Swallowing disorders in the elderly: a guide to diagnosis and treatment.

Swallowing disorders are common in the elderly. They are most commonly seen in patients with cognitive-perceptual changes or neurologic deficits. The history and physical exam may be useful to increase your index of suspicion but cannot determine if a patient is at risk for aspiration. The modified barium swallow using videofluoroscopy is the most useful modality we have at this time for diagnosing swallowing disorders and determining appropriate interventions. Frequently, swallowing problems can be addressed with changes in dietary consistencies, by changes in positioning, or by techniques to improve oral control and sensitivity to food in the mouth.