Swallowing difficulties, or dysphagia, are more common in older adults than many realize. While occasional coughing or trouble swallowing pills might seem minor, these can signal underlying changes in swallowing function that require attention. A recent study by Namasivayam-MacDonald, Werbeloff, and Shune used data from over 11 years of interviews with thousands of older adults to bette
r understand the prevalence and risk factors of swallowing problems in the U.S.
The study found that 8.7–10.2% of older adults reported swallowing difficulties at any given time. Interestingly, these problems were often transient, meaning they came and went rather than staying constant. This suggests that dysphagia in older adults can be linked to episodic health changes—such as illness, injury, or medication side effects—rather than always being permanent.
Several important risk factors emerged, including:
- Poor overall health and multiple medical conditions
- Lower physical activity and reduced muscle strength
- Difficulty eating independently (needing help at meals)
- Low income and less education, highlighting the role of social determinants of health
- Hispanic ethnicity, which the authors linked to disparities in healthcare access and support
These findings underscore that swallowing is not just a medical issue—it’s deeply connected to overall health, nutrition, mobility, and social support.
For caregivers, understanding these risks is crucial. Swallowing problems can lead to serious complications, including pneumonia, malnutrition, dehydration, and reduced quality of life. Because dysphagia is often under diagnosed, caregivers are often the first to notice red flags such as frequent coughing during meals, needing to swallow multiple times per bite, or avoiding certain foods.
What can caregivers do?
- Watch for early signs. Keep track of changes like coughing or throat clearing during meals, unexplained weight loss, or prolonged meal times.
- Encourage regular check-ups. Ask healthcare providers about swallowing screenings, especially if your loved one has dementia, lung disease, or recent hospitalizations.
- Promote safe eating environments. Reduce distractions at meals, ensure good posture (upright position), and allow plenty of time for eating.
- Seek professional help early. Speech-language pathologists (SLPs) can assess swallowing and recommend safe strategies or food textures.
- Support overall health. Physical activity, adequate hydration, and good nutrition can help maintain muscle strength—including swallowing muscles.
- Address barriers. If cost, transportation, or language are obstacles, reach out to social workers or local aging agencies for support.
The research also suggests that periodic re-screening is essential, as swallowing problems can develop or resolve over time. By staying vigilant and advocating for care, caregivers can help prevent complications and maintain their loved one’s safety and dignity.
Understanding dysphagia and its risk factors empowers caregivers to act early and effectively. With proper support, many older adults with swallowing problems can continue to enjoy meals safely and comfortably.
Reference
Namasivayam-MacDonald, A., Werbeloff, M., & Shune, S. (2025). Prevalence and predictors of self-reported swallowing difficulties in community-dwelling older adults: A population-based study from the National Health and Aging Trends Study (NHATS). Dysphagia. Advance online publication. https://doi.org/10.1007/s00455-025-10860-0