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Introduction  Dysphagia is a common symptom in Parkinson's disease (PD) and it has been associated with poor quality of life (QoL), anxiety, depression.Objective  The aim of this study was to evaluate the quality of life in individuals with PD before and after SLP therapy.Methods  The program consisted of four individual therapy sessions. Each session comprised guidelines regarding food and postural maneuvers (chin down). The Quality of Life in Swallowing Disorders (SWAL-QOL) questionnaire was applied before and after therapy.Results  The sample comprised of 10 individuals (8 men), with a mean (SD) age of 62.2 (11.3) years, mean educational attainment of 7.5 (4.3) years, and mean disease duration of 10.7 (4.7) years. Thirty percent of patients were Hoehn and Yahr (H&Y) stage 2, 50% were H&Y stage 3, and 20% were H&Y stage 4. Mean scores for all SWAL-QOL domains increased after the intervention period, with significant pre- to post-therapy differences in total score (p = 0.033) and domain 4 (symptom frequency) (p = 0.025). There was also a bias significance for domain 5 (food selection) (p = 0.095).Conclusion  Patients exhibited improvement in swallowing-related quality of life after a SLP therapy program. The earlier in the course of PD, greater the improvement observed after therapy.

Aims. To verify the effectiveness of the maneuver application in swallowing therapy with PD. Materials and Method. We performed an open-label trial, with three groups compounds by PD individuals: the experimental group, control group, and orientation group. The study included PD patients with dysphagia. A cognitive screening, through a questionnaire about depression and quality of life, was conducted. Swallowing assessment was performed through (1) fiberoptic endoscopic evaluation of swallowing (FEES); (2) clinical evaluation and Functional Oral Intake Scale (FOIS); and (3) assessment of the quality life related to swallowing (SWALQOL). A therapeutic program, which consisted of chin-down postural maneuver and orientations on feeding, was applied. Both groups (EG and OG) received on-month therapeutic program. Results. A significant improvement in swallowing, evaluated by clinical assessment, was observed in solid (p < 0.001) and liquid (p = 0.022) consistencies in EG when compared to OG and CG. Patients in EG presented improvement in QoL, with the significant difference in comparison with the other groups, about domain frequency of symptoms (p = 0.029) in SWALQOL questionnaire. Conclusion. The postural maneuver chin-down improved swallowing performance and self-perception, but not the laryngeal signs. This trial is registered with registration number NCT02973698.

BackgroundEvidence points to the occurrence of cognitive impairment in all stages of PD, constituting a frequent and debilitating symptom, due to high impact on quality of life and mortality of patients.ObjectiveTo correlate cognitive performance with quality of life in PD.MethodsThe sample was drawn from a Movement Disorders Clinic of a reference hospital in Porto Alegre. Inclusion criteria were: PD diagnosis, according to the United Kingdom Parkinson's Disease Society Brain Bank criteria for idiopathic PD (Hughes et al. 1992) and patient consent to participate. Patients with other neurological pathologies and those submitted to deep brain stimulation were excluded. The evaluation consisted of a cognitive testing battery (composed of eight tests for assessing cognitive performance), and a questionnaire on quality of life (PDQ-39) and depression (BDI).ResultsThe sample comprised 85 individuals with PD, with a mean age of 62.9 years (±10.7), mean disease duration of 10.4 years (±5.7), and mean educational level of four years (±4.3). There was a significant relationship between total score on the PDQ and all cognitive tests, showing that poor cognitive performance was correlated with poor quality of life. Moreover, a significant correlation was observed between cognitive tests and depression, H&Y, education level, and age.ConclusionIt may be concluded that the individuals with PD in this sample showed a correlation between poorer quality of life and worse cognitive performance. Poor performance was also correlated with more advanced stage, older age, low level of education and depression.

Memory is a cognitive domain extensively evaluated in the neuropsychiatric setting. Assessment tools with appropriate norms for age and educational level are necessary for the proper interpretation of results.Objective:To present normative data for older adults stratified by age and education for the Rivermead Behavioral Memory Test (RBMT). The effect of age and education on the total and sub-test scores was also analyzed. Methods:A cross-sectional study involving a sample of 233 healthy elderly from a third-age group in Porto Alegre with an average age of 70 (SD 7.9) years and 10.7 (SD 4.8) years of education was carried out. The RBMT is considered an ecologically valid memory test, since it includes tasks similar to everyday situations. The sample was stratified into the following age groups: 60-69 years, 70-79 years and > 80 years. The sample was also divided into individuals with < 8 years and ≥ 8 years of education. Pearson's Chi-squared test and Spearman correlations were used. Results:The elderly participants with low educational level had worse performance on all sub-tests, except the Pictures, Messages, Belongings and Orientation. Older elderly performed worse for total RBMT score and on the Face Recognition, Immediate and Delayed Route, Messages and Belongings subtests (p ≤ 0.005). Conclusion:Education and age significantly influenced RBMT scores. Therefore, norms for this test should be stratified according to these factors.

