Effects of age and non-oropharyngeal proprioceptive and exteroceptive sensation on the magnitude of anticipatory mouth opening during eating

Abstract

To best prevent and treat eating/swallowing problems, it is essential to understand how components of oral physiology contribute to the preservation and/or degradation of eating/swallowing in healthy ageing. Anticipatory, pre-swallow motor movements may be critical to safe and efficient eating/swallowing, particularly for older adults. However, the nature of these responses is relatively unknown. This study compared the magnitude of anticipatory mouth opening during eating in healthy older (aged 70-85) and younger (aged 18-30) adults under four eating conditions: typical self-feeding, typical assisted feeding (being fed by a research assistant resulting in proprioceptive loss), sensory loss self-feeding (wearing blindfold/headphones resulting in exteroceptive loss) and sensory loss assisted feeding (proprioceptive and exteroceptive loss). Older adults opened their mouths wider than younger adults in anticipation of food intake under both typical and most non-oropharyngeal sensory loss conditions. Further, the loss of proprioceptive and exteroceptive cues resulted in decreased anticipatory mouth opening for all participants. Greater mouth opening in older adults may be a protective compensation, contributing to the preservation of function associated with healthy ageing. Our finding that the loss of non-oropharyngeal sensory cues resulted in decreased anticipatory mouth opening highlights how important proprioception, vision, and hearing are in pre-swallow behaviour. Age- and disease-related changes in vision, hearing, and the ability to self-feed may reduce the effectiveness of these pre-swallow strategies.

Keywords: aged; deglutition; deglutition disorders; eating; motor activity; oropharynx.

© 2016 John Wiley & Sons Ltd.

Figures

Figure 1

A sample movement waveform in the x-dimension (vertical movement) for the lower lip sensor across time relative to the reference point (forehead sensor) during typical self-feeding. The approximate baseline and maximal lip lowering values are indicated by the first and second arrows, respectively.

Figure 2

Lower lip position at baseline for older and younger adults across four experimental conditions. Note: SL = sensory loss. Error bars indicate the 90th and 10th percentiles. All data points outside this range are marked as outliers (shaded circles).

Figure 3

Lower lip position at maximal lowering for older and younger adults across four experimental conditions. Note: SL = sensory loss. Error bars indicate the 90th and 10th percentiles. All data points outside this range are marked as outliers (shaded circles).

Figure 4

Total anticipatory lower lip displacement for older and younger adults across four experimental conditions. Note: SL = sensory loss. Error bars indicate the 90th and 10th percentiles. All data points outside this range are marked as outliers (shaded circles).