Effect of aging on bolus kinematics during the pharyngeal phase of swallowing

2006 ◽  
Vol 290 (3) ◽  
pp. G458-G465 ◽  
Author(s):  
Eytan Bardan ◽  
Mark Kern ◽  
Ronald C. Arndorfer ◽  
Candy Hofmann ◽  
Reza Shaker
Keyword(s):  
Pressure Gradient ◽  
The Elderly ◽  
Upper Esophageal Sphincter ◽  
Elderly Subjects ◽  
Kinematics And Dynamics ◽  
Pressure Gradients ◽  
Swallowing Difficulty ◽  
Esophageal Sphincter ◽  
Young Subjects ◽  
Liquid Bolus

Swallowing difficulty is a common complaint in the elderly and, although there are data for the biomechanics of liquid swallows, little is known about solid bolus motion, or kinematics, in the elderly. The aims of this study were as follows: 1) to characterize and compare solid and liquid bolus kinematics in the elderly and compare the findings with those in young subjects and 2) to correlate bolus kinematics and dynamics. Concurrent manometric-fluoroscopic techniques were used to study eight young and eight elderly subjects. The subjects performed four swallows each of 0.2-cm-diameter solid barium pellets and 5 ml of liquid barium during sagittal fluoroscopy and six-channel pharyngoesophageal manometry. Images were digitized for analysis of kinematic properties such as velocity and acceleration. Dynamic pressures were recorded and coordinated with kinematic events. Image analysis showed that velocity varied as the pellet passed through the hypopharynx, pharynx, and upper esophageal sphincter. In young subjects, pellet kinematics were characterized by two zones of pellet acceleration: one over the tongue base and another as the pellet passed through the upper esophageal sphincter. Although the elderly showed a similar zone of acceleration over the base of the tongue, the second zone of pellet acceleration was not seen. Decreasing pressure gradients immediately distal to the position of the solid pellet and liquid bolus characterized dynamics for all subjects. This decreasing pressure gradient was significantly larger in elderly than in young subjects. Bolus kinematics and dynamics were significantly altered among elderly compared with young subjects. Among these differences were the absence of hypopharyngeal bolus acceleration and a significant increase in the transsphincteric pressure gradient in the elderly.

Frequency of gastroesophageal reflux events induced by pharyngeal water stimulation in young and elderly subjects

1997 ◽  
Vol 272 (2) ◽  
pp. G233-G237 ◽  
Author(s):  
P. Xie ◽  
J. Ren ◽  
E. Bardan ◽  
R. K. Mittal ◽  
Z. Sui ◽  
...  
Keyword(s):  
Gastroesophageal Reflux ◽  
Lower Esophageal Sphincter ◽  
Abdominal Segment ◽  
The Elderly ◽  
Elderly Subjects ◽  
Postprandial Period ◽  
Esophageal Sphincter ◽  
Young Subjects ◽  
Young And Elderly Subjects

Earlier studies have shown that isolated complete lower esophageal sphincter (LES) relaxation occurs as a result of pharyngeal water stimulation. Association of these relaxations with gastroesophageal reflux has not been studied systematically. Our aim was to determine this association in young and elderly subjects during precibal and postprandial periods. We studied 8 young subjects and 10 elderly subjects for 1 h before and 2 h after a 1,000-cal meal. In both groups, during the precibal period, negligible LES relaxation induced by pharyngeal water stimulation resulted in gastroesophageal reflux. In the postprandial period, gastroesophageal reflux events occurred after 16% of pharyngeal water injections in young subjects and after 44% in elderly subjects (P < 0.05). Intraabdominal length of the LES in elderly subjects was significantly shorter compared with younger subjects (P < 0.05). We conclude that gastroesophageal reflux events induced by pharyngeal water stimulation in the postprandial period are significantly increased compared with those of the precibal period and are significantly more prevalent in the elderly compared with the young. These differences seem to be associated with a significantly shorter intra-abdominal segment of the LES in the elderly.

