scholarly journals Dysphagia Onset in Older Adults during Unrelated Hospital Admission: Quantitative Videofluoroscopic Measures

Geriatrics ◽  
2018 ◽  
Vol 3 (4) ◽  
pp. 66 ◽  
Author(s):  
Marie Jardine ◽  
Anna Miles ◽  
Jacqui Allen

New-onset swallowing difficulties in older patients during unrelated hospital admissions are well recognized and may result in prolonged hospital stay and increased morbidity. Presbyphagia denotes age-related swallowing changes which do not necessarily result in pathological effects. The trajectory from presbyphagia to dysphagia is not well understood. This retrospective observational study compared quantitative videofluoroscopic measures in hospitalized older adults aged 70–100 years, reporting new dysphagia symptoms during admission (n = 52), to healthy asymptomatic older (n = 56) and younger adults (n = 43). Significant physiological differences seen in hospitalized older adults but not healthy adults, were elevated pharyngeal area (p < 0.001) and pharyngeal constriction ratio (p < 0.001). Significantly increased penetration (p < 0.001), aspiration (p < 0.001) and pharyngeal residue (p < 0.001) were also observed in the hospitalized older cohort. Reasons for onset of new swallow problems during hospitalization are likely multifactorial and complex. Alongside multimorbidity and polypharmacy, a combination of factors during hospitalization, such as fatigue, low levels of alertness, delirium, reduced respiratory support and disuse atrophy, may tip the balance of age-related swallowing adaptations and compensation toward dysfunctional swallowing. To optimize swallowing assessment and management for our aging population, care must be taken not to oversimplify dysphagia complaints as a characteristic of aging.

Author(s):  
Zachary R Hettinger ◽  
Kyoko Hamagata ◽  
Amy L Confides ◽  
Marcus M Lawrence ◽  
Benjamin F Miller ◽  
...  

Abstract The inability to fully recover lost muscle mass following periods of disuse atrophy predisposes older adults to lost independence and poor quality of life. We have previously shown that mechanotherapy at a moderate load (4.5 N) enhances muscle mass recovery following atrophy in adult, but not older adult rats. We propose that elevated transverse stiffness in aged muscle inhibits the growth response to mechanotherapy and hypothesize that a higher load (7.6 N) will overcome this resistance to mechanical stimuli. F344/BN adult and older adult male rats underwent 14-days of hindlimb suspension, followed by 7-days of recovery with (RE+M) or without (RE) mechanotherapy at 7.6 N on gastrocnemius muscle. The 7.6 N load was determined by measuring transverse passive stiffness and linearly scaling up from 4.5 N. No differences in protein turnover or mean fiber cross sectional area were observed between RE and RE+M for older adult rats or adult rats at 7.6 N. However, there was a higher number of small muscle fibers present in older adult, but not adult rats, which was explained by a 16-fold increase in the frequency of small fibers expressing embryonic myosin heavy chain. Elevated central nucleation, satellite cell abundance, and dystrophin -/laminin + fibers were present in older adult rats only following 7.6 N, while 4.5 N did not induce damage at either age. We conclude that age is an important variable when considering load used during mechanotherapy and age-related transverse stiffness may predispose older adults to damage during the recovery period following disuse atrophy.


Author(s):  
Mert Esme ◽  
Meltem Koca ◽  
Ayse Dikmeer ◽  
Cafer Balci ◽  
Naim Ata ◽  
...  

