Effects of Swallowing Effort on Bolus Accommodation in Healthy Elderly Individuals


Material Information

Effects of Swallowing Effort on Bolus Accommodation in Healthy Elderly Individuals
Physical Description:
1 online resource (120 p.)
LaGorio, Lisa A.
University of Florida
Place of Publication:
Gainesville, Fla.
Publication Date:

Thesis/Dissertation Information

Doctorate ( Ph.D.)
Degree Grantor:
University of Florida
Degree Disciplines:
Rehabilitation Science
Committee Chair:
Crary, Michael A
Committee Members:
Carnaby, Giselle Denya
Fuller, David D
Striley, Catherine L


Subjects / Keywords:
accommodation -- age -- aging -- biokinematic -- bolus -- effort -- hyoid -- larynx -- lingual -- palatal -- pharyngeal -- pressure -- swallowing -- typical -- viscosity -- volume
Rehabilitation Science -- Dissertations, Academic -- UF
Rehabilitation Science thesis, Ph.D.
Electronic Thesis or Dissertation
bibliography   ( marcgt )
theses   ( marcgt )
government publication (state, provincial, terriorial, dependent)   ( marcgt )


Bolus accommodation is the involuntary process of physiologic adjustment to varying bolus characteristics during swallowing. These adjustments facilitate precisely coordinated timing and sufficient contractile force to safely propel different materials through the upper aerodigestive tract. Bolus accommodation may change with advancing age. Age-related changes may reflect reduced physiologic swallowing efficiency and relate to increased risk of swallow-related morbidity. As such, bolus accommodation may serve as a surrogate for sub-clinical dysphagia in the elderly. To develop this potential marker of dysphagia, comprehensive knowledge of aging-related effects on bolus accommodation is needed. Prior studies of bolus accommodation in the elderly have focused primarily on swallow timing and movement parameters. Few studies have investigated bolus accommodation effect on swallow pressures. This cross-sectional study improved upon previous studies by simultaneously evaluating change in lingual-palatal pressures, pharyngeal pressures, and swallow biokinematics as a function of increased swallowing effort, bolus volume and viscosity, and age. Thirty-one adults between 60-88 years of age participated. Each underwent videomanofluoroscopic swallowing evaluation that simultaneously captured seven oropharyngeal pressures and two kinematic measures during each swallow. Participants swallowed a series of 32 boluses, systematically varying in volume and viscosity, under two conditions (typical and effortful swallowing). A 4-way repeated measures ANOVA (swallowing condition x volume x viscosity x age group) was conducted for each physiologic parameter investigated. Significant main and interaction effects were identified for several physiologic measures. Swallowing condition effects demonstrated greater pressure generation during effortful swallowing. Volume effects showed greater laryngeal movement with larger volumes. Viscosity effects demonstrated linear trend of greater pressure generation with increased viscosity. Age group effects demonstrated that the 80 year old group generated lower pressures than younger participants. Overall, the oldest adults produced lower pressures than their younger counterparts. However, swallow pressures were modulated by bolus characteristics and by volitionally increasing swallowing effort. Moreover, by volitionally increasing swallowing effort, the oldest adults produced pressures approximating those pressures produced by younger adults during typical swallowing. When taken as a whole, these results support the notion that volitionally increasing swallowing effort and manipulating bolus characteristics may serve to over-ride automatic aspects of bolus accommodation.
General Note:
In the series University of Florida Digital Collections.
General Note:
Includes vita.
Includes bibliographical references.
Source of Description:
Description based on online resource; title from PDF title page.
Source of Description:
This bibliographic record is available under the Creative Commons CC0 public domain dedication. The University of Florida Libraries, as creator of this bibliographic record, has waived all rights to it worldwide under copyright law, including all related and neighboring rights, to the extent allowed by law.
Thesis (Ph.D.)--University of Florida, 2012.
Adviser: Crary, Michael A.
Electronic Access:
Statement of Responsibility:
by Lisa A. LaGorio.

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Applicable rights reserved.
lcc - LD1780 2012
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