Prevalence of dysphagia in multiple sclerosis: a systematic review and meta-analysis

Abstract

Although dysphagia was recognized as a clinical finding in multiple sclerosis (MS) as early as 1877, it has not received enough attention yet. With the progress of diagnostic method for dysphagia, there has been a rapid development in estimating the prevalence of deglutition disorder in MS. In this review, we aimed to conduct a systematic review and meta-analysis of published literature to establish the prevalence of dysphagia in multiple sclerosis. We systematically searched Embase, PubMed databases and Cochrane library from 1980 to August 2014, supplemented by hand searching to identify relevant studies. We used random-effects model to calculate pooled prevalence. Potential sources of heterogeneity were explored using sensitivity test and subgroup analysis, meta-regression analysis. Of 198 retrieved articles, 15 eligible surveys with a total population of 4,510 met the criteria. Twelve studies provided an estimate based on subjective screening test, which proved substantial heterogeneity (Cochran's χ(2) significant at p < 0.0001; I(2) = 92.4 %, 95 % CI 31-42 %), with a combined prevalence estimate of 36 %. Four studies provided an estimate based on objective measurements (clinical or instrument tools), which were substantial heterogeneity (Cochran's χ(2) significant at p < 0.005; I(2) = 77 %, 95 % CI 67-94 %), with a pooled prevalence estimate of 81 %. A large heterogeneity still existed after conducting several subgroup analyses and sensitivity tests. The findings confirm that more than one-third of the multiple sclerosis patients are suffering from swallowing difficulties. Therefore, we should be careful to interpret the pooled estimate due to the substantial heterogeneity between studies.

Prevalence of drooling, swallowing, and feeding problems in cerebral palsy across the lifespan: a systematic review and meta‐analyses

“…However, determining the prevalence of a condition is essential to guide health policy and to ensure appropriate resource allocation. Several reviews have been published on the prevalence of drooling, swallowing, and feeding problems in specific populations: for example, the prevalence of drooling in Parkinson disease; swallowing problems in stroke, Alzheimer disease, head injury, Parkinson disease, and multiple sclerosis; and feeding problems in infants born very preterm and patients in intensive care units . For the CP population, data on the prevalence of drooling, swallowing, and feeding problems can be retrieved from individual studies.…”

Formatting an experiential learning education module to encourage dysphagia assessment in apheresis patients

“…3,7 Multiple sclerosis patients, for example, have 31%-33% incidence of dysphagia. 8,9 Dysphagia can lead to unwanted outcomes such as pneumonia 4 ; therefore, efforts should be aimed toward assessing for dysphagia and preventing aspiration. 5 Most nurses working in hospital inpatient units perform routine dysphagia screening in high risk populations.…”

“…This is especially true of patients with progressive neurological disorders . Multiple sclerosis patients, for example, have 31%–33% incidence of dysphagia . Dysphagia can lead to unwanted outcomes such as pneumonia; therefore, efforts should be aimed toward assessing for dysphagia and preventing aspiration…”

Effective Fluoride Mouthwash Delivery Methods as an Alternative to Rinsing

“…Fluoride mouthwash requires a user to be able to rinse, which can be difficult for special-needs individuals. Patients with rinsing difficulty include those with (a) acute illness, including patients in the intensive care unit and stroke patients; (b) chronic illness, including multiple sclerosis and neuromuscular disorders affecting oral motor function; and (c) developmental disabilities, including cerebral palsy, intellectual disabilities, and developmental coordination disorders (difficulty following oral rinsing instructions; Bhattacharyya, 2014; Calis et al, 2008;Erkin, Culha, Ozel, & Kirbiyik, 2010;Guan, Wang, Huang, & Meng, 2015;Parkes, Hill, Platt, & Donnelly, 2010;Willig, Paulus, Lacau Saint Guily, Béon, & Navarro, 1994). Therefore, the preventive oral healthcare needs of individuals with special needs were a motivation for this study.…”