Abstract
Dementia is one of the leading causes of dysfunctionality and disability among older people and has a high physical, psychological, social, and economic impact. Oropharyngeal dysphagia (OD) is a frequent condition in patients with dementia of various types, including early stages, showing a delayed and prolonged swallow, and usually self-feeding difficulties and feeding dependency. In addition, OD is associated with several complications and negative outcomes such as malnutrition, respiratory infections, aspiration pneumonia and increased hospital stay, health-resource consumption, and mortality. OD should therefore be systematically screened, managed, and treated in patients with dementia, taking into account their intrinsic characteristics. The aim of this chapter is to present an overview of the prevalence, pathophysiology, diagnosis, complications, and treatment of OD in patients with dementia.
References
Affoo RH, Foley N, Rosenbek J, Kevin Shoemaker J, Martin RE (2013) Swallowing dysfunction and autonomic nervous system dysfunction in Alzheimer’s disease: A scoping review of the evidence. J Am Geriatr Soc 61(12):2203–2213
Alagiakrishnan K, Bhanji RA, Kurian M (2013) Evaluation and management of oropharyngeal dysphagia in different types of dementia: A systematic review. Arch Gerontol Geriatr 56(1):1–9
Almirall J, Bolibar I, Serra-Prat M, Roig J, Hospital I, Carandell E et al (2008) New evidence of risk factors for community-acquired pneumonia: a population-based study. Eur Respir J 31(6):1274–1284
Almirall J, Rofes L, Serra-Prat M, Icart R, Palomera E, Arreola V et al (2013) Oropharyngeal dysphagia is a risk factor for community-acquired pneumonia in the elderly. Eur Respir J 41(4):923–926
Arai T, Yasuda Y, Toshima S, Yoshimi N, Kashiki Y (1998) ACE inhibitors and pneumonia in elderly people. Lancet 352(9144):1937–1938
Baijens L, Clave P, Cras P, Ekberg O, Forster A, Kolb G, Leners JC, Masiero S, Mateos-Nazal OO, Smithard G, Speyer R, Walshe M (2016) European Society for Swallowing Disorders—European Union Geriatric Medicine Society white paper: oropharyngeal dysphagia as a geriatric syndrome. Clin Interv Aging 11:1–16
Bashford G, Bradd P (1996) Drug-induced Parkinsonism associated with dysphagia and aspiration: a brief report. J Geriatr Psychiatry Neurol 9(3):133–135
Bautmans I, Demarteau J, Cruts B, Lemper J-C, Mets T (2008) Dysphagia in elderly nursing home residents with severe cognitive impairment can be attenuated by cervical spine mobilization. J Rehabil Med 40(9):755–760
Belafsky PC, Mouadeb DA, Rees CJ, Pryor JC, Postma GN, Allen J et al (2008) Validity and reliability of the Eating Assessment Tool (EAT-10). Ann Otol Rhinol Laryngol 117(12):919–924
Berenstein EG, Ortiz Z (2005) Megestrol acetate for the treatment of anorexia-cachexia syndrome. Cochrane Database Syst Rev 2:CD004310
Bradley W, Daroff R, Fenichel G, Marsden D (1997) Neurology in clinical practice. Butterworth-Heinemann, Boston
Brunnstrom HR, Englund EM (2009) Cause of death in patients with dementia disorders. Eur J Neurol 16(4):488–492
Burks TN, Andres-Mateos E, Marx R, Mejias R, Van Erp C, Simmers JL et al (2011) Losartan restores skeletal muscle remodeling and protects against disuse atrophy in sarcopenia. Sci Transl Med 3(82):82ra37