RESUMOObjetivo: Avaliar as funções do sistema estomatognático em idosos usuários de prótese dentária. Material e Métodos: Realizou-se avaliação fonoaudiológica constituída por uma anamnese e uma avaliação clínica composta por duas etapas. Na primeira etapa, foram observadas as características corporais e faciais gerais. Na segunda etapa, realizouse avaliação das estruturas orofaciais e das funções orais por meio da observação e apalpação. Foram incluídos indivíduos com mais de 60 anos, usuários de prótese dentária parcial superior e/ou inferior e total superior e/ou inferior. Resultados: Avaliou-se 44 idosos que foram divididos em três Grupos, de acordo com o tipo de prótese: Grupo 1 idosos sem falhas dentárias com 18 idosos; Grupo 2 composto por usuários de prótese total superior e inferior, com 14 idosos; Grupo 3 constituído por usuários de prótese parcial removível superior e inferior com 12 idosos. Destes 84,9% do sexo feminino. Com relação à função de deglutição observou-se presença de alteração em 55,5% dos idosos no Grupo 1, 85,7% no Grupo 2 e 91,6% no Grupo 3, desta forma os usuários de prótese dentária apresentaram valores maiores em comparação ao Grupo controle. Na função mastigatória, encontrouse alterações em 57,1% indivíduos do Grupo 2, e em 66,6% do Grupo 1 e 3. Conclusão: Desta forma, conclui-se que a utilização da prótese dentária ocasiona alterações nas funções do sistema estomatognático, mastigação e deglutição. Além disso, o tipo de prótese dentária utilizada pelo indivíduo ocasiona diferentes alterações com relação às estruturas. DESCRITORESFonoaudiologia. Prótese Dentária. Mastigação. Deglutição ABSTRACT Objective: To evaluate the stomatognathic system functions in aged denture wearers. Material and Methods: A phonoaudiological assessment was carried out consisting of anamnesis and a two-step clinical examination. Firstly, general facial and body features were observed. Secondly, orofacial structures and oral functions were checked through observation and palpation. The sample was composed of individuals aged more than 60 years, wearing upper or lower partial/ complete dentures. Results: A total of 44 elderlies were examined, who were divided into three groups according to the type of denture: group 1 including elderlies with no dental issues (n=18); group 2 consisting of elderlies wearing upper and lower complete dentures (n=14); and group 3 including elderlies with upper and lower partial dentures (n=12). Of these, 84.9% were female. Modifications of the swallowing function were observed in 55.5% of the subjects in group 1, 85.7% in group 2, and 91.6% in group 3, hence showing that denture wearers had higher prevalence of alterations in this function as compared to those in the control group. As to the chewing function, we found changes in 57.1% of subjects in group 2, and 66.6% in groups 1 and 3. Conclusion: The use of dentures leads to modifications in the functions of the stomatognathic system concerning chewing and swallowing. Furthermore, the type of denture used by the individual may...

Background: Little is known about the cognitive profile of Hereditary Spastic Paraplegias (HSP), where most scientific attention has been given to motor features related to corticospinal tract degeneration. Objectives: We aimed to perform a broad characterization of the cognitive functions of patients with pure and complicated HSP as well as to determine the frequency of abnormal cognitive performances in the studied subtypes. Methods: A two-center cross-sectional case-control study was performed. All individuals underwent cognitive assessment through screening tests (Mini Mental State Examination—MEEM and Montreal Cognitive Assessment—MOCA) and tests to assess specific cognitive functions (Verbal fluency with phonological restriction—FAS; Verbal categorical fluency—FAS-cat and Rey's Verbal Auditory Learning Test -RAVLT). Results: Fifty four patients with genetically confirmed HSP diagnosis, 36 with spastic paraplegia type 4 (SPG4), 5 SPG11, 4 SPG5, 4 cerebrotendinous xanthomatosis (CTX), 3 SPG7 and 2 SPG3A, and 10 healthy, unrelated control subjects, with similar age, sex, and education participated in the study. SPG4 patients had worse performances in MOCA, FAS, FAS-cat, and RAVLT when compared to controls. Most SPG4 patients presented cognitive changes not compatible with dementia, performing poorly in memory, attention and executive functions. SPG5 patients scored lower in executive functions and memory, and SPG7 patients performed poorly on memory tasks. All evaluated cognitive functions were markedly altered in CTX and SPG11 patients. Conclusions: Cognitive abnormalities are frequent in HSP, being more severe in complicated forms. However, cognitive impairments of pure HSPs might impact patients' lives, decreasing families' socioeconomic status and contributing to the overall disease burden.

Some of the most common losses in Parkinson’s disease (PD) are the changes in executive functions. The Trail Making Test is an important test to evaluate the executive functions. The objective of this study was to verify the cutoff point of the Trail Making Test for individuals with PD compared to healthy controls. This was a cross-sectional case-control study. The inclusion criteria for the case group were a diagnosis of PD and having taken PD medicine before the evaluation. Individuals with other neurological disorders and atypical or secondary parkinsonism were excluded. The inclusion criterion for the control group was absence of neurological impairment, and participants were paired by age and level of education with patients with PD. The following protocols were applied to individuals from the two groups: Mini-Mental State Examination (MMSE) and Trail Making Test (TMT) A and B and verbal TMT (vTMT) A and B. The sample was composed of 78 individuals, with 39 persons in both groups. In the Mann-Whitney test, a significant difference was verified in TMT A and B and vTMT B between the groups, and the case group presented worse results. We suggest a cutoff point for TMT A of 103 seconds, TMT B of 297.5 seconds, and vTMT B of 77.5 seconds. In conclusion, the TMT B verbal and written test can differentiate patients with PD from healthy controls. It can be used as a fast application test for executive function screening.