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Effects of carbonated liquid on swallowing dysfunction in dementia with Lewy bodies and Parkinson’s disease dementia

Larsson, Victoria LU ; Torisson, Gustav LU ; Bülow, Margareta LU and Londos, Elisabet LU (2017) In Clinical Interventions in Aging 12. p.1215-1222
Abstract

Background: Swallowing dysfunction is an increasingly recognized problem in patients with dementia with Lewy bodies (DLB) and Parkinson’s disease dementia (PDD), which can result in aspiration pneumonia and death. Few studies have examined potential ways of improving swallowing function in this fragile patient group. The aim of this study was to evaluate swallowing dysfunction and carbonated liquid using videofluoroscopy in DLB and PDD patients. Methods: A total of 48 patients with DLB and PDD were referred for a clinical examination with videofluoroscopy. Descriptive overall assessments were provided at the time of the examination regarding swallowing function and the effects of different modifications, including carbonated thin liquid... (More)

Background: Swallowing dysfunction is an increasingly recognized problem in patients with dementia with Lewy bodies (DLB) and Parkinson’s disease dementia (PDD), which can result in aspiration pneumonia and death. Few studies have examined potential ways of improving swallowing function in this fragile patient group. The aim of this study was to evaluate swallowing dysfunction and carbonated liquid using videofluoroscopy in DLB and PDD patients. Methods: A total of 48 patients with DLB and PDD were referred for a clinical examination with videofluoroscopy. Descriptive overall assessments were provided at the time of the examination regarding swallowing function and the effects of different modifications, including carbonated thin liquid (CTL). Additionally, a repeated measures quantitative retrospective analysis has been performed comparing 1) thin liquids; 2) thickened liquids and 3) CTLs, with regard to the quantitative variables 1) pharyngeal transit time (PTT); 2) pharyngeal retention and 3) tracheal penetration. Results: In all, 40/48 (83%) of the patients had a swallowing dysfunction, which was confirmed on videofluoroscopy, with 34/40 (85%) patients having a pharyngeal-type dysfunction. A total of 14/40 (35%) patients with an objective swallowing impairment did not have any subjective swallowing symptoms. Out of the patients with swallowing dysfunction, 87% had an overall improved swallowing function with carbonated liquid. PTT for carbonated liquid (median 633 ms, interquartile range [IQR] 516–786 ms) was quicker than for thin liquid (760 ms, IQR 613–940 ms, P=0.014) and thickened liquid (880.0 ms, IQR 600–1,500 ms, P<0.001). No significant effect was seen in residue or penetration. Conclusion: The majority of patients with DLB or PDD had a swallowing dysfunction, sometimes without subjective swallowing symptoms, which improved with carbonated liquid. This highlights the importance of investigating patients with videofluoroscopy and to carry out a prospective interventional study to further evaluate carbonated liquid, also addressing the effects on quality of life, aspiration and mortality.

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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Carbonated beverages, Deglutition, Dysphagia, Swallowing disorders, Therapeutics, Video recording
in
Clinical Interventions in Aging
volume
12
pages
8 pages
publisher
Dove Medical Press Ltd.
external identifiers
  • scopus:85027074980
  • wos:000407121800001
ISSN
1176-9092
DOI
10.2147/CIA.S140389
language
English
LU publication?
yes
id
efd4f2c5-c2d9-4c16-9a97-226b785d05b0
date added to LUP
2017-09-04 08:58:34
date last changed
2017-09-18 11:44:08
@article{efd4f2c5-c2d9-4c16-9a97-226b785d05b0,
  abstract     = {<p>Background: Swallowing dysfunction is an increasingly recognized problem in patients with dementia with Lewy bodies (DLB) and Parkinson’s disease dementia (PDD), which can result in aspiration pneumonia and death. Few studies have examined potential ways of improving swallowing function in this fragile patient group. The aim of this study was to evaluate swallowing dysfunction and carbonated liquid using videofluoroscopy in DLB and PDD patients. Methods: A total of 48 patients with DLB and PDD were referred for a clinical examination with videofluoroscopy. Descriptive overall assessments were provided at the time of the examination regarding swallowing function and the effects of different modifications, including carbonated thin liquid (CTL). Additionally, a repeated measures quantitative retrospective analysis has been performed comparing 1) thin liquids; 2) thickened liquids and 3) CTLs, with regard to the quantitative variables 1) pharyngeal transit time (PTT); 2) pharyngeal retention and 3) tracheal penetration. Results: In all, 40/48 (83%) of the patients had a swallowing dysfunction, which was confirmed on videofluoroscopy, with 34/40 (85%) patients having a pharyngeal-type dysfunction. A total of 14/40 (35%) patients with an objective swallowing impairment did not have any subjective swallowing symptoms. Out of the patients with swallowing dysfunction, 87% had an overall improved swallowing function with carbonated liquid. PTT for carbonated liquid (median 633 ms, interquartile range [IQR] 516–786 ms) was quicker than for thin liquid (760 ms, IQR 613–940 ms, P=0.014) and thickened liquid (880.0 ms, IQR 600–1,500 ms, P&lt;0.001). No significant effect was seen in residue or penetration. Conclusion: The majority of patients with DLB or PDD had a swallowing dysfunction, sometimes without subjective swallowing symptoms, which improved with carbonated liquid. This highlights the importance of investigating patients with videofluoroscopy and to carry out a prospective interventional study to further evaluate carbonated liquid, also addressing the effects on quality of life, aspiration and mortality.</p>},
  author       = {Larsson, Victoria and Torisson, Gustav and Bülow, Margareta and Londos, Elisabet},
  issn         = {1176-9092},
  keyword      = {Carbonated beverages,Deglutition,Dysphagia,Swallowing disorders,Therapeutics,Video recording},
  language     = {eng},
  month        = {08},
  pages        = {1215--1222},
  publisher    = {Dove Medical Press Ltd.},
  series       = {Clinical Interventions in Aging},
  title        = {Effects of carbonated liquid on swallowing dysfunction in dementia with Lewy bodies and Parkinson’s disease dementia},
  url          = {http://dx.doi.org/10.2147/CIA.S140389},
  volume       = {12},
  year         = {2017},
}