔组织弹性降低和中轴骨骼变化会导致老年时吞咽模式发生各种改变。
