Examining the frequency of dysphagia and the predictive factors of dysphagia that require attention in patients with Parkinson's disease

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Abstract

Introduction. Due to the prevalence of dysphagia in patients with Parkinson's disease (PD) and its complications such as aspiration pneumonia, which is the main cause of death in these patients, PD-related disability can be prevented by early diagnosis and treatment of dysphagia.

Objective. The present study was aimed at investigating the frequency of dysphagia in PD patients.

Materials and methods. This cross-sectional study included 150 PD patients visiting a Neurology Clinic. The severity of PD was determined based on the Unified Parkinson Disease Rating Scale (UPDRS) and modified Hoen and Yahr (HYS) Scale. The Munich Dysphagia Test-Parkinson's disease (MDT-PD) questionnaire was used to assess dysphagia. Comparisons were made using generalized Fisher exact, Chi-square, ANOVA, and Kruskal–Wallis tests. Predictive factors were analyzed using logistic regression. Statistical analyses were performed at significance level of 0.05.

Results. Out of all 150 patients referred to the Clinic, the prevalence of dysphagia requiring attention was 25.3% (n = 38). The patients of the three groups according to the MDT-PD (no noticeable dysphagia, noticeable oropharyngeal, and dysphagia with aspiration risk) had a significant difference only in terms of the PD duration (p < 0.001). In the predicting of dysphagia, the longer PD duration (p = 0.011) and homemaker occupation (p = 0.033) were protective factors, while female gender was a risk factor (p = 0.011).

Conclusion. The prevalence of dysphagia requiring attention in the studied patients was 25.3%. It decreased with the longer duration of the disease, and its prevalence was lower in homemaker patients, while the odds of dysphagia was 5.8 times higher in women than in men.

About the authors

Tahereh Babajani Roshan

Babol University of Medical Sciences

Email: t.doctor_91@yahoo.com

Medical Student, Student Research Committee

Iran, Islamic Republic of, Babol, Mazandaran

Catherine Behzad

Babol University of Medical Sciences

Email: catherinebehzad@yahoo.com

Assistant Professor, Gastroenterology and Hepatology Department of Internal Medicine

