Communication and Swallowing Changes in Healthy Aging Adults

76565_FMxx_FINAL.QXP 4/6/10 4:19 PM Page i Jones & Bartlett Learning, LLC. NOT FOR SALE OR DISTRIBUTION Communication and Swallowing Changes in Healthy Aging Adults Angela N. Burda, PhD, CCC-SLP Associate Professor Department of Communication Sciences and Disorders University of Northern Iowa Cedar Falls, Iowa

World Headquarters Jones & Bartlett Learning 40 Tall Pine Drive Sudbury, MA 01776 978-443-5000 info@jblearning.com www.jblearning.com Jones & Bartlett Learning Canada 6339 Ormindale Way Mississauga, Ontario L5V 1J2 Canada Jones & Bartlett Learning International Barb House, Barb Mews London W6 7PA United Kingdom Jones & Bartlett Learning books and products are available through most bookstores and online booksellers. To contact Jones & Bartlett Learning directly, call 800-832-0034, fax 978-443-8000, or visit our website www.jblearning.com. Substantial discounts on bulk quantities of Jones & Bartlett Learning publications are available to corporations, professional associations, and other qualified organizations. For details and specific discount information, contact the special sales department at Jones & Bartlett Learning via the above contact information or send an email to specialsales@jblearning.com. Copyright 2011 by Jones & Bartlett Learning, LLC All rights reserved. No part of the material protected by this copyright may be reproduced or utilized in any form, electronic or mechanical, including photocopying, recording, or by any information storage and retrieval system, without written permission from the copyright owner. The authors, editor, and publisher have made every effort to provide accurate information. However, they are not responsible for errors, omissions, or for any outcomes related to the use of the contents of this book and take no responsibility for the use of the products and procedures described.treatments and side effects described in this book may not be applicable to all people; likewise, some people may require a dose or experience a side effect that is not described herein. Drugs and medical devices are discussed that may have limited availability controlled by the Food and Drug Administration (FDA) for use only in a research study or clinical trial. Research, clinical practice, and government regulations often change the accepted standard in this field.when consideration is being given to use of any drug in the clinical setting, the health care provider or reader is responsible for determining FDA status of the drug, reading the package insert, and reviewing prescribing information for the most up-to-date recommendations on dose, precautions, and contraindications, and determining the appropriate usage for the product.this is especially important in the case of drugs that are new or seldom used. Production Credits Publisher: David Cella Associate Editor: Maro Gartside Editorial Assistant:Teresa Reilly Production Manager: Julie Champagne Bolduc Associate Production Editor: Jessica Steele Newfell Marketing Manager: Grace Richards Manufacturing and Inventory Control Supervisor: Amy Bacus Composition: Glyph International Cover Design: Kristin E. Parker Cover and Chapter-Opening Image: Kervie Mata/Dreamstime.com Printing and Binding: Malloy, Inc. Cover Printing: Malloy, Inc. Library of Congress Cataloging-in-Publication Data Communication and swallowing changes in healthy aging adults / edited by Angela N. Burda. p. ; cm. Includes bibliographical references and index. ISBN 978-0-7637-7656-5 (pbk. : alk. paper) 1. Senses and sensation in old age. 2. Deglutition. 3. Esophagus Aging. 4. Communicative disorders in old age. 5. Deglutition disorders Age factors. I. Burda, Angela N. [DNLM: 1. Aging physiology. 2. Aged. 3. Communication. 4. Comprehension physiology. 5. Deglutition physiology. 6. Geriatric Assessment. WT 104 C7336 2011] QP435.C66 2011 612.8 dc22 6048 2010002617 Printed in the United States of America 14 13 12 11 10 10 9 8 7 6 5 4 3 2 1

76565_FMxx_FINAL.QXP 4/3/10 4:27 PM Page iii Jones & Bartlett Learning, LLC. NOT FOR SALE OR DISTRIBUTION Contents Preface.......................................vii Acknowledgments................................ix About the Author................................ xi Contributing Authors.............................xiii Chapter 1 Introduction and Theoretical Perspectives............... 1 Angela N. Burda, PhD, CCC-SLP Introduction........................................ 1 Operational Definitions: Healthy and Older................ 2 Theoretical Perspectives............................... 4 Conclusion........................................ 10 Quick Facts........................................ 10 Discussion Questions................................ 12 References........................................ 12 iii