Abstract Background A novel coronavirus (severe acute respiratory syndrome coronavirus 2 [SARS-CoV-2]) occurred in China in December 2019 and has spread globally. In this study, we aimed to describe the clinical characteristics and outcomes of hospitalized older adults with coronavirus disease 2019 (COVID-19) in Turkey. Methods We retrospectively analyzed the clinical data of hospitalized patients aged ≥ 60 years with confirmed COVID-19 from March 11, 2020 to May 27, 2020 using nationwide health database. Results In this nationwide cohort, a total of 16,942 hospitalized older adults with COVID-19 were enrolled, of whom 8,635 (51%) were women. Mean age was 71.2 ± 8.5 years, ranging from 60 to 113 years. Mortality rate before and after curfew was statistically different (32.2% vs. 17.9%; p &lt; .001, respectively). Through multivariate analysis of the causes of death in older patients, we found that male gender, diabetes mellitus, heart failure, dementia, were all significantly associated with mortality in entire cohort. In addition to abovementioned risk factors, in patients aged between 60 and 79 years, hypertension, chronic kidney disease and cancer and in patients 80 years of age and older malnutrition were also associated with increased risk of mortality. Conclusions In addition to the results of previous studies with smaller sample size, our results confirmed the age-related relationship between specific comorbidities and COVID-19–related mortality.


1992 ◽  
Vol 35 (4) ◽  
pp. 892-902 ◽  
Author(s):  
Robert Allen Fox ◽  
Lida G. Wall ◽  
Jeanne Gokcen

This study examined age-related differences in the use of dynamic acoustic information (in the form of formant transitions) to identify vowel quality in CVCs. Two versions of 61 naturally produced, commonly occurring, monosyllabic English words were created: a control version (the unmodified whole word) and a silent-center version (in which approximately 62% of the medial vowel was replaced by silence). A group of normal-hearing young adults (19–25 years old) and older adults (61–75 years old) identified these tokens. The older subjects were found to be significantly worse than the younger subjects at identifying the medial vowel and the initial and final consonants in the silent-center condition. These results support the hypothesis of an age-related decrement in the ability to process dynamic perceptual cues in the perception of vowel quality.


Author(s):  
Yvonne Rogalski ◽  
Muriel Quintana

The population of older adults is rapidly increasing, as is the number and type of products and interventions proposed to prevent or reduce the risk of age-related cognitive decline. Advocacy and prevention are part of the American Speech-Language-Hearing Association’s (ASHA’s) scope of practice documents, and speech-language pathologists must have basic awareness of the evidence contributing to healthy cognitive aging. In this article, we provide a brief overview outlining the evidence on activity engagement and its effects on cognition in older adults. We explore the current evidence around the activities of eating and drinking with a discussion on the potential benefits of omega-3 fatty acids, polyphenols, alcohol, and coffee. We investigate the evidence on the hypothesized neuroprotective effects of social activity, the evidence on computerized cognitive training, and the emerging behavioral and neuroimaging evidence on physical activity. We conclude that actively aging using a combination of several strategies may be our best line of defense against cognitive decline.


2014 ◽  
Vol 28 (3) ◽  
pp. 148-161 ◽  
Author(s):  
David Friedman ◽  
Ray Johnson

A cardinal feature of aging is a decline in episodic memory (EM). Nevertheless, there is evidence that some older adults may be able to “compensate” for failures in recollection-based processing by recruiting brain regions and cognitive processes not normally recruited by the young. We review the evidence suggesting that age-related declines in EM performance and recollection-related brain activity (left-parietal EM effect; LPEM) are due to altered processing at encoding. We describe results from our laboratory on differences in encoding- and retrieval-related activity between young and older adults. We then show that, relative to the young, in older adults brain activity at encoding is reduced over a brain region believed to be crucial for successful semantic elaboration in a 400–1,400-ms interval (left inferior prefrontal cortex, LIPFC; Johnson, Nessler, & Friedman, 2013 ; Nessler, Friedman, Johnson, & Bersick, 2007 ; Nessler, Johnson, Bersick, & Friedman, 2006 ). This reduced brain activity is associated with diminished subsequent recognition-memory performance and the LPEM at retrieval. We provide evidence for this premise by demonstrating that disrupting encoding-related processes during this 400–1,400-ms interval in young adults affords causal support for the hypothesis that the reduction over LIPFC during encoding produces the hallmarks of an age-related EM deficit: normal semantic retrieval at encoding, reduced subsequent episodic recognition accuracy, free recall, and the LPEM. Finally, we show that the reduced LPEM in young adults is associated with “additional” brain activity over similar brain areas as those activated when older adults show deficient retrieval. Hence, rather than supporting the compensation hypothesis, these data are more consistent with the scaffolding hypothesis, in which the recruitment of additional cognitive processes is an adaptive response across the life span in the face of momentary increases in task demand due to poorly-encoded episodic memories.