Iran, Islamic Republic of, Babol, Mazandaran

Payam Saadat

Babol University of Medical Sciences

Author for correspondence.
Email: sepanta1968@yahoo.com

Associated Professor, Mobility Impairment Research Center

Iran, Islamic Republic of, Babol, Mazandaran

Ali Bijani

Babol University of Medical Sciences

Email: alibijani@yahoo.com

Assistant Professor, Epidemiology, Health Research Institute

Iran, Islamic Republic of, Babol, Mazandaran

Mehdi Dehghan

Babol University of Medical Sciences

Email: m.dehghan26@gmail.com

Master of Science of Speech and Language Pathology

Iran, Islamic Republic of, Babol, Mazandaran

Alijan Ahmadi Ahangar

Babol University of Medical Sciences

Email: rohanresearch88@gmail.com

Professor, Neurology, Mobility Impairment Research Center

Iran, Islamic Republic of, Babol, Mazandaran

References

  1. Çamcı G., Oğuz S. Association between Parkinson’s disease and Helicobacter pylori. J. Clin. Neurol. 2016; 12(2): 147–150. doi: 10.3988/jcn.2016.12.2.147
  2. Pringsheim T., Jette N., Frolkis A., Steeves T.D. The prevalence of Parkinson’s disease: a systematic review and meta-analysis. Mov. Disord. 2014; 29(13): 1583–1590. doi: 10.1002/mds.25945
  3. Suttrup I., Warnecke T. Dysphagia in Parkinson’s disease. Dysphagia. 2016; 31(1): 24–32. doi: 10.1007/s00455-015-9671-9
  4. Luchesi K.F., De Toledo I.P., Mourao L.F. Dysphagia in Parkinson’s disease: prevalence, impact and management challenges. J. Otolaryngol. ENT Res. 2017; 6(5): 00176. doi: 10.15406/joentr.2017.06.00176
  5. López-Liria R., Parra-Egeda J., Vega-Ramírez F.A. et al. Treatment of dysphagia in Parkinson’s disease: a systematic review. Int. J. Environ. Res. Public Health. 2020; 17(11): 4104. doi: 10.3390/ijerph17114104
  6. Benito-Leon J. Epidemiology of Parkinson’s disease in Spain and its contextualisation in the world. Rev. Neurol. 2018; 66(4): 125–134.
  7. Simons J.A., Fietzek U.M., Waldmann A. et al. Development and validation of a new screening questionnaire for dysphagia in early stages of Parkinson’s disease. Parkinsonism Relat. Disord. 2014; 20(9): 992–998. doi: 10.1016/j.parkreldis.2014.06.008
  8. Sutton J.P. Dysphagia in Parkinson’s disease is responsive to levodopa. Parkinsonism Relat. Disord. 2013; 19(3): 282–284. doi: 10.1016/j.parkreldis.2012.11.007
  9. Chaudhuri K.R., Healy D.G., Schapira A.H. Non-motor symptoms of Parkinson’s disease: diagnosis and management. Lancet Neurol. 2006; 5(3): 235–245. doi: 10.1016/S1474-4422(06)70373-8
  10. Jankovic J. Parkinson’s disease: clinical features and diagnosis. J. Neurol Neurosurg. Psychiatry. 2008; 79(4): 368–376. doi: 10.1136/jnnp.2007.131045
  11. Warnecke T., Hamacher C., Oelenberg S., Dziewas R. Off and on state assessment of swallowing function in Parkinson’s disease. Parkinsonism Relat. Disord. 2014; 20(9): 1033–1034. doi: 10.1016/j.parkreldis.2014.06.016
  12. Lam K., Lam F.K., Lau K.K. et al. Simple clinical tests may predict severe oropharyngeal dysphagia in Parkinson’s disease. Mov. Disord. 2007; 22(5): 640–644. doi: 10.1002/mds.21362
  13. Manor Y., Giladi N., Cohen A. et al. Validation of a swallowing disturbance questionnaire for detecting dysphagia in patients with Parkinson’s disease. Mov. Disord. 2007; 22(13): 1917–1921. doi: 10.1002/mds.21625
  14. Prosiegel M. Neurogene dysphagien. Nervenarzt. 2007; 78(10): 1209–1217. doi: 10.1055/s-0038-1629949
  15. Heijnen B.J., Speyer R., Baijens L.W., Bogaardt H.C. Neuromuscular electrical stimulation versus traditional therapy in patients with Parkinson’s disease and oropharyngeal dysphagia: effects on quality of life. Dysphagia. 2012; 27(3): 336–345. doi: 10.1007/s00455-011-9371-z
  16. Manor Y., Mootanah R., Freud D. et al. Video-assisted swallowing therapy for patients with Parkinson’s disease. Parkinsonism Relat. Disord. 2013; 19(2): 207–211. doi: 10.1016/j.parkreldis.2012.10.004