Augmentation of deglutitive upper esophageal sphincter opening in the elderly by exercise

1997 ◽  
Vol 272 (6) ◽  
pp. G1518-G1522 ◽  
Author(s):  
R. Shaker ◽  
M. Kern ◽  
E. Bardan ◽  
A. Taylor ◽  
E. T. Stewart ◽  
...  
Keyword(s):  
The Elderly ◽  
Upper Esophageal Sphincter ◽  
Cross Sectional Area ◽  
Elderly Subjects ◽  
Sectional Area ◽  
Cross Sectional ◽  
Healthy Elderly ◽  
Esophageal Sphincter ◽  
The Cross ◽  
Ues Opening

Earlier studies have shown that the cross-sectional area of the deglutitive upper esophageal sphincter (UES) opening in healthy asymptomatic elderly individuals is reduced compared with healthy young volunteers. The aim of this study was to determine the effect of a head-raising exercise on swallow-induced UES opening and hypopharyngeal intrabolus pressure in the elderly. We studied a total of 31 asymptomatic healthy elderly subjects by videofluoroscopy and manometry before and after real (19 subjects) and sham (12 subjects) exercises. A significant increase was found in the magnitude of the anterior excursion of the larynx, the maximum anteroposterior diameter, and the cross-sectional area of the UES opening after the real exercise (P < 0.05). These changes were associated with a significant decrease in the hypopharyngeal intrabolus pressure studied in 12 (real-exercise) and 6 (sham-exercise) subjects (P < 0.05). A similar effect was not found in the sham-exercise group. In normal elderly subjects, deglutitive UES opening is amenable to augmentation by exercise aimed at strengthening the UES opening muscles. This augmentation is accompanied by a significant decrease in hypopharyngeal intrabolus pressure, indicating a decrease in pharyngeal outflow resistance. This approach may be helpful in some patients with dysphagia due to disorders of deglutitive UES opening.

scholarly journals Extra Virgin Olive Oil Prevents the Age-Related Shifts of the Distribution of HDL Subclasses and Improves Their Functionality

Nutrients ◽  
2021 ◽  
Vol 13 (7) ◽  
pp. 2235
Author(s):  
Alyann Otrante ◽  
Amal Trigui ◽  
Roua Walha ◽  
Hicham Berrougui ◽  
Tamas Fulop ◽  
...  
Keyword(s):  
Olive Oil ◽  
Virgin Olive Oil ◽  
Density Lipoprotein ◽  
Extra Virgin Olive Oil ◽  
The Elderly ◽  
High Density ◽  
Lipoprotein Cholesterol ◽  
Elderly Subjects ◽  
Age Related ◽  
Young Subjects

High-density lipoproteins (HDL) maintain cholesterol homeostasis through the role they play in regulating reverse cholesterol transport (RCT), a process by which excess cholesterol is transported back to the liver for elimination. However, RCT can be altered in the presence of cardiovascular risk factors, such as aging, which contributes to the increase in the incidence of cardiovascular diseases (CVD). The present study was aimed at investigating the effect of extra virgin olive oil (EVOO) intake on the cholesterol efflux capacity (CEC) of HDL, and to elucidate on the mechanisms by which EVOO intake improves the anti-atherogenic activity of HDL. A total of 84 healthy women and men were enrolled and were distributed, according to age, into two groups: 27 young (31.81 ± 6.79 years) and 57 elderly (70.72 ± 5.6 years) subjects. The subjects in both groups were given 25 mL/d of extra virgin olive oil (EVOO) for 12 weeks. CEC was measured using J774 macrophages radiolabeled with tritiated cholesterol ((3H) cholesterol). HDL subclass distributions were analyzed using the Quantimetrix Lipoprint® system. The HDL from the elderly subjects exhibited a lower level of CEC, at 11.12% (p < 0.0001), than the HDL from the young subjects. The CEC of the elderly subjects returned to normal levels following 12 weeks of EVOO intake. An analysis of the distribution of HDL subclasses showed that HDL from the elderly subjects were composed of lower levels of large HDL (L-HDL) (p < 0.03) and higher levels of small HDL (S-HDL) (p < 0.002) compared to HDL from the young subjects. A multiple linear regression analysis revealed a positive correlation between CEC and L-HDL levels (r = 0.35 and p < 0.001) as well as an inverse correlation between CEC and S-HDL levels (r = −0.27 and p < 0.01). This correlation remained significant even when several variables, including age, sex, and BMI as well as low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and glucose levels (β = 0.28, p < 0.002, and β = 0.24, p = 0.01) were accounted for. Consuming EVOO for 12 weeks modulated the age-related difference in the distribution of HDL subclasses by reducing the level of S-HDL and increasing the level of intermediate-HDL/large-HDL (I-HDL/L-HDL) in the elderly subjects. The age-related alteration of the CEC of HDL was due, in part, to an alteration in the distribution of HDL subclasses. A diet enriched in EVOO improved the functionality of HDL through an increase in I-HDL/L-HDL and a decrease in S-HDL.

