Why am I choking more as I get older? A look into swallowing changes

According to the Ohio Department of Aging, choking is the fourth leading cause of home injury death in the U.S., with older adults at increased risk. If you've been asking 'why am I choking more as I get older,' you're not alone, as it's a common concern due to age-related changes in the body.

Quick Summary

Increased choking with age is often caused by a condition called dysphagia, where the muscles and reflexes involved in swallowing weaken and slow down, and saliva production decreases, making it harder to manage food and liquid. It's crucial to address these changes to prevent aspiration and serious health complications.

Key Points

• Dysphagia is the cause: Difficulty swallowing, or dysphagia, is the medical term for the issues that lead to increased choking risk with age.

• Muscle weakness is a primary factor: Aging can weaken the muscles in the mouth and throat used for swallowing and slow down protective reflexes.

• Dry mouth increases difficulty: Decreased saliva production, often due to medications, makes food harder to moisten and swallow safely.

• Dental issues are a factor: Problems with teeth or dentures can prevent proper chewing, leaving large, unsafe food pieces.

• Neurological conditions can impair swallowing: Diseases like Parkinson's and dementia can interfere with the brain's control over the swallowing process.

• Consult a professional: If choking becomes more frequent, seek a medical evaluation to identify the cause and create a management plan, potentially with a speech-language pathologist.

Understanding Dysphagia and Aging

Experiencing difficulty swallowing, known as dysphagia, is a key reason for an increase in choking incidents with age. While not an inevitable part of aging, a phenomenon called 'presbyphagia' refers to the characteristic changes that naturally occur in the swallowing process over time. This involves a gradual weakening of the muscles used for swallowing, less elastic cartilage in the airway, and reduced coordination between swallowing and breathing. Recognizing this as a potential health issue, rather than just a nuisance, is the first step toward managing it effectively.

Age-Related Physical Changes that Increase Choking Risk

Several physiological changes contribute to the higher risk of choking as we get older. Understanding these can help you recognize the signs and take preventive action.

Weakened Swallowing Muscles

• Muscle Atrophy: The muscles in the mouth, throat, and esophagus involved in chewing and swallowing naturally lose mass and strength over time. This reduces the force behind each swallow, making it harder to propel food and liquids down the esophagus effectively.
• Slower Reflexes: The reflex that coordinates the protection of your airway during swallowing becomes slower. This can lead to food or drink entering the windpipe, a condition known as aspiration, which can cause choking or, over time, aspiration pneumonia.

Reduced Saliva Production

• Dry Mouth: As a side effect of certain medications or simply due to age-related changes, many older adults produce less saliva. Saliva is vital for moistening food and breaking it down, and a dry mouth makes it much more difficult to chew and swallow safely.

Dental and Oral Health Issues

• Poorly Fitting Dentures: Dentures that don't fit correctly can interfere with the proper grinding of food, leaving larger pieces that are more difficult to swallow.
• Missing or Brittle Teeth: Damaged or missing teeth impact chewing efficiency, another factor that increases the risk of choking.

Cognitive and Neurological Conditions

• Neurological Diseases: Conditions like Parkinson's disease, Alzheimer's, and dementia can impair the muscle control and coordination necessary for safe swallowing. This is a major factor in dysphagia for many older adults.
• Cognitive Impairment: Seniors with cognitive issues may forget to chew food properly or might eat too quickly, heightening the risk of choking.

How to Manage and Reduce Choking Risk

To proactively address the question of 'why am I choking more as I get older?', consider incorporating these strategies into your daily routine.

Tips for Safer Swallowing

1. Eat Slowly: Take your time during meals and don't rush. This allows your swallowing muscles and reflexes to work without being hurried.
2. Take Small Bites: Cut food into small, manageable pieces. Avoid trying to swallow large chunks of food.
3. Chew Thoroughly: Make sure food is chewed to a soft, consistent texture before attempting to swallow.
4. Stay Upright: Always sit upright while eating and remain in that position for at least 30 minutes after your meal to prevent acid reflux from interfering with swallowing.
5. Focus on Your Meal: Minimize distractions like talking, laughing, or watching TV while eating. This helps you concentrate on the process of chewing and swallowing.

Food and Liquid Texture Modifications

Consulting a speech-language pathologist (SLP) is a great step toward managing dysphagia, as they can recommend specific strategies, including modifying food and liquid textures.

Food/Liquid Type	Why It Can Be a Problem	Recommended Modification
Hard Candy/Nuts	Small, hard pieces are easily aspirated or become lodged.	Avoid completely.
Sticky Foods	Peanut butter, honey, etc., can cling to the throat.	Thin with liquids or choose a smoother texture.
Thin Liquids	Water, juice, etc., can be difficult to control and easily enter the airway.	Use a thickening agent to slow the liquid down.
Tough Meats	Difficult to chew into a fine consistency.	Choose tender cuts, and chop, grind, or puree them.
Crumbly Foods	Crackers or dry cakes can fall apart and be inhaled.	Dip in liquid or choose a moister food.

When to Seek Medical Advice

If you are experiencing increased choking, it is essential to consult with a healthcare provider. A doctor can rule out any underlying medical conditions and may refer you to a specialist. A speech-language pathologist can perform a swallowing assessment and provide tailored exercises and techniques to strengthen your swallowing muscles and improve coordination. For comprehensive resources on dysphagia, a good place to start is the National Institutes of Health website, which offers detailed information and links to additional research.

Conclusion

Choking more frequently as you get older is a serious symptom that points to underlying changes in your body's swallowing mechanics, not just a random occurrence. By understanding the causes, from weakened muscles to dry mouth and underlying conditions, you can take proactive steps to mitigate your risk. Simple adjustments to eating habits and food preparation, along with professional guidance, can significantly improve your safety and quality of life. Don't dismiss choking as a normal part of aging; it’s a warning sign that requires attention and care.

Frequently Asked Questions

Is it normal to start choking more as I get older?

While it can be common, it is not considered a normal or safe part of aging. Increased choking is a sign of a swallowing problem, or dysphagia, that should be evaluated by a healthcare professional to prevent serious complications like aspiration pneumonia.

What is dysphagia and how does it relate to choking?

Dysphagia is the medical term for difficulty swallowing. It can cause choking when weakened muscles or slowed reflexes fail to properly protect the airway, allowing food or liquid to be inhaled into the windpipe instead of entering the esophagus.

Can certain medications cause me to choke more?

Yes, many medications can cause side effects like dry mouth, which makes it harder to swallow safely. Always discuss any changes in swallowing with your doctor to see if your medications might be a factor.

What can I do to reduce my risk of choking?

To reduce your risk, try eating more slowly, taking smaller bites, and chewing food thoroughly. Stay upright for a period after eating and minimize distractions during meals to focus on swallowing. A speech-language pathologist can offer more specific strategies.

When should I see a doctor about swallowing problems?

You should see a doctor if you experience frequent coughing or throat-clearing while eating or drinking, a wet-sounding voice after swallowing, or weight loss. These can be signs of dysphagia and should be professionally assessed.

Are certain foods more likely to cause choking in older adults?

Yes, foods that are particularly hard, sticky, or crumbly can be riskier. Examples include hard candy, tough meat, nuts, and dry crackers. Thin liquids, like water, can also be problematic for some people and may require thickening.

Can stress or anxiety affect my swallowing?

Yes, stress and anxiety can sometimes contribute to swallowing difficulties. However, since increased choking can signal a serious medical issue, it is best to rule out any physical causes with a doctor before attributing it to psychological factors.