Relationship between oral status, swallowing function, and nutritional risk in older people with and without Parkinson's disease.
Ramon Cipriano Pacheco de Araújo, Cynthia Meira de Almeida Godoy, Lidiane Maria de Brito Macedo Ferreira and 2 others
PMID 39109756WHAT IT FOUND
Dysphagic older adults with Parkinson's disease had more thin-liquid residue, penetration and aspiration than dysphagic older adults without Parkinson's disease.
They also had weaker tongue and cough, restricted oral intake and higher nutritional screening scores.
Key findings
01Dysphagic older adults with Parkinson's disease had more thin-liquid pharyngeal residue (63.3% vs 34.4%, p=0.034), laryngeal penetration (31.8% vs 0%, p=0.001), and laryngotracheal aspiration (22.7% vs 0%, p=0.008) than dysphagic older adults without Parkinson's disease.
02The Parkinson's disease group had reduced pharyngeal sensitivity to touch (40.9% vs 12.5%, p=0.016), reduced tongue strength (54.5% vs 15.6%, p=0.002), reduced maximum phonation time (68.2% vs 21.9%, p=0.001), and weak spontaneous cough (27.3% vs 6.3%, p=0.041).
03The Parkinson's disease group had fewer teeth without dentures (13 vs 18, p=0.047) and fewer teeth with dentures (20 vs 24, p=0.015), a lower Functional Oral Intake Scale score (5.1 vs 6.0, p=0.006), and a higher Malnutrition Screening Tool score (1.0 vs 0.2, p=0.004).
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
Small convenience sample of 54 older adults from one hospital outpatient clinic, so results may not apply to other populations. Data were collected retrospectively from medical records, and referrals did not follow a standardized protocol for instrumental swallowing investigation. The groups were not balanced by sex: 14 of 22 participants with Parkinson's disease were male, while 5 of 32 without Parkinson's disease were male. The Parkinson's disease group included stages I, II, and III in unequal numbers (18.1%, 54.5%, and 31.8%), and the study did not account for time since diagnosis or medication effects. It was not possible to verify whether participants were under the influence of dopaminergic medications during the assessments. No anthropometric or biochemical nutritional data were collected, and denture type and location were not recorded. The study compared groups at one time and did not test an intervention, so it cannot show that Parkinson's disease caused these swallowing differences or that treatment would change them.
Declared interests
Financial support: CAPES (Brazil), financing code 001. The supplied text does not report author conflicts of interest.
The easy way to misread this
Do not read the thin-liquid penetration and aspiration percentages as evidence that thickened liquids prevent aspiration. This was an observational comparison of medical records, not a treatment trial. Do not conclude that Parkinson's disease caused the swallowing differences.