Preclinical dysphagia narrative (Madhavan, 2021)

Purpose: Traditionally, etiology of dysphagia is thought to be related to multiple medical diagnoses including stroke, head and neck cancer, degenerative neurological conditions, and so forth. However, community dwelling older adults (CDOAs) can present with dysphagia in the absence of any specific etiology. The purpose of this research was to develop a multidimensional framework to help identify those CDOA at risk for dysphagia of nonspecific etiology.

Method: Pertinent literature was examined to identify support for the proposed framework and to explain how the various elements support the model.

Results: Several factors that are not traditionally thought to be associated with dysphagia can both initiate and exacerbate symptoms of swallowing difficulties. Swallowing difficulties may be subtle and underreported. Monitoring for symptoms related to preclinical dysphagia may be helpful for early identification.

Conclusions: Dysphagia in the CDOA is complex and multidimensional. Clinicians working with older adults will benefit from considering elements described in this multidimensional framework to better understand the etiology of swallowing deficits and improve management.

Supplemental Material S1. Factors with causal evidence in the development of preclinical dysphagia.

Madhavan, A., (2021). Preclinical dysphagia in community dwelling older adults: What should we look for? American Journal of Speech-Language Pathology. Advance online publication. https://doi.org/10.1044/2020_AJSLP-20-00014