Impact of Progression of Parkinson’s Disease on Drooling in Various Ethnic Groups

Abstract

Background/Aims: Drooling or sialorrhea is a common non-motor symptom of Parkinson’s disease (PD), and is reported by 35–75% of patients. Drooling is primarily due to impaired swallowing rather than hypersecretion of saliva. In this study, we examined the prevalence of drooling in PD and its relation to various factors such as age, stage of disease, gender and ethnicity. Methods: A retrospective cohort chart analysis of 307 patients with idiopathic PD was conducted. These patients were seen in the Parkinson’s Disease and Movement Disorders Clinic between 2005 and 2010. Results: 123 (40%) patients exhibited drooling. No correlation between age and development of drooling was observed. However, gender was found to be a significant factor in developing sialorrhea. Males are twice as more likely to develop sialorrhea than females. In addition, drooling becomes more prevalent with disease progression; Hoehn and Yahr stage 4 patients being the most at risk. Ethnicity and immigration status have no relationship in developing drooling. Conclusions: Sialorrhea is seen in a significant number of PD patients. This study, to the best of our knowledge, is the most extensive clinical assessment of drooling in PD to date.

Diurnal drooling in Chinese patients with Parkinson's disease

“…In addition, motor severity of PD was observed to be associated with diurnal drooling in the current study, which is consistent with the finding of a case-control study on a Dutch population [6], and another study on a Canadian population [7], which found that all-day drooling was more prevalent with disease progression, especially in H&Y stage 4. However, no association was found between diurnal drooling and disease duration in the current study.…”

“…In addition, unlike our previous study on all-day drooling [3], male sex was observed to be associated with diurnal drooling in the current study, which is consistent with a previous Dutch study [6] on diurnal drooling and some studies [7,9,25] on all-day drooling. Why male sex should have severer drooling may be related to the finding that women with PD do seem to have a more benign phenotype than men [26].…”

“…Another observational study on 104 Dutch patients found that involuntary mouth opening and dysphagia were the correlated factors with diurnal drooling [4]. Other studies focused on drooling including both diurnal and nocturnal drooling found that drooling was related to disease duration [7], hallucination [8], dysarthria [3,9,10] and, less commonly, cognitive dysfunction [3,11].…”

Drooling in Parkinson's disease: A review

“…Previous studies showed that prevalence ranged from 10 to 84% (Table 1) [2,3,4,5,6,7,8,9,10,11,12,13,14,15,16]. Various tools such as the Unified Parkinson's Disease Rating Scale (UPDRS) part II [12,13,14,15]; Scales for Outcomes in PD for Autonomic Symptoms (SCOPA-AUT) [7,16]; PD non-motor symptoms questionnaire (PDNMSQuest) [8,10]; and different types of screening questionnaires [2,3,4,5,6,7,10,11] were used to screen drooling. The factors associated with drooling have been reported.…”

“…However, results vary among studies and the conclusion remains unclear. Factors possibly associated with drooling were severity of PD [2,14], male gender [3,10], aging [6], hallucinations [11], duration of PD [13], the sum of the scores of UPDRS part II and III greater than 28 points, dysarthria, dysphagia, orthostatic hypotension, and a history of using antidepressants [12]. Drooling during PD can have negative impact for both patients and caregivers.…”