Chen L-L, Li H, Lin R, Zheng J-H, Wei Y-P, Li J et al (2016) Effects of a feeding intervention in patients with Alzheimer’s disease and dysphagia. J Clin Nurs 25(5–6):699–707
Chouinard J (2000) Dysphagia in Alzheimer disease: a review. J Nutr Health Aging 4(4):214–217
Clavé P, Shaker R (2015) Dysphagia: current reality and scope of the problem. Nat Rev Gastroenterol Hepatol 12(5):259–270
Clavé P, Arreola V, Romea M, Medina L, Palomera E, Serra-Prat M (2008) Accuracy of the volume-viscosity swallow test for clinical screening of oropharyngeal dysphagia and aspiration. Clin Nutr 27(6):806–815
Dantas RO, Nobre Souza MA (1997) Dysphagia induced by chronic ingestion of benzodiazepine. Am J Gastroenterol 92(7):1194–1196
Devons CAJ (2002) Comprehensive geriatric assessment: making the most of the aging years. Curr Opin Clin Nutr Metab Care 5(1):19–24
Dziewas R, Warnecke T, Schnabel M, Ritter M, Nabavi DG, Schilling M et al (2007) Neuroleptic-induced dysphagia: case report and literature review. Dysphagia 22(1):63–67
Edahiro A, Hirano H, Yamada R, Chiba Y, Watanabe Y, Tonogi M et al (2012) Factors affecting independence in eating among elderly with Alzheimer’s disease. Geriatr Gerontol Int 12(3):481–490
Feinberg MJ, Ekberg O, Segall L, Tully J (1992) Deglutition in elderly patients with dementia: findings of videofluorographic evaluation and impact on staging and management. Radiology 183(3):811–814
Gaillard J (1989) Benzodiazepines and GABA-ergic transmision. In: Kryger M, Roth T, Dement W (eds) Principles and practie of sleep medicine. WB Saunders, Philadelphia, pp 213–218
Germain I, Dufresne T, Gray-Donald K (2006) A novel dysphagia diet improves the nutrient intake of institutionalized elders. J Am Diet Assoc 106(10):1614–1623
Golden AG, Daiello LA, Silverman MA, Llorente M, Preston RA (2003) University of Miami Division of Clinical Pharmacology Therapeutic Rounds: medications used to treat anorexia in the frail elderly. Am J Ther 10(4):292–298
Gómez-Busto F, Andia V, Ruiz de Alegria L, Francés I (2009) Abordaje de la disfagia en la demencia avanzada. Rev Esp Geriatr Gerontol 44(SUPPL. 2):29–36
Gonzalez F (2008) Extrapyramidal syndrome presenting as dysphagia: a case report. Am J Hosp Palliat Care 25(5):398–400
Groher M, Crary M (2010) Dysphagia: clinical management in adults and children, 1st edn. Mosby, Inc., Maryland Heights
Han M, Ohnishi H, Nonaka M, Yamauchi R, Hozuki T, Hayashi T et al (2011) Relationship between dysphagia and depressive states in patients with Parkinson’s disease. Parkinsonism Relat Disord 17(6):437–439
Hendrie HC (1998) Epidemiology of dementia and Alzheimer’s disease. Am J Geriatr Psychiatry 6(2 Suppl 1):S3–18
Horner J, Alberts MJ, Dawson DV, Cook GM (1994) Swallowing in Alzheimer’s disease. Alzheimer Dis Assoc Disord 8(3):177–189
Humbert IA, McLaren DG, Kosmatka K, Fitzgerald M, Johnson S, Porcaro E et al (2010) Early deficits in cortical control of swallowing in Alzheimer’s disease. J Alzheimers Dis 19(4):1185–1197
Ikeda M, Brown J, Holland AJ, Fukuhara R, Hodges JR (2002) Changes in appetite, food preference, and eating habits in frontotemporal dementia and Alzheimer’s disease. J Neurol Neurosurg Psychiatry 73(4):371–376
Kertscher B, Speyer R, Palmieri M, Plant C (2014) Bedside screening to detect oropharyngeal dysphagia in patients with neurological disorders: an updated systematic review. Dysphagia 29(2):204–212
