Impact of Parkinson's Disease-Related Dysphagia Severity on Quality of Life: Comparison Between Self-Reports and Videofluoroscopic Swallowing Study Results

Year 2024, Volume: 34 Issue: 3, 84 - 91, 30.09.2024

Serkan Bengisu , Merve Savaş , Demet Aygün , Senanur Kahraman Beğen , Tutku Altıntaş , Burak Manay

https://doi.org/10.26650/Tr-ENT.2024.1491389

Abstract

Objective: The aim of this study was to evaluate the impact of dysphagia due to Parkinson's disease (PD) on quality of life and to compare the results of the objective assessment with those of patient self-reports.

Materials and Methods: The study included 28 participants with PD. Patients were assessed clinically using the Eating Assessment Tool (EAT-10) and objectively via video-fluoroscopy (VFSS). The data obtained with VFSS were scored using the Penetration Aspiration Scale (PAS) and Functional Oral Intake Scale (FOIS) by an SLP blinded to patient information and clinical assessment methods. Swallowing disorder-related quality of life was assessed using the Swallowing Quality of Life Questionnaire (SWAL-QOL).

Results: It was found that as PD severity and duration increase, the severity of swallowing impairment also increases, leading to a negative effect on quality of life being affected negatively accordingly (p<0.05). According to the SWAL-QOL questionnaire results, dysphagic patients had lower SWAL-QOL scores, particularly in terms of burden, eating desire, duration, symptom frequency, food selection, and mental health domains. In addition, a statistically significant difference was found between the groups with and without dysphagia in all EAT-10, PAS, and FOIS scores (p=0.000, p=0.20, p= 011). There was no statistically significant difference between self-reports on the presence of swallowing disorders and the results of the objective assessment using the VFSS (p=0.298).

Conclusion: In patients with PD, swallowing impairment becomes more pronounced as the duration and severity of the disease increase, and quality of life is negatively affected. The results of this study suggest that the results between objective assessments and patient reports are inconsistent and therefore emphasise the importance of objective measurement methods in dysphagia assessment.

