Pill swallowing in Parkinson's disease: A prospective study based on flexible endoscopic evaluation of swallowing

Buhmann, Carsten; Bihler, Moritz; Emich, Katharina; Hidding, Ute; Gerloff, Christian; Niessen, Almut; Flügel, Till; Koseki, Jana-Christina; Nienstedt, Julie Cläre; Pflug, Christina

doi:10.1016/j.parkreldis.2019.02.002

Cited by 31 publications

(27 citation statements)

References 21 publications

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“…Severe swallowing disorders can distract PwP from eating and drinking, impair breathing, and increase the risk of aspiration and pneumonia [27,28]. The presence of these symptoms is often underestimated by patients and physicians and might cause dose-failure of PD medication [28]. Regarding to the relevance in clinical practice the expert panel consented the recommendations for or against feeding tube and tracheostomy as possible invasive rescue therapy for swallowing disorders.…”

Section: Discussionmentioning

confidence: 99%

Consensus-Based Recommendations for Advance Directives of People with Parkinson’s Disease in Regard to Typical Complications by German Movement Disorder Specialists

Klietz

Berndt

Wegner

et al. 2020

JCM

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A huge proportion of people with Parkinson’s disease (PwP) in Germany have written an advance directive (AD). However, the content of these forms in regard to specific Parkinson’s disease (PD)-related complications is rather low. There is an urgent need to specify ADs of PwP and consequently to improve decision-making concerning end-of-life aspects for affected patients. Evidence- and consensus-based PD-specific recommendations for ADs might help to close this gap. A Delphi study with two online Delphi rounds was initiated. Initial recommendations were built on findings from previous studies and derived from evidence-based literature. Consensus on recommendations was defined as ≥80% concordance regarding clarity of formulated aspects and relevance for clinical practice. A total of 22 experts (15.2% response rate) predominantly from the workgroup ‘neuro-palliative care’ in Germany performed two Delphi rounds. Consensus was achieved for 14 of 24 initially presented recommendations. Recommendations relating to dopaminergic therapy as well as to non-oral therapy options were considered important by the expert panel. The recommendations should be taken into account when developing and giving advice on ADs for PwP. Health professionals should be trained in counselling ADs of PwP and in integrating these recommendations in ADs during the disease course of PD.

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Section: Discussionmentioning

confidence: 99%

Consensus-Based Recommendations for Advance Directives of People with Parkinson’s Disease in Regard to Typical Complications by German Movement Disorder Specialists

Klietz

Berndt

Wegner

et al. 2020

JCM

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“…These are: increased duration of meals, difficulty in tablet swallowing and sensation of food sticking or persisting in the throat after swallowing, coughing and choking during ingestion of food and liquids, post-swallowing changes in voice (e.g. gurgling voice), weight loss or low body mass index while recurrent chest infections [25][26][27][28][29]. Also, drooling is considered by some authors as a possible indirect marker of dysphagia, since it can be the consequence of oropharyngeal swallowing alterations [30].…”

Section: Screening Of Dysphagia In Pdmentioning

confidence: 99%

A multinational consensus on dysphagia in Parkinson's disease: screening, diagnosis and prognostic value

et al. 2021

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Background Parkinson’s disease (PD) is a neurodegenerative disorder characterized by a combination of motor and non-motor dysfunction. Dysphagia is a common symptom in PD, though it is still too frequently underdiagnosed. Consensus is lacking on screening, diagnosis, and prognosis of dysphagia in PD. Objective To systematically review the literature and to define consensus statements on the screening and the diagnosis of dysphagia in PD, as well as on the impact of dysphagia on the prognosis and quality of life (QoL) of PD patients. Methods A multinational group of experts in the field of neurogenic dysphagia and/or PD conducted a systematic revision of the literature published since January 1990 to February 2021 and reported the results according to PRISMA guidelines. The output of the research was then analyzed and discussed in a consensus conference convened in Pavia, Italy, where the consensus statements were drafted. The final version of statements was subsequently achieved by e-mail consensus. Results Eighty-five papers were used to inform the Panel’s statements even though most of them were of Class IV quality. The statements tackled four main areas: (1) screening of dysphagia: timing and tools; (2) diagnosis of dysphagia: clinical and instrumental detection, severity assessment; (3) dysphagia and QoL: impact and assessment; (4) prognostic value of dysphagia; impact on the outcome and role of associated conditions. Conclusions The statements elaborated by the Consensus Panel provide a framework to guide the neurologist in the timely detection and accurate diagnosis of dysphagia in PD.

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“…Dysphagia increases the risk of malnourishment and malnutrition in patients with PD [62], and dysphagia severity predicts a poor outcome in persons with advanced PD [63]. Dysphagia for pills is an often overlooked aspect of dysphagia in PD and may be evident in close to 30% of patients, particularly those with more advanced disease [64]. Capsules are swallowed most readily; oval tablets pose the most difficulty [64].…”

Section: Dysphagiamentioning

confidence: 99%

“…Dysphagia for pills is an often overlooked aspect of dysphagia in PD and may be evident in close to 30% of patients, particularly those with more advanced disease [64]. Capsules are swallowed most readily; oval tablets pose the most difficulty [64]. One very important and significant risk of dysphagia is aspiration with consequent pneumonia.…”

Section: Dysphagiamentioning

confidence: 99%

Autonomic Dysfunction in Parkinson's Disease

Pfeiffer

2020

Neurotherapeutics

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Recognition of the importance of nonmotor dysfunction as a component of Parkinson's disease has exploded over the past three decades. Autonomic dysfunction is a frequent and particularly important nonmotor feature because of the broad clinical spectrum it covers. Cardiovascular, gastrointestinal, urinary, sexual, and thermoregulatory abnormalities all can appear in the setting of Parkinson's disease. Cardiovascular dysfunction is characterized most prominently by orthostatic hypotension. Gastrointestinal dysfunction can involve virtually all levels of the gastrointestinal tract. Urinary dysfunction can entail either too frequent voiding or difficulty voiding. Sexual dysfunction is frequent and frustrating for both patient and partner. Alterations in sweating and body temperature are not widely recognized but often are present. Autonomic dysfunction can significantly and deleteriously impact quality of life for individuals with Parkinson's disease. Because effective treatment for many aspects of autonomic dysfunction is available, it is vitally important that assessment of autonomic dysfunction be a regular component of the neurologic history and exam and that appropriate treatment be initiated and maintained.

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Pill swallowing in Parkinson's disease: A prospective study based on flexible endoscopic evaluation of swallowing

Cited by 31 publications

References 21 publications

Consensus-Based Recommendations for Advance Directives of People with Parkinson’s Disease in Regard to Typical Complications by German Movement Disorder Specialists

Consensus-Based Recommendations for Advance Directives of People with Parkinson’s Disease in Regard to Typical Complications by German Movement Disorder Specialists

A multinational consensus on dysphagia in Parkinson's disease: screening, diagnosis and prognostic value

Autonomic Dysfunction in Parkinson's Disease

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