The impact of and the factors associated with drooling in Parkinson's disease

Leibner, Joshua; Ramjit, Amit; Sedig, Laura; Dai, Yunfeng; Wu, Samuel S.; Jacobson, Charles E.; Okun, Michael S.; Rodríguez, Ramón; Malaty, Irene A.; Fernández, Hubert H.

doi:10.1016/j.parkreldis.2009.12.003

Cited by 52 publications

(58 citation statements)

References 7 publications

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“…Some argue towards a lack of correlation [2], while recent studies propose a positive correlation of drooling with PD progression [6,7] similar to our results. Statistically, the odds of drooling at stage 3 are half the odds of drooling at stage 4 (OR = 0.538, 95% CI 0.259–1.115).…”

Section: Discussionsupporting

confidence: 83%

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

et al. 2012

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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.

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Section: Discussionsupporting

confidence: 83%

“…Furthermore, drooling severely inhibits a patient’s ability to speak, eat and socially interact with others compared to non-droolers [2], and it may even result in aspiration pneumonia and choking. In 86% of the patients, dysphagia can be found along with drooling [1].…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2012

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“…Psychosocially, drooling is one of the primary reasons for poor QoL, emotional distress, and social embarrassment in PD patients [26]. Besides this, PD patients with drooling problems increased their caregivers' burden [27].…”

Section: Discussionmentioning

confidence: 99%

Quality of Life and Caregivers' Burden of Parkinson's Disease

et al. 2017

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Aim: This study focused on the impact of the clinical features on the quality of life (QoL) of Parkinson's disease (PD) patients and of their caregivers. Methods: This study included PD patients along with their caregivers and was undertaken at the Malaysian Parkinson's Disease Association from June 2016 to November 2016. Clinical features of PD patients were assessed using the Movement Disorder Society revised Unified Parkinson Disease Rating Scale; the Hoehn and Yahr stage and the Schwab and England Activities of Daily Living Scale were used to assess the severity and the ability of PD patients respectively. QoL of PD patients was measured using the Parkinson's Disease Questionnaire-39 (PDQ-39). The revised version of the Zarit Burden Interview assessed caregiver burden. Results: At least one of the clinical features affected PD patients' QoL, and at least one of the QoL domains affected the caregivers' burden. Clinical features “saliva and drooling” and “dyskinesia” explained 29% of variance in QoL of PD patients. The QoL domains “stigma,” along with “emotional well-being” explained 48.6% of variance in caregivers' burden. Conclusions: The clinical features “saliva and drooling” and “dyskinesia” impacted the QoL of PD patients, and the QoL domains “stigma” and “emotional well-being” of PD patients impacted their caregivers' burden.

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“…For adults with neurological conditions such as Parkinson Disease, the impact can be distressing, and individuals that drool have more difficulties with eating, speaking, and with social interactions than individuals with the same condition that do not drool. 2 Many factors influence salivary flow including emotional state, environmental temperature, state of hydration, and the presence of food in the mouth. Quantification of salivary flow rate or drooling is challenging.…”

Section: Management Issues For Chronic Severe Droolingmentioning

confidence: 99%

“…1 In a study in which a seven-question survey on drooling was administered to 58 individuals with Parkinson Disease who were classified as either "droolers" or "non-droolers" and 51 age-matched controls, people with Parkinson Disease who had a drooling problem had worse quality of life and more difficulty speaking, eating, and socially interacting compared with individuals with Parkinson Disease who were non-droolers. 2 For those that have a successful outcome following saliva control surgery, quality of life may be improved. 29 …”

Section: Safety and Tolerabilitymentioning

confidence: 99%

Evaluation of glycopyrrolate in the treatment of chronic drooling

Reddihough¹,

Reid²,

Plover³

2011

DNND

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Drooling is a major problem for children and adults with cerebral palsy and other neurological conditions. Medication is a major treatment option for these individuals. The focus of this review is to review glycopyrrolate, one of the frequently used medications for poor saliva control. Glycopyrrolate is a quaternary ammonium compound structurally related to atropine. The pharmacology, mode of action and pharmocokinetics are discussed, efficacy studies are reviewed, and safety and tolerability are described. Mention is made of the limited amount of information that is available on patient satisfaction and quality of life. Glycopyrrolate has an important place in the treatment of chronic drooling and possible uses for this medication are described. Further research would be helpful comparing glycopyrrolate with other anticholinergic medication and alternative treatments for drooling including botulinum toxins and surgical procedures. Keywords: dribbling, poor saliva control, cerebral palsy, Parkinson Disease Management issues for chronic severe droolingDrooling, sometimes known as dribbling or poor saliva control, is a distressing problem. Drooling may be odorous; the secretions can cause chronic irritation of the facial skin; dehydration can occur if severe; and excessive drooling may damage clothing, books, and computer equipment. The care required for the individual increases the demands on family members.1 Poor saliva control may result in loss of self esteem. It is a major factor in impeding the successful integration of children and young adults into school, the community, and later the workplace. For adults with neurological conditions such as Parkinson Disease, the impact can be distressing, and individuals that drool have more difficulties with eating, speaking, and with social interactions than individuals with the same condition that do not drool. 2Many factors influence salivary flow including emotional state, environmental temperature, state of hydration, and the presence of food in the mouth. Quantification of salivary flow rate or drooling is challenging. Therefore, few studies documenting prevalence of the condition are available. Drooling has been reported as occurring in between 10% and 78% of children with cerebral palsy, and in 38% of a recent population-based cohort of 385 children from the Victorian Cerebral Palsy Register (manuscript in preparation). It also occurs in many individuals with intellectual disability and in other more unusual neurological and head and neck conditions. 3 For those attending special education settings, the number may be higher and was reported to be present in 58% of children with cerebral palsy. 4 Poor saliva control also occurs in acquired neurological conditions including Parkinson Disease, where it is estimated

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The impact of and the factors associated with drooling in Parkinson's disease

Cited by 52 publications

References 7 publications

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

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

Quality of Life and Caregivers' Burden of Parkinson's Disease

Evaluation of glycopyrrolate in the treatment of chronic drooling

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