Dysphagia in the elderly: videofluoroscopic study of elderly people with and without Parkinson's disease Alessandra Bigal

Abstract

This study focused on to describe the changes in oral, pharyngeal and esophageal stages of swallowing in patients with Parkinson’s disease (P.D) , evaluated by videofluoroscopy, comparing the complaints reported by the patients; to compare changes among patients with Parkinson’s disease and a group of elders of more than 60 years of age with no neurological changes (control group). Method: complaints were raised and evaluated by videofluoroscopy in 25 patients with Parkinson’s disease, 19 males and 6 females between II and IV stage of disease, according to Hoehn and Yahr modified scale. All the patients were evaluated in all food consistencies.The findings were compared to a control group of elders. Results: Oral stage common changes: difficulty in the movement of preparation and organization of bolus, inappropriate lip closure, tongue tremor at rest and during chewing and permanence of contrast in oral cavity. Pharyngeal phase: stasis in vallecula, pyriform recesses and upper esophageal sphincter need of multiple swallows to cleaning and laryngeal-tracheal aspiration were observed. Esophageal changes: presence of tertiary contractions, decrease of peristalsis and gastroesophageal reflux. The incidence of inappropriate lip closure, difficulty in the movement of preparation and organization of bolus, stasis in valleculae and pyriform recesses, presence of tertiary contractions, decrease of peristaltism, presence of gastroesophageal reflux is more significant in the group of Parkinson’s disease than in control group. Conclusion: it was concluded that patients with Parkinson’s disease may present changes in oral, pharyngeal and esophageal stages of swallowing and that, specifically in the oral stage, there are changes specific to Parkinson’s disease.