title: European Society for Swallowing Disorders - European Union Geriatric Medicine Society white paper: oropharyngeal dysphagia as a geriatric syndrome.
abstract: This position document has been developed by the Dysphagia Working Group, a committee of members from the European Society for Swallowing Disorders and the European Union Geriatric Medicine Society, and invited experts. It consists of 12 sections that cover all aspects of clinical management of oropharyngeal dysphagia (OD) related to geriatric medicine and discusses prevalence, quality of life, and legal and ethical issues, as well as health economics and social burden. OD constitutes impaired or uncomfortable transit of food or liquids from the oral cavity to the esophagus, and it is included in the World Health Organization's classification of diseases. It can cause severe complications such as malnutrition, dehydration, respiratory infections, aspiration pneumonia, and increased readmissions, institutionalization, and morbimortality. OD is a prevalent and serious problem among all phenotypes of older patients as oropharyngeal swallow response is impaired in older people and can cause aspiration. Despite its prevalence and severity, OD is still underdiagnosed and untreated in many medical centers. There are several validated clinical and instrumental methods (videofluoroscopy and fiberoptic endoscopic evaluation of swallowing) to diagnose OD, and treatment is mainly based on compensatory measures, although new treatments to stimulate the oropharyngeal swallow response are under research. OD matches the definition of a geriatric syndrome as it is highly prevalent among older people, is caused by multiple factors, is associated with several comorbidities and poor prognosis, and needs a multidimensional approach to be treated. OD should be given more importance and attention and thus be included in all standard screening protocols, treated, and regularly monitored to prevent its main complications. More research is needed to develop and standardize new treatments and management protocols for older patients with OD, which is a challenging mission for our societies.
authors: Department of Otorhinolaryngology - Head and Neck Surgery, Maastricht University Medical Center, Maastricht, the Netherlands.
authors: Laura Wj
authors: LW
authors: Baijens
authors: Gastrointestinal Physiology Laboratory, Department of Surgery, Hospital of Mataró, Autonomous University of Barcelona, Mataró; CIBERehd, Instituto de Salud Carlos III, Barcelona, Spain.
authors: Pere
authors: P
authors: Clavé
authors: Department of Neurology, Antwerp University Hospital, University of Antwerp, Born Bunge Institute, Edegem, Belgium.
authors: Patrick
authors: P
authors: Cras
authors: Department of Translational Medicine, Division of Medical Radiology, Skåne University Hospital, Malmö, Sweden.
authors: Olle
authors: O
authors: Ekberg
authors: Clinique Bois-Bougy, Nyon, Switzerland.
authors: Alexandre
authors: A
authors: Forster
authors: Department of Geriatrics and Physical Medicine, Bonifatius Hospital, Lingen, Germany.
authors: Gerald F
authors: GF
authors: Kolb
authors: Long Term Care and Hospice, Ettelbruck, Luxembourg.
authors: Jean-Claude
authors: JC
authors: Leners
authors: Rehabilitation Unit, Department of Neuroscience, University of Padua, Padova, Italy.
authors: Stefano
authors: S
authors: Masiero
authors: Department of Geriatric Medicine, Hospital Ramón y Cajal, Madrid, Spain.
authors: Jesús
authors: J
authors: Mateos-Nozal
authors: Gastrointestinal Physiology Laboratory, Department of Surgery, Hospital of Mataró, Autonomous University of Barcelona, Mataró; CIBERehd, Instituto de Salud Carlos III, Barcelona, Spain.
authors: Omar
authors: O
authors: Ortega
authors: Clinical Gerontology, Princess Royal University Hospital, King's College Hospital Foundation Trust, London, UK.
authors: David G
authors: DG
authors: Smithard
authors: College of Healthcare Sciences, James Cook University, Townsville, QLD, Australia.
authors: Renée
authors: R
authors: Speyer
authors: Department of Clinical Speech and Language Studies, Trinity College Dublin, Dublin, Ireland.
authors: Margaret
authors: M
authors: Walshe
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D015897:Comorbidity; D003680:Deglutition Disorders / Q000453:epidemiology* / Q000628:therapy*; D004992:Ethics, Medical; D005060:Europe; D005062:European Union; D016330:Frail Elderly; D005853:Geriatrics; D006801:Humans; D044342:Malnutrition; D008403:Mass Screening / Q000379:methods*; D011788:Quality of Life; D012307:Risk Factors; D012955:Societies, Medical
keywords: Swallowing disorders; aged; frail elderly; healthy aging; malnutrition; quality of life; sarcopenia