Management of oral drug therapy in elderly patients with dysphagia

We aimed at summarizing current evidence on age-related changes in swallowing, the impact of selected medications on swallowing, and the management of oral drug therapy in older patients with dysphagia. The risk for oropharyngeal swallowing disorders increases with age. Though increasing age facilitates subtle physiologic changes in swallow function, age-related diseases are most significant factors in the onset and severity of dysphagia. In older people, dysphagia can also occur as a side effect of some medications. Drug-induced dysphagia can appear as a drug side effect or as a complication of the therapeutic action of the drug, mainly through induction of xerostomia, impaired swallowing muscle function or esophageal injury. Whatever the mechanism leading to dysphagia, the administraton of drugs to dysphagic patients is a really challenging issue. Manipulations of solid oral drugs frequently occur in geriatric settings, leading to potential medication errors and changes in drug performance. The implementation of guidelines for management of oral drug therapy in dysphagic patients may contribute to improve the quality of care provided to this very frail population.