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Dysphagia: A Geriatric Giant?

26 April 2022

“Geriatric Giants: A term coined by geriatrician Bernard Isaacs, and the expression refers to the principal chronic disabilities of old age that impact on the physical, mental and social domains of older adults”.

Dysphagia is a big issue. Estimates suggest there are currently over 590,000,000 around the world suffering with it.

As a result, David Smithard from King’s College Hospital Foundation Trust in London (UK) argues that it should be considered a Geriatric Giant. We completely agree and so have put the Abstract and Introduction from his paper below.

We would highly recommending reading the full and original article which you can read on line by clicking this link:


With increasing age there are changes to the physiology of all aspects of swallowing. Despite these changes, the majority of older people will swallow safely. With increasing frailty the number of people presenting with dysphagia increases either in the presence of acute illness or with co morbidity; with significant number living in institutions.

The aetiology of dysphagia is multiple and is associated with increased dependency and mortality and as such dysphagia meets the criteria to be classified as a geriatric syndrome or giant. This paper presents the case for dysphagia to be recognised as a geriatric giant.


The worldwide population is increasing, such that it is predicted that there will be 2 billion over the age of 65 years by 2050; the greatest proportional increase will be in those over the age of 85 years.

Accompanying this will be an increase In people living longer with long term conditions and a consequent increase in frail older people.

Old age is frequently accompanied by many long-term conditions that affect health. Many old people will have multiple long-term conditions (e.g. ischaemic heart disease, diabetes, dementia).

Dysphagia, difficulty in swallowing, will accompany many long term conditions and may be latent in many frail older people, and is associated with increasing dependency and death. The time has come to fully recognise dysphagia as a Geriatric Giant /Syndrome.

To be recognised as a Geriatric Syndrome/Giant dysphagia [1] has to meet accepted recognised criteria below. This short paper will outline the reasons why it should be considered thus.

Factor for Geriatric Giant Dysphagia
Cognitive Function (✓)
Functional Impairment (✓)

You can read on line by clicking this link:

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