scholarly journals POS1288 TUBERCULOUS SPONDYLODISCITIS IN ELDERLY: EPIDEMIOLOGY, CLINICAL, FEATURES, TREATMENT AND OUTCOMES

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 926.1-926
Author(s):  
M. Mrabet ◽  
S. Boussaid ◽  
S. Jemmali ◽  
H. Sahli ◽  
H. Ajlani ◽  
...  
Keyword(s):  
Clinical Features ◽  
The Elderly ◽  
Lumbar Pain ◽  
Elderly Subjects ◽  
Normocytic Anemia ◽  
Imaging Features ◽  
X Rays ◽  
Significant Difference ◽  
Young Subjects ◽  
Tuberculous Spondylodiscitis

Background:Tuberculosis is still endemic all over the world. The incidence of tuberculous spondylodiscitis (TS) is steadily increasing. Clinical features and outcomes of this affection are various and depending on various parameters, including age.Objectives:Our objective was to explore the differences in presentation and the results of further investigations and the prognosis of TS between young and elderly subjects.Methods:We conduct a retrospective and descriptive study in a single rheumatology department. Data were collected from files of patients hospitalized in the past 20 years (2000-2020) who have been diagnosed with TS. We carried out a comparative study concerning the clinical biological, imaging features and outcomes between young subjects and subjects aged over 65 years.Results:Fifty-two cases of TS were collected (37F/15M). The mean age of the population was 55.21 years ± 17.79 [19-91]. Thirty-three patients (69.2%) were classified as young versus 16 elderly patients (30.8%), with female predominance in both groups (69.4% and 75% respectively, p = 0.57). Young subjects was more frequently vaccinated (88.9%) by Bacillus Calmette–Guérin (BCG) (p < 0.001). A delayed diagnosis was noted in both groups (p = 0.24). Lumbar spine involvement was the most common (57.7%). In the two age ranges, the onset of the disease was progressive (p = 0.22), characterized by segmental spine stiffness (p = 0.57) and lumbar pain with general signs (p = 0.27), such as: impaired general condition, fever, night sweats and weight loss. Biological inflammatory syndrome and normochrome normocytic anemia were encountered in both cases (p = 0.08 and p = 0.2, respectively). Standard X-rays and Computed tomography were more performed in young subjects (94.4% and 69.4%, respectively; p < 0.001), unlike magnetic resonance imaging which was more common in elderly subjects but with no statistically significant difference (p = 0.22). Disc pinch, erosion of vertebral plateaus and vertebral collapse were the major signs (82.7%, 65.4% and 67.3%, respectively). Clinical, biological and imaging arguments contributed to positive diagnosis in both groups (p = 0.24). Common medical treatment was anti-tuberculosis: Isoniazid (H), Rifampicin (R), Pyrazinamide (Z), Ethambutol (E) and physical treatment such as immobilization witch was more common in the eldery (56.3%, p = 0.16). The evolution of the disease was characterized by a clear improvement of young subjects during the second week of treatment (p < 0.001). A more frequent clinical improvement in older subjects was during the fourth week but with no statistically significant difference (p = 0.13). The occurrence of immediate complications was more frequent in the elderly (p = 0.23) with a predominance for drug complications (56.3%) such as: hepatic cytolysis (12.5%), hyperuricemia (18.8%) and major intolerance to anti-tuberculosis (18.8%).Conclusion:TS is a frequent condition that needs to be treated rapidly. the clinical presentation of TS in the elderly is less noisy which leads to more frequent complications and mortality.Disclosure of Interests:None declared

scholarly journals The Effect of Bolus Volume on Hyoid Kinematics in Healthy Swallowing

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Ahmed Nagy ◽  
Sonja M. Molfenter ◽  
Melanie Péladeau-Pigeon ◽  
Shauna Stokely ◽  
Catriona M. Steele
Keyword(s):  
Peak Velocity ◽  
Upper Esophageal Sphincter ◽  
Healthy Population ◽  
Bolus Volume ◽  
Velocity Increase ◽  
Movement Distance ◽  
Hyoid Movement ◽  
Laryngeal Vestibule ◽  
Esophageal Sphincter ◽  
Liquid Bolus

Hyoid movement in swallowing is biomechanically linked to closure of the laryngeal vestibule for airway protection and to opening of the upper esophageal sphincter. Studies suggest that the range of hyoid movement is highly variable in the healthy population. However, other aspects of hyoid movement such as velocity remain relatively unexplored. In this study, we analyze data from a sample of 20 healthy young participants (10 male) to determine whether hyoid movement distance, duration, velocity, and peak velocity vary systematically with increases in thin liquid bolus volume from 5 to 20 mL. The temporal correspondence between peak hyoid velocity and laryngeal vestibule closure was also examined. The results show that maximum hyoid position and peak velocity increase significantly for 20 mL bolus volumes compared to smaller volumes, and that the timing of peak velocity is closely linked to achieving laryngeal vestibule closure. This suggests that generating hyoid movements with increased power is a strategy for handling larger volumes.