Keywords

Parkinson disease, dysphagia, quality of life, videofluoroscopy, self reports

References

• Burke RE, O’Malley K. Axon degeneration in Parkinson’s disease. Experimental Neurology 2013;246:72-83. google scholar
• Suttrup I, Warnecke T. Dysphagia in Parkinson’s Disease. Dysphagia 2016;31(1):24-32. google scholar
• Pringsheim T, Jette N, Frolkis A, Steeves TD. The prevalence of Parkinson’s disease: a systematic review and meta-analysis. Mov Disord 2014;29(13):1583-90. google scholar
• Durmus H, Gokalp MA, Hanagasi HA. Prevalence of Parkinson’s disease in Baskale, Turkey: a population based study. Neurol Sci 2015;3 (3):411-3. google scholar
• Atalar MS, Genç G. Approach to swallowing disorders in Parkinson’s disease. Mugla Sitki Kocman Univ Med J 2022;9(2):189-203. google scholar
• Umemoto G, Furuya H. Management of Dysphagia in Patients with Parkinson’s Disease and Related Disorders. Intern Med 2020;59(1):7-14. google scholar
• Müller J, Wenning GK, Verny M, McKee A, Chaudhuri KR, Jellinger K, et al. Progression of dysarthria and dysphagia in postmortem-confirmed parkinsonian disorders. Arch Neurol 2001;58(2):259-64. google scholar
• Panebianco M, Marchese-Ragona R, Masiero S, Restivo DA. Dysphagia in neurological diseases: a literature review. Neurol Sci 2020;41(11):3067-73. google scholar
• van der Maarel-Wierink CD, Meijers JM, De Visschere LM, de Baat C, Halfens RJ, Schols JM. Subjective dysphagia in older care home residents: a cross-sectional, multi-centre point prevalence measurement. Int J Nurs Stud 2014;51(6):875-81. google scholar
• Nacci A, Ursino F, La Vela R, Matteucci F, Mallardi V, Fattori B. Fiberoptic endoscopic evaluation of swallowing (FEES): proposal for informed consent. Acta Otorhinolaryngol Ital 2008;28(4):206-11. google scholar
• Fukuoka T, Ono T, Hori K, Wada Y, Uchiyama Y, Kasama S, et al. Tongue pressure measurement and videofluoroscopic study of swallowing in patients with Parkinson’s disease. Dysphagia 2019;34(1):80-8. google scholar
• Restivo DA, Marchese-Ragona R, Lauria G, Squatrito S, Gullo D, Vigneri R. Botulinum toxin treatment for oropharyngeal dysphagia associated with diabetic neuropathy. Diabetes Care 2006;29(12):2650-3. google scholar
• Bengisu S, Gündüz İ. Evaluation of aspiration-penetration presence in patients with unilateral vocal cord paralysis. Dil Konuşma ve Yutma Araştırmaları Derg 2020;3(1):91-108. google scholar
• Hassan HE, Aboloyoun AI. The value of bedside tests in dysphagia evaluation. Egypt J Ear Nose Throat Allied Sci 2014;15(3):197-203. google scholar
• Farneti D, Genovese E. Correlations between bedside and instrumental endoscopic parameters in determining severity of dysphagia: an integrated clinical evaluation of safety and efficiency. Acta Otorhinolaryngol Ital 2020;40(4):277-81. google scholar
• Heckert KD, Konnaroff E, Adler U, Barrett AM. Post acute reevaluation may prevent dysphagia-associated morbidity. Stroke 2009;40:1381-5. google scholar
• Liou HH, Tsai SW, Hsieh MH, Chen YJ, Hsiao JR, Huang CC, et al. Evaluation of objective and subjective swallowing outcomes in patients with dysphagia treated for head and neck cancer. J Clin Med 2022;11(3):692. google scholar
• Fuh JL, Lee RC, Wang SJ, Lin CH, Wang PN, Chiang JH, et al. Swallowing difficulty in Parkinson’s disease. Clin Neurol Neurosurg 1997;99(2):106-12. google scholar
• Pflug C, Bihler M, Emich K, Niessen A, Nienstedt JC, Flügel T, et al. Critical dysphagia is common in Parkinson disease and occurs even in early stages: a prospective cohort study. Dysphagia 2018;33(1):41-50. google scholar
• Kalf J, de Swart B, Bloem B, Munneke M. Prevalence of oropharyngeal dysphagia in Parkinson’s disease: a meta-analysis. Parkinsonism Relat Disord 2012;18:311-5. google scholar
• Bird MR, Woodward MC, Gibson EM, Phyland DJ, Fonda D. Asymptomatic swallowing disorders in elderly patients with Parkinson’s disease: a description of findings on clinical examination and videofluoroscopy in sixteen patients. Age Ageing 1994;23(3):251-4. google scholar
• Bushmann M, Dobmeyer SM, Leeker L, Perlmutter JS. Swallowing abnormalities and their response to treatment in Parkinson’s disease. Neurology 1989;39(10):1309. google scholar
• Ali GN, Wallace KL, Schwartz R, Decarle DJ, Zagami AS, Cook IJ. Mechanisms of oral-pharyngeal dysphagia in patients with Parkinson’s disease. Gastroenterology 1996;110:383-92. google scholar
• Ebihara S, Saito H, Kanda A, Nakajoh M, Takahashi H, Arai H, et al. Impaired efficacy of cough in patients with Parkinson disease. Chest 2003;124(3):1009-15. google scholar
