The prevalence and associated factors of dysphagia in Parkinson's disease: A systematic review and meta-analysis

Abstract

BackgroundThe prevalence and associated factors of dysphagia in Parkinson's disease (PD) are different in studies conducted in different countries. The purpose of our systematic review and meta-analysis was to evaluate the prevalence of dysphagia in PD and to clarify its associated factors.MethodsTwo researchers systematically searched PubMed, Embase, Web of Science, Cochrane Library, CNKI, Wanfang Database, SinoMed and VIP databases and manually searched references in the retrieved articles to identify potential research subjects. The last search was conducted on June 28, 2022. Finally, a total of 58 studies including 60 observations with 20,530 PD patients were included in our meta-analysis.ResultsThe meta-analysis estimated that the pooled prevalence rate of dysphagia in PD was 36.9% (95% CI: 30.7–43.6%) and instrumental examination showed a higher prevalence (57.3%, 95% CI: 44.3–69.1%). Oceania showed the highest prevalence of dysphagia in PD (56.3%) compared to Africa (39.5%), Asia (38.6%), Europe (36.1%) and America (28.9%). Dysphagia in PD was associated with older age, lower body mass index, longer disease duration, higher Hoehn and Yahr stage and levodopa equivalent daily dose, PIGD subtype, severe motor symptoms, drooling and higher levels of depression, and lower quality of life.ConclusionsIn conclusion, our meta-analysis showed that dysphagia occurs in more than one-third of PD patients and was associated with several demographic characteristics and PD-related characteristics, motor symptoms, non-motor symptoms, as well as decreased quality of life. It deserves early screening, diagnosis, and treatment in clinical practice to prevent serious complications from dysphagia.

Association of risk factor and the number of risk factors with classification, GMFCS and comorbidity of CP

“…However, the prevalence of CP aged 1-6 years old in 12 reported provinces and cities in China is 2.46/1000 [4 .Perlstein had divided CP into congenital and acquired; the former is caused by various causes, from the fetal to the perinatal period, and the latter is caused by brain damage during perinatal development. Preterm delivery, asphyxia, and hyperbilirubinemia are the main causes of CP [5 . Our meta-analysis [ 6 showed that 79.7% of CP combined with one or more comorbidities, among them, 17.9% was with epilepsy, 58.0% was with an intellectual disability, 48.0% was with a language disability, 17.2% was with a hearing disability, and 23.1% was with a visual disability. There is a certain relationship between the comorbidity and the characteristics, severity, and risk factors of brain injury.…”

Sensitivity and specificity of the EAT-10 and SDQ-DP in identifying the risk of dysphagia in Parkinson's disease

“…Respiratória standard deviation of 12.9, as per the prevalence value from the literature (36.9% with a 95% CI: 30.7-43.6%). 10 The resulting sample included 29 patients.…”

“…In another study, 95% of 119 PD patients did not report swallowing problems but exhibited signs of penetration/aspiration during FEES. 3 Although the use of questionnaires for screening dysphagia risk in patients with PD has been widely discussed, 3,[6][7][8][9] there are controversies regarding these instruments because patients with PD often do not report changes in swallowing physiology, 3,5,6,8,10 which can lead to a delayed diagnosis of dysphagia. 11 This delay can worsen symptoms and lead to clinical complications, often resulting in hospitalization for bronchoaspiration pneumonia.…”

Gastrointestinal Dysfunction in Parkinson’s Disease: Neuro-Gastroenterology Perspectives on a Multifaceted Problem

“…The term 'dyspepsia' refers to a symptom complex that originates from the gastroduodenal region. 20 These symptoms include discomfort or pain in the upper abdomen, epigastric fullness, bloating, early satiety, nausea, and/or vomiting, 21 which Dysphagia ≈ 35.6%-80% 11,12 Oropharyngeal Lower gut…”

“…9 The entire GI tract is affected in PD 7,10 and leads to a wide variety of issues, including oropharyngeal and upper-mid gut (stomach and small bowel) and lower gut (large bowel) problems (Figure 1). 1,[11][12][13][14][15][16][17][18] Oropharyngeal problems, such as sialorrhea and dysphagia, are prevalent in advanced PD and were recently reviewed elsewhere. 10,19 Gastric and bowel dysfunction are prevalent in early and later stages of PD, and manifest as heterogeneous upper and lower GI symptoms.…”