Dear Doctor, The older I get (I'm 73) the easier it is for me to choke on my food and even on saliva in my mouth. I did not choke so easily when I was younger. Also, I remember that my mother was prone to choke on her food when she was over seventy. Is this an old age thing, a weight thing, or what? Thanks for your help. -Ron (At Right: A couple probably not practicing mouth to mouth resuscitation.)

Hi Ron, in the Japanese style I would answer yes. To clarify: with age there is less brisk action of muscles in part due to reduced briskness of nervous transmission. This is likely in diabetics and people with vascular disease since it affects the micro circulation that nourishes the nerves. there can also be age related atrophy.

With obesity, there is fat deposition in the neck and jowl and can also alter anatomy with relationships being changed.

Personally speaking, recently I have been increasing my flute playing which works the nerves and muscles and also helps the lungs. Music increases many connections. Don't choke. -Ellar , M.D.