Cognitive Dysphagia and Effectively Managing The Five Systems In order for a person to swallow safely and effectively, five bodily systems must work in coordination. Dysphagia occurs when there is a breakdown in one or more of these systems: neurological (NeuroDys), cognitive (CogDys), muscular (MuscDys), respiratory (RespDys), and gastrointestinal (GIDys). The present perspective discusses cognitive decline preceding or ... Article
Article  |   September 01, 2015
Cognitive Dysphagia and Effectively Managing The Five Systems
Author Affiliations & Notes
  • Jeanna Winchester
    Dysphagia Management Systems LLC, Sarasota, FL
    Department of General Sciences, Concorde Career Institute, Orlando, FL
    Department of Anatomy & Physiology, International University of the Health Sciences, Basseterre, St. Kitts West Indies
  • Carol G. Winchester
    Dysphagia Management Systems LLC, Sarasota, FL
  • Disclosures: Financial: Jeanna Winchester and Carol G. Winchester have no financial interests to disclose.
    Disclosures: Financial: Jeanna Winchester and Carol G. Winchester have no financial interests to disclose.×
  • Nonfinancial: Portions of this paper were previously presented at the Florida Speech and Hearing Association Conference, May 2015.
    Nonfinancial: Portions of this paper were previously presented at the Florida Speech and Hearing Association Conference, May 2015.×
Article Information
Swallowing, Dysphagia & Feeding Disorders / Older Adults & Aging / Articles
Article   |   September 01, 2015
Cognitive Dysphagia and Effectively Managing The Five Systems
SIG 15 Perspectives on Gerontology, September 2015, Vol. 20, 116-132. doi:10.1044/gero20.3.116
History: Received June 3, 2015 , Revised July 15, 2015 , Accepted July 19, 2015
SIG 15 Perspectives on Gerontology, September 2015, Vol. 20, 116-132. doi:10.1044/gero20.3.116
History: Received June 3, 2015; Revised July 15, 2015; Accepted July 19, 2015

In order for a person to swallow safely and effectively, five bodily systems must work in coordination. Dysphagia occurs when there is a breakdown in one or more of these systems: neurological (NeuroDys), cognitive (CogDys), muscular (MuscDys), respiratory (RespDys), and gastrointestinal (GIDys). The present perspective discusses cognitive decline preceding or concurrently degrading mechanisms of the swallow. We put forth current evidence supporting the premise that cognitive decline can cause dysphagia, and that dysphagia can cause cognitive decline through the exploration of anatomy, physiology, cellular architecture, basic homeostatic mechanisms, metabolism, and nutrition. Additionally, this perspective distinguishes CogDys from NeuroDys and provides an overview of the remaining systems. These types of dysphagia comprise a bi-directional, constantly evolving relationship in which cognition can affect neurological function, and the reverse can be true. We propose literature-driven conclusions and further discussion into considerations for certified nursing assistants, medical physicians, speech-language pathologists, occupational therapists, & physical therapists in effective dysphagia management.

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