Kuo S, Rhodes RL, Mitchell SL, Mor V, Teno JM (2009) Natural history of feeding-tube use in nursing home residents with advanced dementia. J Am Med Dir Assoc 10(4):264–270
Lai EC-C, Wong MB, Iwata I, Zhang Y, Hsieh C-Y, Kao Yang Y-H et al (2015) Risk of pneumonia in new users of cholinesterase inhibitors for dementia. J Am Geriatr Soc 63(5):869–876
Langmore SE, Olney RK, Lomen-Hoerth C, Miller BL (2007) Dysphagia in patients with frontotemporal lobar dementia. Arch Neurol 64(1):58–62
Lee JSW, Chui PY, Ma HM, Auyeung TW, Kng C, Law T et al (2015) Does low dose angiotensin converting enzyme inhibitor prevent pneumonia in older people with neurologic dysphagia—a randomized placebo-controlled trial. J Am Med Dir Assoc 16(8):702–707
Lillyman S, Bruce M (2016) Palliative care for people with dementia: a literature review. Int J Palliat Nurs 22(2):76–81
Lin L-C, Watson R, Wu S-C (2010) What is associated with low food intake in older people with dementia? J Clin Nurs 19(1–2):53–59
Logemann JA, Gensler G, Robbins J, Lindblad AS, Brandt D, Hind JA et al (2008) A randomized study of three interventions for aspiration of thin liquids in patients with dementia or Parkinson’s disease. J Speech Lang Hear Res 51(1):173–183
Londos E, Hanxsson O, Alm Hirsch I, Janneskog A, Bulow M, Palmqvist S (2013) Dysphagia in Lewy body dementia—a clinical observational study of swallowing function by videofluoroscopic examination. BMC Neurol 13:140
van der Maarel-Wierink CD, Vanobbergen JNO, Bronkhorst EM, Schols JMGA, de Baat C (2011) Risk factors for aspiration pneumonia in frail older people: a systematic literature review. J Am Med Dir Assoc 12(5):344–354
Martino R, Silver F, Teasell R, Bayley M, Nicholson G, Streiner DL et al (2009) The Toronto Bedside Swallowing Screening Test (TOR-BSST): development and validation of a dysphagia screening tool for patients with stroke. Stroke 40(2):555–561
Miarons M, Campins L, Palomera E, Serra-Prat M, Cabré M, Rofes L (2016) Drugs related to oropharyngeal dysphagia in older people. Dysphagia 31(5):697–705
Miller N, Allcock L, Hildreth AJ, Jones D, Noble E, Burn DJ (2009) Swallowing problems in Parkinson disease: frequency and clinical correlates. J Neurol Neurosurg Psychiatry 80(9):1047–1049
Mitchell SL, Teno JM, Kiely DK, Shaffer ML, Jones RN, Prigerson HG et al (2010) The clinical course of advanced dementia. N Engl J Med 361(16):1529–1538
Monte FS, da Silva-Júnior FP, Braga-Neto P, Nobre e Souza MA, de Bruin VMS (2005) Swallowing abnormalities and dyskinesia in Parkinson’s disease. Mov Disord 20(4):457–462
Murphy RJ, Gardiner PF, Rousseau G, Bouvier M, Béliveau L (1997) Chronic beta-blockade increases skeletal muscle beta-adrenergic-receptor density and enhances contractile force. J Appl Physiol 83(2):459–465
Murphy E, Froggatt K, Connolly S, O’Shea E, Sampson EL, Casey D et al (2016) Palliative care interventions in advanced dementia. Cochrane Database Syst Rev 12:CD011513
Nakagawa T, Wada H, Sekizawa K, Arai H, Sasaki H (1999) Amantadine and pneumonia. Lancet 353(9159):1157
Newman R, Vilardell N, Clavé P, Speyer R (2016) Effect of bolus viscosity on the safety and efficacy of swallowing and the kinematics of the swallow response in patients with oropharyngeal dysphagia: white paper by the European Society for Swallowing Disorders (ESSD). Dysphagia 31(5):719
