An elderly person is at increased risk for aspiration primarily due to what factor?

The increased risk for aspiration in elderly individuals is primarily due to decreased cough and gag reflexes. As people age, the natural protective reflexes that safeguard the airway can become diminished. The cough reflex is essential for clearing food, liquids, or foreign materials that may inadvertently enter the airway, while the gag reflex helps prevent aspiration by triggering a response to expel substances that could block breathing.

As these reflexes weaken, the capacity to react effectively to aspirations diminishes, leading to a higher risk of aspiration pneumonia and other related complications. The changes in neurological function that accompany aging can also affect the brain's signaling for these reflexes, exacerbating the issue.

While atrophy of the epiglottis, a decreased ability to swallow, and slowing of the ciliary mechanisms can impact swallowing and airway protection, the most immediate and significant factor directly influencing the risk of aspiration in the elderly population is the reduction in the efficacy of the cough and gag reflexes.