Swallowing Problems and Older Adults

If you are caring for an older family member, you understand that chewing and swallowing issues are common. The following information was written by Wendy J. Dahl, PhD, assistant professor; Food Science and Human Nutrition Department; University of Florida.


Many older adults have problems with chewing their food due to missing or broken teeth, poor fitting dentures, or a sore mouth or toothache. Our tongues are needed to help move food around the mouth when we chew. Some older adults may have problems with tongue movement after a stroke, which can lead to problems with chewing.

Adding the right amount of saliva is important for swallowing. Dry foods, such as bread, crackers, and cookies, require a lot of saliva incorporation. An older adult with a dry mouth, due to reduced saliva production, may have problems chewing and swallowing dry foods.

Causes of dry mouth include the following:

• side effects of some medicines

• diseases such as diabetes and Parkinson's disease

• nerve damage after injury to the head or neck

• radiation cancer treatment to the head or neck

• chemotherapy cancer treatment

Difficulties with keeping lips closed or controlling tongue movement, or a lack of feeling or sensation in the mouth, will interfere with swallowing. Older adults may also have problems with food getting stuck in the esophagus. Swallowing can be slow or uncontrolled.

Stroke is one of the most common causes of swallowing problems. Diseases such as multiple sclerosis (MS), cerebral palsy, Parkinson's disease and Alzheimer"s disease often lead to swallowing problems. Head and neck cancer and some cancer treatments, as well as spinal cord and head injuries, also can cause swallowing problems. Some medications may also affect swallowing.

Some frail older adults may have problems communicating their symptoms. Caregivers can be on the lookout for signs of swallowing problems:

• coughing while eating

• gargling voice quality

• drooling while eating

• food pieces in the cheeks or under the tongue

• very slow eating or swallowing

Many older adults with swallowing problems may become much more "picky" with respect to what foods they want to eat. Older adults with swallowing problems may begin to eat less. This may lead to dehydration and weight loss. As weight loss progresses, malnutrition may be the result.