Ohkubo T, Chapman N, Neal B, Woodward M, Omae T, Chalmers J et al (2004) Effects of an angiotensin-converting enzyme inhibitor-based regimen on pneumonia risk. Am J Respir Crit Care Med 169(9):1041–1045
Ortega O, Clavé P (2013) Oral hygiene, aspiration, and aspiration pneumonia: from pathophysiology to therapeutic strategies. Curr Phys Med Rehabil Rep 1(4):292–295
Paranji S, Paranji N, Wright S, Chandra S (2017) A nationwide study of the impact of dysphagia on hospital outcomes among patients with dementia. Am J Alzheimers Dis Other Demen 32(1):5–11
Plassman BL, Langa KM, Fisher GG, Heeringa SG, Weir DR, Ofstedal MB et al (2007) Prevalence of dementia in the United States: the aging, demographics, and memory study. Neuroepidemiology 29(1–2):125–132
Priefer BA, Robbins J (1997) Eating changes in mild-stage Alzheimer’s disease: a pilot study. Dysphagia 12(4):212–221
Robbins J, Gensler G, Hind J, Logemann JA, Lindblad AS, Brandt D et al (2008) Comparison of 2 interventions for liquid aspiration on pneumonia incidence: a randomized trial. Ann Intern Med 148(7):509–518
Rofes L, Arreola V, Almirall J, Cabré M, Campins L, García-Peris P et al (2011) Diagnosis and management of oropharyngeal dysphagia and its nutritional and respiratory complications in the elderly. Gastroenterol Res Pract 2011. doi:10.1155/2011/818979
Rofes L, Arreola V, Mukherjee R, Clavé P (2014a) Sensitivity and specificity of the eating assessment tool and the volume-viscosity swallow test for clinical evaluation of oropharyngeal dysphagia. Neurogastroenterol Motil 26(9):1256–1265
Rofes L, Cola PC, Clave P (2014b) The effects of sensory stimulation on neurogenic oropharyngeal dysphagia. J Gastroenterol Hepatol Res 3(5):1066–1072
Rosler A, Pfeil S, Lessmann H, Hoder J, Befahr A, von Renteln-Kruse W (2015) Dysphagia in dementia: influence of dementia severity and food texture on the prevalence of aspiration and latency to swallow in hospitalized geriatric patients. J Am Med Dir Assoc 16(8):697–701
Sanders DS, Carter MJ, D’Silva J, James G, Bolton RP, Bardhan KD (2000) Survival analysis in percutaneous endoscopic gastrostomy feeding: a worse outcome in patients with dementia. Am J Gastroenterol 95(6):1472–1475
Serra-Prat M, Palomera M, Gomez C, Sar-Shalom D, Saiz A, Montoya JG et al (2012) Oropharyngeal dysphagia as a risk factor for malnutrition and lower respiratory tract infection in independently living older persons: A population-based prospective study. Age Ageing 41(3):376–381
Shimizu T, Fujioka S, Otonashi H, Kondo M, Sekizawa K (2008) ACE inhibitor and swallowing difficulties in stroke. A preliminary study. J Neurol 255(2):288–289
Simons A, Hamdy S (2017) The use of brain stimulation in dysphagia management. Dysphagia 32(2):209–215
Sjögren P, Nilsson E, Forsell M, Johansson O, Hoogstraate J (2008) A systematic review of the preventive effect of oral hygiene on pneumonia and respiratory tract infection in elderly people in hospitals and nursing homes: effect estimates and methodological quality of randomized controlled trials. J Am Geriatr Soc 56(11):2124–2130
Sokoloff LG, Pavlakovic R (1997) Neuroleptic-induced dysphagia. Dysphagia 12(4):177–179
