Affecting Gastroenterology Practice and Research Age-related changes in GI function will have increasing importance for health care delivery as the number of elderly individuals increases significantly over the next 2–3 decades. The aging process per se has clinically significant effects on oropharyngeal and upper esophageal motility, colonic function, GI immunity, and GI drug metabolism. Although many essential aspects of GI function, such as intestinal secretion, are generally preserved with aging, superimposed effects of chronic diseases and environmental/lifestyle exposures (medications, alcohol, tobacco) impair GI function in older patients.14 A modest decline in gastric mucosal cytoprotection or esophageal acid clearance may be significant when superimposed side effects of certain medications or concurrent disease are also present.13, 15, 16 Certain age-related changes in GI function, such as constipation, are viewed as dysfunctional by patients and health care providers. Research areas that have been identified as important in aging include the pathophysiology of swallowing disorders, esophageal reflux, dysmotility syndromes, GI immunobiology, and the cellular mechanisms of neoplasia in the GI tract. Food Intake and Nutritional Status Geriatric patients, particularly those older than 85 years, are at risk for decreased food intake,17 and this should be considered in any geriatric patient with significant weight loss. Mobility impairment, with inability to obtain or prepare food, is a common problem, particularly in patients in long-term care facilities.18 Functional screening for mobility impairment by asking about the ability to perform activities of daily living (ADLs) such as bathing and toileting, food preparation, grocery shopping, and mobility outside the home should be a part of the history for geriatric patients. Simple screening of ambulation by observing the gait can be helpful in documenting significant mobility impairment. The ability to obtain food should be considered in the differential diagnosis of unexplained weight loss in geriatric patients. Loss of taste is also common in this age group and is often due to decreased olfaction rather than decreased taste sensation per se.19 Appetite is decreased in the elderly. Older subjects were less likely to be hungry after a 36-hour fast, and blood sugar levels did not correlate with the subjective sensation of hunger.20 Other factors that have been identified include changes in prophagic and antiphagic endocrine hormones that occur with aging and that may contribute to “anorexia of aging.”21 Similar decreased food intake has been documented in animal studies in which food availability was not an issue, suggesting that aging itself may be associated with neuroendocrine changes that contribute to “anorexia of aging.”22 Finally, depression is a common cause of weight loss in geriatric patients,23 and gastroenterologists need to be familiar with rapid screening techniques for depression, such as the 2-question depression screen outlined in the section on general geriatric conditions in this report. Age-Associated Changes in Oropharyngeal Function The increasing likelihood of dental decay and tooth loss with aging has an obvious effect on the efficiency and completeness of mastication. This contributes to dysphagia, particularly when other mechanisms involved in swallowing are also impaired. Chewing and swallowing are also impaired by xerostomia, which affects roughly 25% of older patients, while as many as 50%