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J Neurol Neurosurg Psychiatry 2009;80:1047-1049 doi:10.1136/jnnp.2008.157701
  • Short report

Swallowing problems in Parkinson disease: frequency and clinical correlates

  1. N Miller1,
  2. L Allcock2,
  3. A J Hildreth3,
  4. D Jones4,
  5. E Noble5,
  6. D J Burn6
  1. 1
    Institute of Health and Society, Speech and language sciences, Newcastle University, Newcastle upon Tyne, UK
  2. 2
    Geriatric Medicine, Newcastle General Hospital, Newcastle upon Tyne, UK
  3. 3
    Research and Development, Royal Hospital, Sunderland, UK
  4. 4
    School of Health, Community and Education Studies, Northumbria University, Newcastle upon Tyne, UK
  5. 5
    Speech and Language Sciences, Newcastle University, Newcastle upon Tyne, UK
  6. 6
    Institute for Ageing and Health, Clinical Ageing Research Unit, Newcastle University, Newcastle upon Tyne, UK
  1. Correspondence to Dr N Miller, Institute of Health and Society, Speech and Language Sciences, George VI Building, Newcastle University, Newcastle upon Tyne NE1 7RU, UK; nicholas.miller{at}ncl.ac.uk
  • Received 8 July 2008
  • Revised 23 September 2008
  • Accepted 4 October 2008

Abstract

Background: Changes to the efficiency and integrity of swallowing mechanisms are inevitable in Parkinson disease (PD); however, it remains unclear how many people with PD are at risk of dysphagia. The aim of this study was to establish the frequency of impaired swallowing in people with PD and the relationship between swallowing performance and indicators of disease progression.

Methods: A community-based and hospital-based cohort of 137 individuals with PD were asked to drink 150 ml of water as quickly as possible while in an ‘off drug’ state.

Results: Thirty-one (23%) patients could not completely drink the full 150 ml. Swallowing rate (ml/sec) fell to more than 1SD below published norms for 115 (84%) patients and to more than 2SD below for 44 (32%) individuals. There were moderate correlations between rate of swallowing and disease severity, depression and cognition, but not between swallowing speed and disease duration. There was poor correlation between subjective reports of dysphagia and performance on the water swallow test.

Conclusions: Swallowing problems are frequent in PD. Self-report of ’no difficulty’ is not a reliable indicator of swallowing ability. Studies employing more-objective assessment of aspiration risk to compare with water swallow test performance are advocated.

Footnotes

  • Funding The research was supported by a grant from the Parkinson’s Disease Society (UK). LA was supported by an NHS Research and Development Training Fellowship RRCC/01F/019. Funders played no part in the collection, analysis or interpretation of the data, nor in writing the report or the decision to submit for publication.

  • Competing interests None.

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