Skip to main content
Top

Open Access 04-05-2024 | Aspiration | Original Article

Swallowing Characteristics and Water Swallow Capacity in Patients with Parkinsonism

Authors: Per Martell, BSpPath, Masters in Speech and Language Pathology, Örjan Skogar, MD, PhD, Liza Bergström, BSpPath, Masters in Speech and Language Pathology, PhD

Published in: Dysphagia

Login to get access

Abstract

Prevalence and characteristics of dysphagia (including aspiration) in patients with parkinsonism is variable, depending on type of assessment, diagnosis, disease stage and duration. The aim of this study was to further evaluate dysphagia characteristics in patients with different types of parkinsonism with both instrumental (Flexible Endoscopic Evaluation of Swallowing, FEES) and non-instrumental (Timed Water Swallow Test, TWST) assessments. Swallowing characteristics in 74 patients with parkinsonism were prospectively assessed using FEES and TWST. Statistics employed were (a) Spearman rank correlation to measure correlation between dysphagia results and Parkinson subtypes, disease severity and duration and (b) the non-parametric tests Mann Whitney U and Kruskal Wallis to measure difference between groups. Dysphagia was common, with 50 (67.6%) of the patients demonstrating a mild-severe Dysphagia Outcome Severity Scale (DOSS, level 1–5). During FEES, 42% aspirated and 68% of these had silent aspiration. Aspiration was seen more frequently with increased disease severity as per Hoehn and Yahr (H&Y) (r = .459, p = < 0.001) and disease duration (r = .269, p = .021). Thin liquid (IDDSI level 0) was the most common consistency to aspirate, and the frequency of aspiration decreased with thicker liquids. Dysphagia and aspiration are common in all subgroups of parkinsonism and seen in early stages of H&Y and within the first year of disease duration. Hence, it is recommended that these patients are evaluated early for optimal management and to avoid aspiration-related complications.
Literature
7.
go back to reference Zermansky A, Ben-Shlomo Y. Epidemiology of Progressive Supranuclear Palsy and multiple system atrophy. In: Litvan I, editor. Atypical Parkinsonian disorders: clinical and Research Aspects. Totowa, NJ: Humana; 2005. pp. 23–31.CrossRef Zermansky A, Ben-Shlomo Y. Epidemiology of Progressive Supranuclear Palsy and multiple system atrophy. In: Litvan I, editor. Atypical Parkinsonian disorders: clinical and Research Aspects. Totowa, NJ: Humana; 2005. pp. 23–31.CrossRef
9.
go back to reference Wirth R, Dziewas R, Beck AM, Clavé P, Hamdy S, Heppner HJ, Langmore S, Leischker AH, Martino R, Pluschinski P, Rösler A, Shaker R, Warnecke T, Sieber CC, Volkert D. Oropharyngeal dysphagia in older persons - from pathophysiology to adequate intervention: a review and summary of an international expert meeting. Clin Interv Aging. 2016;11:189–208. https://doi.org/10.2147/CIA.S97481.CrossRefPubMedPubMedCentral Wirth R, Dziewas R, Beck AM, Clavé P, Hamdy S, Heppner HJ, Langmore S, Leischker AH, Martino R, Pluschinski P, Rösler A, Shaker R, Warnecke T, Sieber CC, Volkert D. Oropharyngeal dysphagia in older persons - from pathophysiology to adequate intervention: a review and summary of an international expert meeting. Clin Interv Aging. 2016;11:189–208. https://​doi.​org/​10.​2147/​CIA.​S97481.CrossRefPubMedPubMedCentral
13.
go back to reference Rosenbek JC, Troche MS. Progressive neurologic disease and Dysphagia (including Parkinson’s Disease, multiple sclerosis, amyotrophic lateral sclerosis, Myasthenia Gravis, Post-polio Syndrome). In: Shaker R, Belafsky P, Postma G, Easterling C, editors. Principles of Deglutition: A Multidisciplinary text for swallowing and its disorders. New York, NY: Springer; 2013. pp. 395–410.CrossRef Rosenbek JC, Troche MS. Progressive neurologic disease and Dysphagia (including Parkinson’s Disease, multiple sclerosis, amyotrophic lateral sclerosis, Myasthenia Gravis, Post-polio Syndrome). In: Shaker R, Belafsky P, Postma G, Easterling C, editors. Principles of Deglutition: A Multidisciplinary text for swallowing and its disorders. New York, NY: Springer; 2013. pp. 395–410.CrossRef
30.
go back to reference Langmore S. Endoscopic evaluation and treatment of swallowing disorders. 2 ed. New York: Thieme; 2001. Langmore S. Endoscopic evaluation and treatment of swallowing disorders. 2 ed. New York: Thieme; 2001.
Metadata
Title
Swallowing Characteristics and Water Swallow Capacity in Patients with Parkinsonism
Authors
Per Martell, BSpPath, Masters in Speech and Language Pathology
Örjan Skogar, MD, PhD
Liza Bergström, BSpPath, Masters in Speech and Language Pathology, PhD
Publication date
04-05-2024
Publisher
Springer US
Published in
Dysphagia
Print ISSN: 0179-051X
Electronic ISSN: 1432-0460
DOI
https://doi.org/10.1007/s00455-024-10685-3