iv Contents Chapter2 Cognition..................................... 19 Angela N. Burda, PhD, CCC-SLP Introduction....................................... 19 Older Adults General Cognitive Abilities.................. 20 Factors Affecting Older Adults Cognition and Signs of Problems................................. 30 Strategies to Help Older Adults Cognitive Abilities.......... 32 Quick Facts....................................... 33 Discussion Questions................................ 36 References........................................ 36 Chapter3 Auditory Comprehension.......................... 41 Angela N. Burda, PhD, CCC-SLP Introduction....................................... 41 Older Adults General Auditory Comprehension Abilities...... 42 Factors Affecting Older Adults Auditory Comprehension and Signs of Problems............................. 46 Strategies to Help Older Adults Auditory Comprehension.... 49 Quick Facts....................................... 51 Discussion Questions................................ 53 References........................................ 53 Chapter4 Reading Comprehension.......................... 59 Angela N. Burda, PhD, CCC-SLP Jill L. Champley, PhD, CCC-SLP Introduction....................................... 59 Older Adults General Reading Comprehension Abilities..... 60 Factors Affecting Older Adults Reading Comprehension and Signs of Problems............................. 65 Strategies to Help Older Adults Reading Comprehension..... 67 Quick Facts....................................... 68 Discussion Questions................................ 70 References........................................ 71 Chapter5 Verbal Expression............................... 75 Angela N. Burda, PhD, CCC-SLP Introduction....................................... 75 Older Adults General Verbal Expression Abilities........... 76 Factors Affecting Older Adults Verbal Expression and Signs of Problems............................. 84 Strategies to Help Older Adults Verbal Expression.......... 87 Quick Facts....................................... 88 Discussion Questions................................ 89 References........................................ 90

Contents v Chapter6 Writing....................................... 93 Angela N. Burda, PhD, CCC-SLP Introduction....................................... 93 Older Adults General Writing Abilities................... 94 Factors Affecting Older Adults Writing and Signs of Problems....................................... 99 Strategies to Help Older Adults Writing................. 102 Quick Facts....................................... 103 Discussion Questions............................... 105 References....................................... 105 Chapter7 Voice and Motor Speech Abilities................... 109 Todd A. Bohnenkamp, PhD, CCC-SLP Carlin F. Hageman, PhD, CCC-SLP Introduction...................................... 109 Older Adults General Voice and Motor Speech Abilities...... 110 Factors Affecting Voice and Motor Speech Abilities and Signs of Problems................................ 110 Strategies to Help Older Adults Voice and Motor Speech Abilities................................. 118 Instrumentation and Evaluation....................... 119 Quick Facts....................................... 123 Discussion Questions............................... 126 References....................................... 126 Chapter8 Swallowing................................... 131 Julia D. Edgar, PhD, CCC-SLP Introduction...................................... 131 Older Adults General Swallowing Abilities............... 133 Factors Affecting Older Adults Swallowing and Signs of Problems...................................... 136 Strategies to Help Older Adults Swallowing.............. 140 Quick Facts....................................... 143 Discussion Questions............................... 145 References....................................... 145 Chapter9 Principles of the WHO International Classification of Functioning, Disability, and Health: Applications for the Community-Dwelling Elderly Population......... 151 Travis T. Threats, PhD, CCC-SLP Introduction...................................... 151 The Need for a Functional Classification System........... 153 Development of the ICF............................. 154

vi Contents Description of the ICF............................... 156 ICF Use for Persons With Communication and Swallowing Disorders...................................... 159 ICF and Issues in Normal Aging....................... 161 Contextual Factors With Aging........................ 162 Conclusion....................................... 167 Quick Facts...................................... 167 Discussion Questions............................... 168 References....................................... 168 Appendix: Tests for Adults........................171 Glossary.....................................181 Index........................................... 185

76565_FMxx_FINAL.QXP 4/3/10 4:27 PM Page vii Jones & Bartlett Learning, LLC. NOT FOR SALE OR DISTRIBUTION Preface ccording to the American Speech-Language-Hearing Association, approximately 39,000 speech-language pathologists (SLPs) work in healthcare facilities, with 6000 currently working in longterm care facilities. It is likely that many of the patients these SLPs see are elderly adults. Fortunately, our discipline has a significant amount of literature available on the kinds of cognitive-linguistic, motor speech, and swallowing impairments that older adults may have as a result of strokes, head injuries, and disease processes such as Alzheimer s disease or Parkinson s disease.what our field is lacking, however, is normative information as to what SLPs can expect from healthy older adults. Lack of such data does not allow SLPs to fully compare what would be considered normal for their elderly patients versus what is considered pathological.without knowing what would be considered within the spectrum of normal, SLPs may not address therapy as effectively as possible.they may overestimate or underestimate what aging adults are A vii

viii Preface capable of doing.yet, medically based SLPs must evaluate patients and typically make treatment decisions quickly.thus, this book was written to serve as a resource for SLPs and assist them in determining their course of evaluation and treatment of their elderly patients.this book was also developed to provide SLP students with useful information when learning about the aging population. In addition, several of the chapters contain original data not published elsewhere. The final chapter discusses the communication abilities and health of aging adults in a much broader fashion using the World Health Organization s International Classification of Functioning, Disability, and Health, an increasingly important perspective of which to be knowledgeable. I hope that readers of all levels, whether students or practicing professionals, find this text helpful.

