The relationship between quality of life and swallowing in Parkinson's disease

Abstract

Few studies exist in the literature investigating the impact of idiopathic Parkinson’s Disease (IPD) on swallow-related quality of life. We therefore aimed in this project to: (1) evaluate swallow-specific quality of life in IPD; (2) delineate potential relationships between IPD duration and severity with swallow-specific quality of life; (3) investigate relationships between swallow-specific quality of life and general health-related quality of life; and (4) investigate relationships between swallow-specific quality of life and depression. Thirty-six patients diagnosed with IPD with and without dysphagia filled out self-report assessments of the SWAL-QOL, Parkinson’s Disease Questionnaire-39 (PDQ-39), and Beck Depression Inventory (BDI). A series of Mann Whitney U tests were performed between non-dysphagic and dysphagic groups for the total SWAL-QOL score and the 10 SWAL-QOL domains. Spearman’s Rho correlation analyses were performed between the SWAL-QOL and (1) PDQ-39; (2) Hoehn and Yahr stage; (3) PD disease duration; (4) UPDRS “on” score; and (5) the BDI. The dysphagia swallowing group reported significant reductions compared to the nondysphagic group for the total SWAL-QOL score (P = 0.02), mental health domain score (P = 0.002) and social domain score (P = 0.002). No relationships existed between swallow-specific quality of life and disease duration or severity. Significant relationships existed between swallow-specific quality of life and general health-related quality of life (rs =−0.56, P = 0.000) and depression (rs = −0.48, P = 0.003). These exploratory data highlight the psychosocial sequelae that swallowing impairment can have in those with IPD and suggest a possible association between swallowing, social function, and depression.

Perceived changes to swallowing in people with Parkinson's disease

“…In agreement with other studies (Miller et al 2006, Han et al 2011, Plowman-Prine et al 2009, Manor et al 2009) we found a weak-moderate association of reported swallowing problems with depression. The association requires further investigation.…”

“…Alterations to swallowing will be apparent from their partner changing their food preferences, with implications for shopping and food preparation in the family; taking longer over meals than the rest of the family; experiencing choking or fear of choking episodes (Miller et al 2006, Plowman-Prine et al 2009) and similar. Nevertheless carers still significantly underestimated the impact of these changes on their partners, suggesting that carer ratings do not represent entirely insightful proxy estimation.…”

“…There has been an increasing interest in the use of patient reported outcome measurement (PROM) alongside objective clinical measures (Duncan et al 2014, Plowman-Prine et al 2009, Nisenzon et al 2011, Silbergleit et al 2012. PROM can enhance communication, especially about living with a long term condition, and support shared decision making about treatments and their effectiveness (Yorkston, Baylor, Amtmann (2014).…”

The Impact of Dysphagia on Quality of Life in Ageing and Parkinson’s Disease as Measured by the Swallowing Quality of Life (SWAL-QOL) Questionnaire

“…The relationship between QOL and swallowing in PD may also be influenced by depression in these patients. There is recent evidence to suggest a significant relationship between swallow-specific QOL and depression [21]. It was an assumption of this study that PD subjects with known history of depression have their symptoms adequately controlled by pharmacological means.…”

Swallowing Quality of Life After Zona Incerta Deep Brain Stimulation

“…The effect of DBS on swallowing is a complicated but important matter to address, as DBS brings a clear-cut improvement in cardinal symptoms of PD, but does not seem to have the same pronounced effect on swallowing function 23 . Swallowing function can be assessed by using fiber endoscopy, video fluoroscopy, or patient selfreports 13,16,29 . Traditionally, little attention has been given to patients' subjective experience, even though it has been shown that the feelings and attitudes towards swallowing and eating of patients with PD affect both their eating habits and their mental well-being 13,16 .…”