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Predictive clinical factors for penetration and aspiration in Parkinson's disease.
- Source :
-
Neurogastroenterology and motility [Neurogastroenterol Motil] 2019 Mar; Vol. 31 (3), pp. e13524. Date of Electronic Publication: 2018 Dec 11. - Publication Year :
- 2019
-
Abstract
- Background: Do the current swallow-specific subquestions of neurological diagnostic tools reflect the objective swallowing function in Parkinson's disease (PD) patients or are clinical factors superior to predict critical aspiration?<br />Methods: In a cross-sectional, observational study a total of 119 Parkinson outpatients were examined clinically and by flexible-endoscopic evaluation of swallowing (FEES). Self-reported dysphagia by subquestions of the MDS-UPDRS and NMS questionnaire and history of subjective aspiration signs were collected.<br />Key Results: Nearly, all PD patients showed deglutition abnormalities in FEES (113/119) while only 12%-27% of them reported swallowing problems in the swallow-specific subquestions of neurological standard diagnostic tools (MDS-UPDRS and NMS-Quest), and the answers were heterogeneous and poorly reproducible. With a sensitivity of up to a maximum of 50%, self-reported dysphagia is therefore no reliable tool for identifying dysphagia in PD. While most clinical parameters were linked to dysphagia to some extent, logistic regression analysis revealed high age (Odds Ratio (OR) 1.1 in years, 95% CI 1.03-1.18, P < 0.01), gender (OR 0.3 for females, 95% CI 0.08-0.97, P = 0.04), and affirmed subjective aspiration signs (OR 8.6, 95% CI 3.05-26.52, P < 0.001) as the most significant predictors for critical dysphagia.<br />Conclusions and Inferences: Self-perception of swallowing is no reliable tool for identifying dysphagia and questionnaires are insufficient for detecting previous aspiration. Consequent and specific asking for previous subjective aspiration signs is the single most important measure for identifying PD patients at risk for critical aspiration.<br /> (© 2018 John Wiley & Sons Ltd.)
- Subjects :
- Aged
Aged, 80 and over
Cross-Sectional Studies
Female
Humans
Male
Middle Aged
Predictive Value of Tests
Reproducibility of Results
Self Concept
Self Report
Surveys and Questionnaires
Deglutition
Deglutition Disorders diagnosis
Deglutition Disorders etiology
Parkinson Disease complications
Pneumonia, Aspiration diagnosis
Pneumonia, Aspiration etiology
Subjects
Details
- Language :
- English
- ISSN :
- 1365-2982
- Volume :
- 31
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- Neurogastroenterology and motility
- Publication Type :
- Academic Journal
- Accession number :
- 30548367
- Full Text :
- https://doi.org/10.1111/nmo.13524