76565_FMxx_FINAL.QXP 4/3/10 4:27 PM Page ix Jones & Bartlett Learning, LLC. NOT FOR SALE OR DISTRIBUTION Acknowledgments have been extremely fortunate to have had many wonderful individuals involved in this project. Although it has been a marathon, it has also been an experience in which I have learned a great deal. First and foremost, I certainly appreciate the willingness of Jones & Bartlett Learning to give me this opportunity. Dave Cella, Publisher, and Maro Gartside, Associate Editor, at Jones & Bartlett Learning have been incredibly helpful throughout the entire process. I also appreciate the useful feedback provided by the reviewers. I am grateful to be a 2007 and 2008 recipient of the University of Northern Iowa s Adele Whitenack Davis Faculty Research in Gerontology Award.These funding opportunities allowed me to conduct research pertinent to this book, which I have included in Chapters 2 through 6. Special thanks to the contributing authors: Todd Bohnenkamp, Jill Champley, Julia Edgar, Carlin Hageman, and Travis Threats. They are friends and colleagues who kindly agreed to share their expertise. A huge thank you goes out to my graduate assistants and students who worked long and hard I ix

x Acknowledgments to help me out on this endeavor: Andrea Bakeris, Alison Corbett, Ashley Cox, Holly Drury, Stephanie Jones, Beth Kluesner, Laci Kuker, Bekah Rickels, Leslie Spalding, Janet Thomas, and Laura Wright. Special thanks to the (self-proclaimed) Cool Kids in my spring 2008 Acquired Cognitive Disorders seminar for providing their feedback on Chapter 2: Jamie Flatness, Laci Kuker, Brandi Lawrance, Alisha Sanchez, Jenny Scharn, Sara Smith,Tally Stowell, and Janet Thomas. Special thanks also goes out to the students in my fall 2009 Speech-Language Pathology (SLP) Issues in Aging and Accent seminar for their help with the discussion questions: Andrea Bakeris, Ashley Cox, LeAnn Gaughan, Julie Hennessy, Meghan Kelly, Jennifer Kemps, Beth Kluesner, Lindsey Schoening, Leslie Spalding, and Jacayla Vittetoe. My parents, Dick and Jan, my sister Susan, her boyfriend Charlie, and my Grandma Jacky have always been a great source of support. I am lucky to have such a great family. Thanks, Deb for everything, especially all of your kind words. Kim, you and I lead parallel lives, and I always appreciate your encouragement. To my husband, Jim, words cannot express how much your kindness, love, and support every day mean to me.thanks for being my number-one fan.

76565_FMxx_FINAL.QXP 4/3/10 4:27 PM Page xi Jones & Bartlett Learning, LLC. NOT FOR SALE OR DISTRIBUTION About the Author Angela N. Burda is an Associate Professor in the Department of Communication Sciences and Disorders at the University of Northern Iowa (UNI). Dr. Burda obtained her BA and MA degrees from the University of Minnesota Duluth and her PhD from Wichita State University. She has been at UNI since 2000 and teaches courses in acquired neurogenic disorders, normal aging, and accent modification. Her primary areas of research include investigating cognitivelinguistic performance in healthy middle-aged and older adults and the understanding of accented speech by aging adults. She has published several articles and presented her research regionally, nationally, and internationally. Prior to working in academe, Dr. Burda worked as a speech-language pathologist in rehabilitation hospitals and long-term care facilities in St. Paul, Minnesota, and Wichita, Kansas. xi

76565_FMxx_FINAL.QXP 4/3/10 4:27 PM Page xiii Jones & Bartlett Learning, LLC. NOT FOR SALE OR DISTRIBUTION Contributing Authors Todd A. Bohnenkamp, PhD, CCC-SLP Assistant Professor Department of Communication Sciences and Disorders University of Northern Iowa Cedar Falls, Iowa Jill L. Champley, PhD, CCC-SLP Speech-Language Pathologist VA Nebraska Western Iowa Health Care System Omaha, Nebraska Julia D. Edgar, PhD, CCC-SLP Research Scientist Department of Otolaryngology Research Washington University School of Medicine St. Louis, Missouri xiii

xiv Contributing Authors Carlin F. Hageman, PhD, CCC-SLP Professor and Department Head Department of Communication Sciences and Disorders University of Northern Iowa Cedar Falls, Iowa Travis T. Threats, PhD, CCC-SLP Professor and Chair Department of Communication Sciences and Disorders St. Louis University St. Louis, Missouri