Decreased Neutrophil Cyclic AMP Response to Isoprenaline Stimulation in the Elderly

1983 ◽  
Vol 65 (2) ◽  
pp. 155-157 ◽  
Author(s):  
T. G. Cotter ◽  
K. O'Malley
Keyword(s):  
Monoclonal Antibodies ◽  
Cyclic Amp ◽  
The Elderly ◽  
Population Heterogeneity ◽  
Elderly Subjects ◽  
Age Related ◽  
Significant Difference ◽  
Young Subjects ◽  
Drug Free

1. Neutrophils from drug-free elderly subjects produced approximately 50% less cyclic AMP in response to isoprenaline than did neutrophils from young subjects. A significant difference in basal cyclic AMP levels was also evident (elderly 2.8 ± 0.37; young 4.9 ± 0.36 pmol of cAMP/107 cells; P < 0.05). 2. With a range of anti-neutrophil monoclonal antibodies no evidence of age-related neutrophil population heterogeneity was found. 3. These findings indicate that the age-related decline in β-adrenoceptor responsiveness is not due to changes in the neutrophil population. 4. The present results support the hypothesis that there is a generalized decline in β-adrenoceptor-mediated responsiveness in the elderly.

Cold-induced Increases in Erythrocyte Count, Plasma Cholesterol and Plasma Fibrinogen of Elderly People without a Comparable Rise in Protein C or Factor X

1994 ◽  
Vol 86 (1) ◽  
pp. 43-48 ◽  
Author(s):  
Penelope J. Neild ◽  
Denise Syndercombe-Court ◽  
W. R. Keatinge ◽  
G. C. Donaldson ◽  
M. Mattock ◽  
...  
Keyword(s):  
Elderly People ◽  
Plasma Volume ◽  
Arterial Thrombosis ◽  
Protein C ◽  
Plasma Cholesterol ◽  
The Elderly ◽  
Erythrocyte Count ◽  
Elderly Subjects ◽  
Factor X ◽  
Young Subjects

1. Six elderly (66-71 years) and six young (20-23 years) subjects (half of each group women) were cooled for 2 h in moving air at 18°C to investigate possible causes of increased mortality from arterial thrombosis among elderly people in cold weather. Compared with thermoneutral control experiments, skin temperature (trunk) fell from 35.5 to 29.5°C, with little change in core temperature. 2. Erythrocyte count rose in the cold from 4.29 to 4.69 × 1012/l, without a change in mean corpuscular volume, indicating a 14% or 438 ml decline in plasma volume; increased excretion of water, Na+ and K+ accounted for loss of only 179 ml of extracellular water. 3. Plasma cholesterol and fibrinogen concentrations rose in the elderly subjects from 4.9 mmol/l and 2.97 g/l (control) to 5.45 mmol/l and 3.39 g/l in the cold, and in the young subjects from 3.33 mmol/l and 1.84 g/l (control) to 3.77 mmol/l and 2.07 g/l in the cold. Increases were significant for the elderly subjects, the young subjects and the group as a whole, except for cholesterol in the young subjects, and all were close to those expected from the fall in plasma volume. 4. Plasma levels of Protein C and factor X did not increase significantly in the cold in the elderly subjects, young subjects, or the group as a whole. 5. The results suggest that loss of plasma fluid in the cold concentrates major risk factors for arterial thrombosis, while small molecules, including protective Protein C, redistribute to interstitial fluid.