Speyer R, Baijens L, Heijnen M, Zwijnenberg I (2010) Effects of therapy in oropharyngeal dysphagia by speech and language therapists: a systematic review. Dysphagia 25(1):40–65
Stewart JT (2001) Reversible dysphagia associated with neuroleptic treatment. J Am Geriatr Soc 49(9):1260–1261
Stewart JT (2003) Dysphagia associated with risperidone therapy. Dysphagia 18(4):274–275
Stockdell R, Amella EJ (2008) The Edinburgh Feeding Evaluation in Dementia Scale: determining how much help people with dementia need at mealtime. Am J Nurs 108(8):46–54
Suh MK, Kim H, Na DL (2009) Dysphagia in patients with dementia: Alzheimer versus vascular. Alzheimer Dis Assoc Disord 23(2):178–184
Sura L, Madhavan A, Carnaby G, Crary MA (2012) Dysphagia in the elderly: management and nutritional considerations. Clin Interv Aging 7:287–298
Taipale H, Koponen M, Tanskanen A, Lavikainen P, Tolppanen A-M, Sund R et al (2017) Use of benzodiazepines and related drugs is associated with a risk of stroke among persons with Alzheimer’s disease. Int Clin Psychopharmacol 32(3):135–141
Takagi D, Hirano H, Watanabe Y, Edahiro A, Ohara Y, Yoshida H et al (2017) Relationship between skeletal muscle mass and swallowing function in patients with Alzheimer’s disease. Geriatr Gerontol Int 17(3):402–409
Terré R, Mearin F (2012) Effectiveness of chin-down posture to prevent tracheal aspiration in dysphagia secondary to acquired brain injury. A videofluoroscopy study. Neurogastroenterol Motil 24(5):414–419
Uwano C, Suzuki M, Aikawa T, Ebihara T, Une K, Tomita N et al (2012) Rivastigmine dermal patch solves eating problems in an individual with advanced Alzheimer’s disease. J Am Geriatr Soc 60(10):1979–1980
Van Der Maarel-Wierink CD, Vanobbergen JNO, Bronkhorst EM, Schols JMGA, De Baat C (2013) Oral health care and aspiration pneumonia in frail older people: a systematic literature review. Gerodontology 30(1):3–9
Volkert D, Chourdakis M, Faxen-Irving G, Frühwald T, Landi F, Suominen MH et al (2015) ESPEN guidelines on nutrition in dementia. Clin Nutr 34(6):1052–1073
Wada H, Nakajoh K, Satoh-Nakagawa T, Suzuki T, Ohrui T, Arai H et al (2001) Risk factors of aspiration pneumonia in Alzheimer’s disease patients. Gerontology 47(5):271–276
Wallace KL, Middleton S, Cook IJ (2000) Development and validation of a self-report symptom inventory to assess the severity of oral-pharyngeal dysphagia. Gastroenterology 118(4):678–687
Watson R (1994a) Measuring feeding difficulty in patients with dementia: developing a scale. J Adv Nurs 19(2):257–263
Watson R (1994b) Measuring feeding difficulty in patients with dementia: replication and validation of the EdFED Scale #1. J Adv Nurs 19(5):850–855
World Health Organization (2017) Dementia Fact sheet. http://www.who.int/mediacentre/factsheets/fs362/en/
Zanini M, Bagnasco A, Catania G, Aleo G, Sartini M, Cristina ML et al (2017) A Dedicated Nutritional Care Program (NUTRICARE) to reduce malnutrition in institutionalised dysphagic older people: a quasi-experimental study. J Clin Nurs 49. doi:10.1111/jocn.13774
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Ortega, O., Espinosa, M.C. (2017). Oropharyngeal Dysphagia and Dementia. In: Ekberg, O. (eds) Dysphagia. Medical Radiology(). Springer, Cham. https://doi.org/10.1007/174_2017_120
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