  17. Athukorala R.P., Jones R.D., Sella O., Huckabee M.L. Skill training for swallowing rehabilitation in patients with Parkinson’s disease. Arch. Phys. Med. Rehabil. 2014; 95(7): 1374–1382. doi: 10.1016/j.apmr.2014.03.001
  18. Luchesi K.F., Kitamura S., Mourão L.F. Dysphagia progression and swallowing management in Parkinson’s disease: an observational study. Braz. J. Otorhinolaryngol. 2015; 81(1): 24–30. doi: 10.1016/j.bjorl.2014.09.006
  19. Langmore S.E. Evaluation of oropharyngeal dysphagia: which diagnostic tool is superior? Curr. Opin. Otolaryngol. Head Neck Surg. 2003; 11(6): 485–489. doi: 10.1097/00020840-200312000-00014
  20. Suttrup I., Oelenberg S., Hamacher C. et al. Endoscopic L-dopa-test for parkinsonian dysphagia (a pilot study). Dysphagia. 2011; 26: 482.
  21. Lim A., Leow L., Huckabee M.L. et al. A pilot study of respiration and swallowing integration in Parkinson’s disease: “on” and “off” levodopa. Dysphagia. 2008; 23(1): 76–81. doi: 10.1007/s00455-007-9100-9
  22. Hirano M., Isono C., Sakamoto H. et al. Rotigotine transdermal patch improves swallowing in dysphagic patients with Parkinson’s disease. Dysphagia. 2015; 30(4): 452–456. doi: 10.1007/s00455-015-9622-5
  23. Goetz C.G., Tilley B.C., Shaftman S.R. et al. Movement disorder society-sponsored revision of the Unified Parkinson’s Disease Rating Scale (MDS-UPDRS): scale presentation and clinimetric testing results. Mov. Disord. 2008; 23(15): 2129–2170. doi: 10.1002/mds.22340
  24. Goetz C.G., Poewe W., Rascol O. et al. Movement Disorder Society Task Force report on the Hoehn and Yahr staging scale: status and recommendations the Movement Disorder Society Task Force on rating scales for Parkinson’s disease. Mov. Disord. 2004; 19(9): 1020–1028. doi: 10.1002/mds.20213
  25. Zamani P. Prevalence of dysphagia in patients admitted to Ahvaz teaching hospitals in the first six months of 2010. J. Med. Life. 2012; 11(3): 261–268.
  26. Kalf J.G., de Swart B.J., Bloem B.R., Munneke M. Prevalence of oropharyngeal dysphagia in Parkinson’s disease: a meta-analysis. Parkinsonism Relat. Disord. 2012; 18(4): 311–315. doi: 10.1016/j.parkreldis.2011.11.006
  27. Michou E., Hamdy S., Harris M. et al. Characterization of corticobulbar pharyngeal neurophysiology in dysphagic patients with Parkinson’s disease. Clin. Gastroenterol. Hepatol. 2014; 12(12): 2037–2045. doi: 10.1016/j.cgh.2014.03.020
  28. Ding X., Gao J., Xie C. et al. Prevalence and clinical correlation of dysphagia in Parkinson disease: a study on Chinese patients. Eur. J. Clin. Nutr. 2018; 72(1): 82–86. doi: 10.1038/ejcn.2017.100
  29. Cereda E., Cilia R., Klersy C. et al. Swallowing disturbances in Parkinson’s disease: a multivariate analysis of contributing factors. Parkinsonism Relat. Disord. 2014; 20(12): 1382–1387. doi: 10.1016/j.parkreldis.2014.09.031
  30. Ali G., Wallace K.L., Schwartz R. et al. Mechanisms of oral-pharyngeal dysphagia in patients with Parkinson’s disease. Gastroenterology. 1996; 110(2): 383–392. doi: 10.1053/gast.1996.v110.pm8566584
  31. Logemann J. Evaluation and treatment of swallowing disorders. 2nd ed. Austin, Tex; 1998. P. 456–970.
  32. Buhmann C., Flügel T., Bihler M. et al. Is the Munich dysphagia Test–Parkinson’s disease (MDT-PD) a valid screening tool for patients at risk for aspiration? Parkinsonism Relat. Disord. 2019; 61: 138–143. doi: 10.1016/j.parkreldis.2018.10.031
  33. Tiple D., Fabbrini G., Colosimo C. et al. Camptocormia in Parkinson disease: an epidemiological and clinical study. J. Neurol. Neurosurg. Psychiatry. 2009; 80(2): 145–148. doi: 10.1136/jnnp.2008.150011

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Copyright (c) 2023 Babajani Roshan T., Behzad C., Saadat P., Bijani A., Dehghan M., Ahmadi Ahangar A.

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