Differences in Respiratory-Swallowing Patterns Across Eating Conditions Among Healthy Older Adults

Abstract

Safe and efficient eating relies on the precise coordination of the respiratory and swallowing systems. It is necessary for the airway to be briefly closed during the swallow itself in order to prevent food/liquid from entering the lungs (aspiration). Previous research has suggested that an exhale before and after the swallow is the most protective pattern. Yet, little is known about the effects of aging and sensory environment on these patterns. The purpose of the current study was to characterize the pre- and post-swallow respiratory patterns in older adults across different eating environments. A total of 18 older adults participated (age range 65-90; 11 females). Participants consumed water (via straw) and applesauce (via spoon) under three different conditions: typical self-feeding, assisted feeding (being fed by someone else), and sensory loss assisted feeding (being fed by someone else while blindfolded). Across all three conditions, exhalations prior to the swallow were commonly observed; 58-61% of swallows were preceded by an exhale across the three conditions. Inhales were most commonly observed after the swallow, with a trend for increasing percentages given increased sensory loss (59% self-feeding, 64%, assisted feeding, 71% blindfolded assisted feeding). Future analyses will continue to explore the differences across conditions within the individual participants and differences across the consistency types (i.e., water – drink and applesauce – eat). These findings preliminarily support that various factors can influence respiratory-swallow coordination, potentially increasing risk during eating for older adults.