Esophageal motility disorders among elderly patients: An international multicenter study

Background: The impact of advanced age on esophageal motility remains relatively underexplored, particularly using updated diagnostic protocols. Aims: To evaluate esophageal motility findings, indications, success rate, and diagnostic yields of high-resolution manometry (HRM) in elderly patients. Methods: A retrospective multicenter study was conducted across six tertiary medical centers of adult patients undergoing HRM between 2022 and 2024. The indications, success rate, diagnostic yield, and HRM metrics were compared according to the novel definition of elderly (≥75 years old). Results: 1146 patients were included (275 ≥ 75 years and 871 < 75 years). Dysphagia was the most common indication among elderly patients (≥75 years: 69.0 % vs. <75 years: 45.2 %, p < 0.001). The success rate of HRM was similar (91.7 % vs. 90.0 %, p = 0.575). Elderly patients exhibited higher rates of type III achalasia (6.1 % vs. 1.2 %, p < 0.001), esophagogastric junction (EGJ) outflow obstruction (13.6 % vs. 3.1 %, p < 0.001), and hypercontractile esophagus (5.3 % vs. 2.5 %, p < 0.001). Diagnostic yield increased with age for any motility disorder (p = 0.016) and Disorders of EGJ Outflow (p < 0.001). For any motility disorder, the prevalence increased from 45.7 % (<65 years) to 48.9 % (65–74 years) to 56.0 % (≥75 years)(p = 0.016). Conclusion: There is a higher prevalence of motility disorders observed in older populations, especially after age 75, supporting the relevance of the novel definition of elderly.