Author(s):  
Rachel L. C. Mitchell ◽  
Rachel A. Kingston

It is now accepted that older adults have difficulty recognizing prosodic emotion cues, but it is not clear at what processing stage this ability breaks down. We manipulated the acoustic characteristics of tones in pitch, amplitude, and duration discrimination tasks to assess whether impaired basic auditory perception coexisted with our previously demonstrated age-related prosodic emotion perception impairment. It was found that pitch perception was particularly impaired in older adults, and that it displayed the strongest correlation with prosodic emotion discrimination. We conclude that an important cause of age-related impairment in prosodic emotion comprehension exists at the fundamental sensory level of processing.


2019 ◽  
Author(s):  
Debbie Marianne Yee ◽  
Sarah L Adams ◽  
Asad Beck ◽  
Todd Samuel Braver

Motivational incentives play an influential role in value-based decision-making and cognitive control. A compelling hypothesis in the literature suggests that the brain integrates the motivational value of diverse incentives (e.g., motivational integration) into a common currency value signal that influences decision-making and behavior. To investigate whether motivational integration processes change during healthy aging, we tested older (N=44) and younger (N=54) adults in an innovative incentive integration task paradigm that establishes dissociable and additive effects of liquid (e.g., juice, neutral, saltwater) and monetary incentives on cognitive task performance. The results reveal that motivational incentives improve cognitive task performance in both older and younger adults, providing novel evidence demonstrating that age-related cognitive control deficits can be ameliorated with sufficient incentive motivation. Additional analyses revealed clear age-related differences in motivational integration. Younger adult task performance was modulated by both monetary and liquid incentives, whereas monetary reward effects were more gradual in older adults and more strongly impacted by trial-by-trial performance feedback. A surprising discovery was that older adults shifted attention from liquid valence toward monetary reward throughout task performance, but younger adults shifted attention from monetary reward toward integrating both monetary reward and liquid valence by the end of the task, suggesting differential strategic utilization of incentives. Together these data suggest that older adults may have impairments in incentive integration, and employ different motivational strategies to improve cognitive task performance. The findings suggest potential candidate neural mechanisms that may serve as the locus of age-related change, providing targets for future cognitive neuroscience investigations.


2020 ◽  
Author(s):  
Samina Rahman ◽  
Victoria Kordovski ◽  
Savanna Tierney ◽  
Steven Paul Woods

Objective: Online banking is becoming increasingly common among older adults, whomay experience difficulties effectively navigating this instrumental technology. Thisstudy examined age effects on a performance-based Internet banking task and itsassociation with neurocognitive ability and functional capacity in older and youngeradults. Method: Thirty-five older adults and 50 younger adults completed anexperimenter-controlled online banking measure in which they independentlyperformed a series of naturalistic financial tasks (e.g., account transfers, bill paying).Participants also completed a standardized battery of neuropsychological tests andmeasures of functional capacity. Results: Older adults were markedly slower and lessaccurate in completing the Internet-based banking task, which was not confounded byother demographic, mood, or computer use factors. Higher scores on measures ofneurocognition and financial functional capacity were both strongly associated withhigher Internet-based banking task accuracy scores and quicker completion times inthe older, but not the younger adults. Conclusions: Findings suggest that older adultsexperience difficultly quickly and accurately navigating online banking platforms, whichmay be partly related to age-related declines in neurocognitive functions and basicfinancial capacity. Future studies might examine whether neurocognitive approaches toremediation and compensation can be used to improve online banking capacity inolder adults.


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