The influence of dynamic visual environments on postural sway in the elderly

1999 ◽  
Vol 9 (3) ◽  
pp. 197-205
Author(s):  
L.L. Borger ◽  
S.L. Whitney ◽  
M.S. Redfern ◽  
J.M. Furman
Keyword(s):  
Visual Information ◽  
Postural Sway ◽  
Center Of Pressure ◽  
Age Groups ◽  
The Elderly ◽  
Visual Scene ◽  
Elderly Subjects ◽  
Mean Velocity ◽  
Healthy Elderly ◽  
Young Subjects

Postural sway during stance has been found to be sensitive to moving visual scenes in young adults, children, and those with vestibular disease. The effect of visual environments on balance in elderly individuals is relatively unknown. The purpose of this study was to compare postural sway responses of healthy elderly to those of young subjects when both groups were exposed to a moving visual scene. Peak to peak, root mean squared, and mean velocity of the center of pressure were analyzed under conditions combining four moving scene amplitudes ( 2 . 5 ∘ , 5 ∘ , 7 . 5 ∘ , 10 ∘ ) and two frequencies of scene movement (0.1 Hz, 0.25 Hz). Each visual condition was tested with a fixed floor and sway referenced platform. Results showed that elderly subjects swayed more than younger subjects when experiencing a moving visual scene under all conditions. The elderly were affected more than the young by sway referencing the platform. The differences between the two age groups were greater at increased amplitudes of scene movement. These results suggest that elderly are more influenced by dynamic visual information for balance than the young, particularly when cues from the ankles are altered.

CLINICALAND ELECTROPHYSIOLOGICAL STUDY OF THE PERIPHERAL NERVOUS SYSTEM IN THE ELDERLY PEOPLE IN DARBHANGA

2021 ◽  
pp. 19-21
Author(s):  
Nutan Bala ◽  
Priyanka Priyanka ◽  
Sheela Kumari ◽  
Debarshi Jana
Keyword(s):  
Nervous System ◽  
Peripheral Nervous System ◽  
Linear Models ◽  
Electrophysiological Study ◽  
The Elderly ◽  
Elderly Subjects ◽  
Neurophysiological Studies ◽  
Age Dependent ◽  
Young Subjects ◽  
Effect Of Age

The effect of age on the peripheral nervous system was investigated by clinical examination and neurophysiological studies in 59 subjects aged 60- 103 years and 23 young subjects. Afull laboratory screen for factors which, though clinically silent, may constitute risk factors (RFs) for peripheral neuropathy was also performed in the elderly subjects. Our ndings show that the presence of RFs affects exceptionally the electrophysiological parameters in a statistically signicant way. The age-dependent changes in nerve conduction parameters were well predicted by non-linear models. The simultaneous electromyographical study demonstrates the re-innervation capacity of the motor system

Effect of aging and bolus variables on pharyngeal and upper esophageal sphincter motor function

1993 ◽  
Vol 264 (3) ◽  
pp. G427-G432 ◽  
Author(s):  
R. Shaker ◽  
J. Ren ◽  
B. Podvrsan ◽  
W. J. Dodds ◽  
W. J. Hogan ◽  
...  
Keyword(s):  
Pressure Wave ◽  
Wave Amplitude ◽  
Age Groups ◽  
The Elderly ◽  
Young Group ◽  
Upper Esophageal Sphincter ◽  
Healthy Elderly ◽  
Pressure Wave Amplitude ◽  
Resting Pressure ◽  
Esophageal Sphincter

Effect of aging, bolus volume, temperature, and consistency on the pharyngeal peristalsis, as well as the effect of aging on the upper esophageal sphincter (UES) resting pressure and its response to esophageal distension by air and balloon, were studied in 14 young and 12 healthy elderly volunteers. In both age groups there was no significant volume or temperature effect on amplitude, duration, or velocity of the pharyngeal peristalsis. Compared with water swallows, mashed potato swallows resulted in a significant increase in the amplitude and duration of the hypopharyngeal peristaltic pressure wave (P < 0.05). For water swallows, the amplitude and duration of the peristaltic pressure wave in the hypopharynx were significantly increased in the elderly compared with the young group (P < 0.01). UES resting pressure in the elderly measured 43 +/- 5 (SE) mmHg and was significantly less than that of the young (71 +/- 8 mmHg; P < 0.01). Magnitude of the UES pressure decrease because of esophageal distension by air, as well as magnitude of its pressure increase because of esophageal balloon distension, was similar among young and elderly. 1) Contrary to common expectations, the parameters of the pharyngeal peristaltic pressure wave do not deteriorate in the elderly in their seventh and eighth decade. 2) Compared with the young, hypopharyngeal pressure wave amplitude and duration are significantly increased in the elderly. This increase could be caused by an adaptation response to a pharyngeal outflow compromise. 3) Pharyngeal peristaltic pressure wave amplitude and duration, but not its velocity, are modulated by the bolus consistency. This modulatory mechanism is preserved in the elderly. 4) Although UES resting pressure is significantly decreased in the elderly, its pressure response to esophageal distension by air and balloon is preserved.

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