• Carneiro D, das Graças Wanderley de Sales Coriolano M, Belo LR, de Marcos Rabelo AR, Asano AG, Lins OG. Quality of life related to swallowing in Parkinson’s disease. Dysphagia 2014;29(5):578-82. google scholar
• Tsai C-f. Quality-of-life of Chinese older adults with poststroke dysphagia [master’s thesis]. University of Hong Kong 2013. google scholar
• McHorney CA, Robbins J, Lomax K, Rosenbek JC, Chignell K, Kramer AE, et al. The SWAL-QOL and SWAL-CARE outcomes tool for oropharyngeal dysphagia in adults: III. Documentation of reliability and validity. Dysphagia 2002;17(2):97-114. google scholar
• Chan HF, Ng ML, Kim H, Kim DY. Swallowing-related quality of life among oral-feeding Chinese patients with Parkinson’s disease -a preliminary study using Chinese SWAL-QOL. Disabil Rehabil 2022;44(7):1077-83. google scholar
• Bayes-Rusinol A, Forjaz MJ, Ayala A, Crespo Mde L, Prats A, Valles E, et al. Consciencia de disfagia en la enfermedad de Parkinson [Awareness of dysphagia in Parkinson’s disease]. Rev Neurol 2011;53(11):664-72. google scholar
• Hammer MJ, Murphy CA, Abrams TM. Airway somatosensory deficits and dysphagia in Parkinson’s disease. J Parkinsons Dis 2013;3(1):39-44. google scholar
• Hoehn MM, Yahr MD. Parkinsonism: onset, progression and mortality. Neurology 1967; 17:427-42. google scholar
• Crary MA, Mann GD, Groher ME. Initial psychometric assessment of a functional oral intake scale for dysphagia in stroke patients. Arch Phys Med Rehabil 2005;86(8):1516-20. google scholar
• Belafsky PC, Kuhn MA. The Clinician’s Guide to Swallowing Fluoroscopy. New York: Springer; 2014:59-69. google scholar
• Demir N, Serel Arslan S, İnal Ö, Karaduman AA. Reliability and validity of the Turkish Eating Assessment Tool (T-EAT-10). Dysphagia 2016;31:644-9. google scholar
• Rugiu M. Role of videofluoroscopy in the evaluation of neurologic dysphagia. Acta Otorhinolaryngol Ital 2007;27(6):306. google scholar
• Rosenbek JC, Robbins JA, Roecker EB, Coyle JL, Wood JL. A penetration-aspiration scale. Dysphagia 1996;11:93-8. google scholar
• Karaduman A, Serel S, Ünlüer Ö, Demir N. Penetrasyon Aspirasyon Skalası: kişiler arası güvenirlik çalışması. Fizyoter Rehabil 2012;23(3):151-5. google scholar
• Demir N, Arslan SS, İnal Ö, Ünlüer NÖ, Karaduman AA. Reliability and validity of the Turkish version of the swallow quality of life questionnaire. Türk Fizyoterapi ve Rehabilitasyon Dergisi 2016;27(1):19-24. google scholar
• Tabor L, Gaziano J, Watts S, Robison R, Plowman EK. Defining swallowing-related quality of life profiles in individuals with Amyotrophic Lateral Sclerosis. Dysphagia 2006;31:376-82. google scholar
• Leow LP, Huckabee ML, Anderson T, Beckert L. The Impact of dysphagia on quality of life in ageing and Parkinson’s disease as measured by the Swallowing Quality of Life (SWAL-QOL) Questionnaire. Dysphagia 2010;25:216-20. google scholar
• Gaspar M, Pinto GS, Gomes RHS, Santos RS, Leonor VD. Evaluation of quality of life in patients with neurogenic dysphagia. Revista CEFAC 2015;17:1939-45. google scholar
• Ekberg O, Hamdy S, Woisard V, Wuttge-Hannig A, Ortega P. Social and psychological burden of dysphagia: Its impact on diagnosis and treatment. Dysphagia 2002;17:139-46. google scholar
• Plowman-Prine EK, Sapienza CM, Okun MS, Pollock SL, Jacobson C, Wu SS, et al. The relationship between quality of life and swallowing in Parkinson’s disease. Mov Disord 2009;24:1352-8. google scholar
• Coriolano MGSW. Surface electromyography of muscles involved in swallowing in patients with Parkinson’s disease. [Master’s thesis]. Universidade Federal de Pernambuco; 2009. google scholar
• Rinkel RN, Verdonck-de Leeuw IM, Langendijk JA, van Reij EJ, Aaronson NK, Leemans CR. The psychometric and clinical validity of the SWAL-QOL questionnaire in evaluating swallowing problems experienced by patients with oral and oropharyngeal cancer. Oral Oncol 2009;45(8):67-71. google scholar
• Chan HF, Ng ML, Kim H, Kim DY. Swallowing-related quality of life among oral-feeding Chinese patients with Parkinson’s disease -a preliminary study using Chinese SWAL-QOL. Disabil Rehabil 2022;44(7):1077-83. google scholar
• Costa MM. Videofluoroscopy:the gold standard exam for studying swallowing and its dysfunction. Arq Gastroenterol 2010;47:327-8. google scholar
• Logemann JA. Manual for the Videofluorographic Study of Swallowing, 2nd edition. Pro-ed: Austin, TX, USA 1993;115-7. google scholar
• Mukaka MM. Statistics Corner: A guide to appropriate use of Correlation coeficient in medical research. Malawi Med J 2012;24:69-71. google scholar