Falls risk is predictive of dysphagia in Parkinson’s disease

Abstract

Objective Evaluate the relationship between falls, freezing of gait, and swallowing disturbance in Parkinson’s disease (PD). Background Dysphagia is a common symptom in PD, and is often thought of as an axial feature along with falls and gait disturbance. It is of interest to examine the relationship between these symptoms in PD, given the possibility of shared pathophysiology due to non-dopaminergic and extranigral dysfunction. Methods We recruited 29 consecutive non-demented patients with idiopathic PD and at least one clinically determined impairment in swallowing, falls, or freezing of gait. Swallow dysfunction was assessed using the Swallowing Disturbance Questionnaire (SDQ). The Falls Efficacy Scale and Freezing-of-gait questionnaire were recorded. Correlation analysis and multiple regression were used to determine the relationship between swallow and gait disturbance. Results Total SDQ score correlated strongly with the falls efficacy scale (Spearman’s rho = 0.594; P = 0.001), but not with the freezing-of-gait score. Linear regression controlling for other factors associated with dysphagia identified falls efficacy score as a significant predictor of swallow dysfunction. Conclusions The severity of dysphagia in PD is closely related to severity of falls, but not gait freezing. This may be helpful to more precisely determine the anatomical substrate of levodopa-resistant axial symptoms in PD and provide clues to further management.

Development and validation of a nomogram for freezing of gait in patients with Parkinson's Disease

“…the FOGQ compared with patients without oropharyngeal freezing and swallowing in PD patients can be impaired by oropharyngeal freezing, while one prospective study disagreed. 24 In the present study, patients with FOG in both the training and the validation cohorts had higher HAMA and HAMD scores than those without FOG. This is consistent with the findings of previous studies.…”

“…Our study also found that higher dysfunction of swallow and turn over are the risk factors for FOG in two cohorts. One study 23 agreed that PD patients with signs for oropharyngeal freezing scored significantly higher in the FOGQ compared with patients without oropharyngeal freezing and swallowing in PD patients can be impaired by oropharyngeal freezing, while one prospective study disagreed 24 …”

Technological support for people with Parkinson’s disease: a narrative review

“…In the literature, different cueing strategies such as, continuous stimulation devices during movement 22 or activated only when needed, through autonomous real-time sensing algorithms to start stimulation [23][24][25][26] have shown to be efficacy. Moreover, devices have shown to predict disease course by rest tremor (RT) monitoring thanks to the study of upper limbs movements 27 , identify problems related to food intake 28 , detect problems through handwriting and digitography analysis 29,30 . Other studies [31][32][33][34][35] have focused on the definition of high-tech miniaturized and portable devices made of fabrics and materials that conform to the body.…”