Swallowing impairment and pulmonary dysfunction in Parkinson's disease: the silent threats

J Neurol Sci. 2014 Apr 15;339(1-2):149-52. doi: 10.1016/j.jns.2014.02.004. Epub 2014 Feb 14.

Abstract

Introduction: Swallowing disorders and respiratory impairment are frequent in Parkinson's disease (PD) patients, and aspiration pneumonia remains the leading cause of death among these subjects.

Objective: The objective of this study was to investigate whether there is an association between pulmonary impairment and swallowing dysfunction in PD patients.

Methods: A cross-sectional study with a comparison group was conducted with PD patients. Subjects were submitted to demographic questionnaires and underwent spirometric and videofluorographic assessments. Significance level was considered at 95% (p<0.05).

Results: Among 35 PD patients, 40% presented with swallowing complaints. However, 22% of the clinically asymptomatic patients presented airway food penetration when submitted to videofluoroscopy. In 20% of PD patients material entered the airways and there was contact with the vocal folds in 7%. However, there was an efficient cleaning with residue deglutition in almost all patients. No penetration/aspiration was detected among the controls. Respiratory parameters were below the normal predicted values in PD patients when compared to the healthy controls.

Conclusion: These data suggest an association between pulmonary dysfunction and swallowing impairment in PD patients; even in patients without swallowing complaints, impaired pulmonary function can be detected.

Keywords: Deglutition; Dysphagia; Parkinson's disease; Pulmonary function; Respiratory dysfunction; Swallowing.

MeSH terms

  • Aged
  • Cross-Sectional Studies
  • Deglutition Disorders / diagnosis*
  • Deglutition Disorders / epidemiology
  • Deglutition Disorders / physiopathology*
  • Female
  • Forced Expiratory Volume / physiology
  • Humans
  • Lung Diseases / diagnosis*
  • Lung Diseases / epidemiology
  • Lung Diseases / physiopathology*
  • Male
  • Middle Aged
  • Parkinson Disease / diagnosis*
  • Parkinson Disease / epidemiology
  • Parkinson Disease / physiopathology*
  • Single-Blind Method