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Elderly people with dementia, for example, Alzheimer’s disease and Parkinson’s disease are most strongly associated with deaths from choking on food.

One American study examined the clinical background and scenarios surrounding 75 patients who survived a near-fatal choking episode. Sixty of the people had choked on a solid bolus of food and almost half of them had neurologic disease. 25 of the people choked at home and most incidents happened elsewhere: 18 in nursing homes, 14 in hospitals, 9 in restaurants, and 9 in drinking establishments.

This study highlighted a growing awareness that choking emergencies in a portion of the elderly population are partially due to swallowing issues, with nearly 40% of Americans over the age of 60, experiencing some form of dysphagia, which is a difficulty or discomfort in swallowing.

Prader–Willi syndrome or PWS, is a genetic disorder due to loss of function of specific genes on chromosome 15. In newborns, symptoms include weak muscles, poor feeding, and slow development. In childhood, the person becomes constantly hungry which often leads to obesity and type 2 diabetes. When it comes to life-threatening obesity, PWS is cited as the most common cause and choking has been observed as key contributing factor n death in this group.

A survey of the families of deceased PWS patients reported that 1 in 3 had a history of choking and almost 1 in 10 listed choking as the cause of death. Causes of increased choking hazards among this population included poor oral/motor coordination, poor gag reflex, low muscle tone, excessive desire for food, decreased chewing ability and voracious eating habits.

It is important to note that while these symptoms were reported for PWS patients, caregivers should identify these symptoms in other populations and recognise an increased choking risk.