The Frequency of Atypical and Extreme Values for Pharyngeal Phase Swallowing Measures in Mild Parkinson Disease Compared to Healthy Aging.
Pooja Gandhi, Renata Mancopes, Danielle Sutton and 2 others
PMID 34314250WHAT IT FOUND
People with mild Parkinson disease showed no more swallowing impairments than healthy older adults.
Both groups had similar rates of slow swallowing and residue. Differences found favored compensation, not deficit. Small sample size means these results are preliminary.
Key findings
01The study found no significant difference between people with Parkinson disease and healthy controls in the frequency of extreme swallowing values, and only a few significant differences in atypical values.
02Both groups showed high frequencies of atypical values for slow swallow reaction time, poor pharyngeal constriction, and residue, suggesting these are features of normal aging rather than Parkinson disease.
03Where differences were found, people with Parkinson disease showed prolonged laryngeal vestibule closure and upper esophageal sphincter opening durations, which the authors interpret as compensatory mechanisms rather than impairments.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The sample size was very small (17 per group), which limited the statistical power to detect real differences. The authors state the study was only powered to detect large differences (at least twofold). Participants had only mild Parkinson disease and were tested in their medication 'on' state, so the results may not apply to those with advanced disease or those in an 'off' state. The study used natural sip sizes rather than controlled volumes, which makes it harder to isolate specific physiological deficits. The reference ranges for 'atypical' and 'extreme' values were based on healthy adults under 60, while the study participants were older (median age 69), potentially skewing the classification of normal aging changes as atypical.
Declared interests
Funding was provided by the National Institute on Deafness and Other Communication Disorders (NIH).
The easy way to misread this
Do not conclude that mild Parkinson disease causes no swallowing problems. The study was underpowered and only looked at patients in their medication 'on' state. It suggests that some common signs like slow reaction time are also seen in healthy aging, but it does not rule out subtle deficits or issues in more advanced disease.