The Effects of Swallowing Exercises in Healthy Older Adults: A Systematic Review.

Dysphagia, common among older adults, leads to significant morbidity and potential mortality. The role of preventative exercises in healthy, community-dwelling elderly people remains to be understood. In this systematic review, we aimed to understand whether preemptive exercise programs can improve swallowing in healthy older adults. Articles published from 1990 to 2023 were included and identified through searches of MEDLINE, EMBASE and Cochrane databases by a medical librarian using the keywords "presbyphagia" and" aging" and "dysphagia" and "management", as well as "therapy" and "treatment", "swallowing therapy", and the combinations of these keywords. Of 2269 abstracts initially screened, 15 full-text articles were included in this review, consisting of 454 patients. Of the 15 studies included, ten were randomized controlled, three non-randomized clinical trial, one a prospective cohort study, and one an interventional study. The reported age range of the participants was between 60 and 91 years-old. Sixty-two percent of the participants were elderly females. In terms of interventions, nine studies employed tongue strengthening exercises, five utilized swallowing resistance techniques, two involved pronunciation and karaoke practice, two focused on recline and head lift exercises, one utilized high-speed jaw opening exercises, and one employed electrical stimulation of swallowing muscles. Swallowing exercises strengthen targeted muscle groups in healthy older adults and can be utilized to prevent swallowing problems that occur with aging. Further longitudinal studies are needed to understand the benefits of preventative therapy models. Level of Evidence: Level 4.