This prospective, cross-sectional study evaluated the impact of dysphagia on quality of life in healthy ageing and in subjects with Parkinson's disease (PD) using the Swallowing Quality of Life (SWAL-QOL) questionnaire. Sixteen healthy young adults (8 males, mean age = 25.1 years) and 16 healthy elders (8 males, mean age = 72.8 years) were recruited. Thirty-two subjects with idiopathic PD (mean age = 68.5 years) were recruited from a movement disorders clinic. The severity of PD was staged using the Hoehn and Yahr scale. Results revealed that elders experienced symptoms of dysphagia more frequently than young adults but the overall SWAL-QOL scores were not significantly different. Subjects with PD who experienced dysphagia reported greatly reduced QOL, and significant differences were found in all but one subsection of the SWAL-QOL. Disease progression detrimentally impacts QOL, with subjects in later-stage PD experiencing further reduction in the desire to eat, difficulty with food selection, and prolonged eating duration. These features, which increase with disease severity, are likely to impact negatively upon nutritional status, which is already under threat from PD-related dysphagia.

The risk of aspiration pneumonia in Parkinson's disease (PD) may be increased by sensory loss in the laryngopharynx and a reduced cough reflex. This study investigated changes in chemo- and mechanosensation with age and in PD and documented cough thresholds and cortical influences over cough. Single-breath citric acid inhalation cough challenge and flexible nasendoscopy were performed in 32 participants with idiopathic PD (mean age = 68.5 years, range = 45.8-82.5) and 16 healthy young adults (8 males, mean age = 25.1 years, range = 21.3-32.4), and 16 healthy elders (8 males, mean age = 72.8 years, range = 61.5-84.7) as controls. Individuals with PD had reduced sensation at the base of the tongue compared to age- and gender-matched counterparts (p < 0.005). All groups demonstrated lower natural cough thresholds than suppressed cough thresholds. No differences in natural cough thresholds were found across groups. Young adults demonstrated greater ability to suppress cough compared to healthy elders (p = 0.021). Tongue-base mechanosensory impairment in PD may account for vallecular residue and complaints of globus sensation. However, decreased cough response was not found to be a characteristic of PD. This study provided evidence for voluntary control of cough and the lack of decline of chemosensitivity with age or disease.

Making appropriate recommendations for safe drinking behavior among different age groups requires understanding of differences between young and older adults in following them. The purpose of this study was to investigate how drinking behavior in terms of drinking speed and bolus size differs between young and older adults following instructions to change drinking rate. Thirty young (mean age 24.7 years) and 30 older (mean age 66.9 years) healthy female participants were recruited. All participants drank water under different drinking instructions: "as they normally would", "as quickly as is comfortably possible", and "slowly". Results showed that when asked to drink quickly, both age groups increased drinking speed to a similar extent. When asked to drink slowly, older adults were unable to slow their drinking rate as much as young adults (P < .001). When drinking slowly, older adults had significantly larger bolus size than young adults'. These suggest that in a healthcare setting, the often prescribed advice to "drinking slowly" may be insufficient precaution for older patients. Prudence is suggested to carefully observe patients drinking after they've been asked to drink slowly, before making a clinical judgment if additional, more specific strategies may be indicated.

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