Objective
Elderly patients have a higher risk of aspiration pneumonia even without dysphagia. Swallowing process might be affected by senile changes but those changes have not fully investigated yet. This study is designed to delineate the changes in elderly patients with aspiration pneumonia based on the findings of videofluoroscopic swallowing study (VFSS).
Method
Eighteen patients diagnosed as aspiration pneumonia, who underwent VFSS were included. Those who have direct causes of dysphagia such as recent brain disorders, cranial nerve palsy or structural abnormalities were excluded. Baseline characteristics and VFSS findings including American Speech-Language-Hearing Association National Outcome Measurement System (ASHA NOMS) score, Penetration-aspiration scale (PAS), oral transit time (OTT), pharyngeal delay time (PDT), pharyngeal transit time (PTT) were reviewed retrospectively.
Results
Mean age of subjects was 72.56±11.05. Fourteen patients had one or more systemic disease (e.g. diabetes mellitus, hypertension, chronic obstructive pulmonary disease, or heart failure). In VFSS finding, mean ASHA NOMS score and PAS were respectively 3.00±2.24, 5.22±3.11. Time parameters of oral and pharyngeal phase were generally delayed compared with normal (OTT was 4.99±6.68 sec (normal≤1.50 sec), PDT was 2.73±3.23 sec (normal<0.36 sec), and PTT was 4.03±3.88 sec (normal<1.00 sec)), respectively.
Conclusion
The elderly patients with aspiration pneumonia show delay in oral and pharyngeal phases although they have no disorders directly causing dysphagia. The results suggest that higher risk of aspiration pneumonia in elderly probably originates from delay in swallowing process.
|
