加齢と口腔・咽頭・食道の運動機能

加齢と口腔・咽頭・食道の運動機能に関するレビュー論文を紹介します。presbyphagia（老嚥）のレビュー論文ともいえます。

JoAnne Robbins, Allison Duke Bridges, and Andrew Taylor: Oral, pharyngeal and esophageal motor function in aging. GI Motility online (2006) doi:10.1038/gimo39

下記のHPで全文見ることができますので、presbyphagia（老嚥）に関心のある方はぜひ読んでみてください。サルコペニアによる嚥下障害とかなり関連があります。

http://www.nature.com/gimo/contents/pt1/full/gimo39.html

この論文では何度もpresbyphagia（老嚥）という言葉が出てきます。また、presbyesophagus（老人性食道機能低下）という言葉も出てきます。これは1960年代に造られた言葉だそうです。

Weblio英和辞典でもpresbyesophagusは、加齢による食道括約筋の収縮力低下、老人性食道、老人食道という訳語があります。でもpresbyphagiaは登録されていないので、presbyesophagusのほうがメジャーな言葉かもしれません。

http://ejje.weblio.jp/content/presbyesophagus

Key Points

• Presbyphagia refers to age-related changes in the oropharyngeal and esophageal swallowing of healthy adults.
• Sarcopenia is age-related loss of skeletal muscle mass, organization, and strength.
• Good health is maintained in the presence of disease-free presbyphagia.
• Healthy persons depend on a highly automated neuromuscular sensorimotor process that coordinates chewing, swallowing, and airway protection.
• Central and peripheral nervous system changes with age affect swallowing.
• Oropharyngeal swallowing changes with healthy aging:
• Slower
• Delayed onset of airway protection and upper esophageal sphincter (UES) opening
• Bolus adjacent to airway longer
• Reduced lingual pressures
• Esophageal swallowing changes with aging:
• Duration of esophageal peristalsis is prolonged and amplitude decreases (60–80 years).
• Esophageal contraction amplitude diminishes but function remains intact (80-90 years).
• Reduced frequency of secondary peristalsis
• Increased reflux events in elders
• Although compensatory interventions are traditional, exercise is promising to remediate and perhaps prevent decline in function.