Effects of Age and Bolus Volume on Velocity of Hyolaryngeal Excursion in Healthy Adults

Reduced movement velocity has been identified as a risk marker for movement impairment in older adults. Hyolaryngeal excursion is a key movement feature of normal swallowing function which is known to change with age and other extrinsic variables such as bolus volume. However, velocity of hyolaryngeal excursion has received limited attention in the literature on normal or abnormal swallowing. This study evaluated the effects of age and bolus volume on the velocity of hyoid and laryngeal excursion during swallowing in healthy adults. Forty-four healthy volunteers were grouped into three age bands (young: 20-35 years, middle age: 36-55 years, older: 56 ≥ years). All subjects swallowed 5 and 20 mL of thin liquid during fluoroscopic recording. Fluoroscopic images were extracted for each swallow representing the onset and maximum excursion positions of the hyoid and larynx. Superior and anterior excursion distance (excursion magnitude) and the time difference between rest and maximum excursion (excursion duration) were calculated. Velocity was calculated as a ratio of distance over time. Superior hyoid excursion magnitude was significantly increased for the 20 mL volume. Anterior laryngeal excursion magnitude was also significantly increased for the 20 mL volume. No kinematic duration measure demonstrated significant change across age or bolus conditions. Superior hyoid excursion velocity was significantly faster for the 20 mL volume. Superior and anterior laryngeal excursion velocity were significantly faster for the 20 mL volume only in the older group. Results of this study indicate that magnitude and velocity of hyoid and laryngeal excursion vary with age and volume. Comprising both excursion magnitude and duration, kinematic velocity may be a more complete metric to evaluate age-related swallowing performance.