Dysphagia in Alzheimer's disease

Seçıl, Yaprak; Arıcı, Şehnaz; İncesu, Tülay Kurt; Gürgör, Nevin; Beckmann, Yeşim; Ertekin, Çumhur

doi:10.1016/j.neucli.2015.12.007

Cited by 55 publications

(30 citation statements)

References 45 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…A study in Parkinson's disease patients suggested that there are significant correlations between frontal/executive or learning/memory functions and the oral phase of swallowing, whereas the pharyngeal phase showed weak correlations with frontal functions [ 30 ]. In Alzheimer's disease (AD), dysphagia has also been thought to be associated with cognitive impairment [ 31 ]. If cortical involvement and cognitive decline progressed, swallowing problems could worsen in AD [ 31 32 ].…”

Section: Discussionmentioning

confidence: 99%

Relationship Between Cognitive Function and Dysphagia After Stroke

Hwang

Pyun

2017

Ann Rehabil Med

View full text Add to dashboard Cite

ObjectiveTo investigate the characteristics of cognitive deficits in patients with post-stroke dysphagia, and to analyze the relationships between cognitive dysfunction and severity of dysphagia in supratentorial stroke.MethodsA total of 55 patients with first-ever supratentorial lesion stroke were enrolled retrospectively, within 3 months of onset. We rated dysphagia from 0 (normal) to 4 (severe) using the dysphagia severity scale (DSS) through clinical examinations and videofluoroscopic swallowing studies (VFSS). The subjects were classified either as non-dysphagic (scale 0) or dysphagic (scale 1 to 4). We compared general characteristics, stroke severity and the functional scores of the two groups. We then performed comprehensive cognitive function tests and investigated the differences in cognitive performance between the two groups, and analyzed the correlation between cognitive test scores, DSS, and parameters of oral and pharyngeal phase.ResultsFugl-Meyer motor assessment, the Berg Balance Scale, and the Korean version of the Modified Barthel Index showed significant differences between the two groups. Cognitive test scores for the dysphagia group were significantly lower than the non-dysphagia group. Significant correlations were shown between dysphagia severity and certain cognitive subtest scores: visual span backward (p=0.039), trail making tests A (p=0.042) and B (p=0.002), and Raven progressive matrices (p=0.002). The presence of dysphagia was also significantly correlated with cognitive subtests, in particular for visual attention and executive attention (odds ratio [OR]=1.009; 95% confidence interval [CI], 1.002–1.016; p=0.017). Parameters of premature loss were also significantly correlated with the same subtests (OR=1.009; 95% CI, 1.002–1.016; p=0.017).ConclusionOur results suggest that cognitive function is associated with the presence and severity of post-stroke dysphagia. Above all, visual attention and executive functions may have meaningful influence on the oral phase of swallowing in stroke patients with supratentorial lesions.

show abstract

Section: Discussionmentioning

confidence: 99%

Relationship Between Cognitive Function and Dysphagia After Stroke

Hwang

Pyun

2017

Ann Rehabil Med

View full text Add to dashboard Cite

show abstract

“…Similarly, dementia has previously been reported as a risk factor for chronic opioid use after total hip arthroplasty [49]. Transdermal opioid treatment may be preferred due to difficulties in the ingestion of oral medicines, and particularly in patients with moderate to severe AD [50]. Treatment schemes of transdermal buprenorphine, i.e., change every 7 days, may provide additional ease of use, for example, reducing administration time and staffing requirements in home care services and in residential care [51].…”

Section: Discussionmentioning

confidence: 90%

Opioid Use After Hospital Care due to Hip Fracture Among Community-Dwelling Persons With and Without Alzheimer’s Disease

et al. 2019

View full text Add to dashboard Cite

Background Hip fractures are common among persons with Alzheimer's disease (AD), but problems in pain assessment may lead to insufficient analgesia after hospitalization. Objective We investigated the prevalence of opioid use in the 6 months after discharge from hospital care due to hip fracture among community-dwellers with and without AD. Setting and method The Medication use and Alzheimer's disease (MEDALZ) cohort was used for this study, consisting of all community-dwelling persons newly diagnosed with AD during 2005-2011 in Finland and their comparison persons without AD matched on age, sex, and region of residence at the time of AD diagnosis. Data were collected from nationwide healthcare registers. Main outcome measures We investigated opioid use versus non-use in persons with and without AD in the 6 months after discharge from hospital care due to hip fracture. Results Altogether 2342 persons with AD and 1615 persons without AD, discharged to community settings within ≤ 120 days after a hip fracture, were included. A higher percentage of persons with AD used opioids compared to those without AD, 39.5% [95% confidence interval (CI) 37.5-41.5] versus 31.2% (95% CI 28.9-33.5). Persons with AD used more frequently strong opioids during the first 3 months and buprenorphine during the 6-month period, and used weak opioids less frequently after the first month after discharge compared to those without AD. Conclusions Frequent opioid use after hospital care due to hip fracture may indicate increased attention to pain among persons with AD. Nevertheless, the benefits and harms of opioid use should be evaluated regularly in community-dwelling older persons.

show abstract

“…A previous study reported that ligamentous laxity, reduced muscle tone in the pharynx and esophagus, and increased duration of swallowing were recognized as physiological changes due to aging [42]. Patients with Alzheimer's dementia tended to have an increased number of swallows for any given amount in their mouth, a longer duration of the swallow, and a longer period of apnea [43]. They developed reduced pharyngeal clearance, reduced upper esophageal opening, and penetration and/or aspiration as the disease progresses [44].…”

Section: Discussionmentioning

confidence: 99%

Associations between Age, Oral Health-Related Quality of Life, and Oral and Swallowing Function among Psychiatric Inpatients in Japan : a cross-sectional study

Haresaku

Nakashima

Hara

et al. 2020

Preprint

View full text Add to dashboard Cite

BackgroundAlong with the ageing society, hospitalized psychiatric patients are also ageing in Japan. The purpose of this study was to investigate the associations between age, oral health-related quality of life (OHRQoL), and oral health, including oral and swallowing function, among psychiatric inpatients.MethodsThe subjects included 165 psychiatric inpatients in psychiatric hospitals in Japan. The General Oral Health Assessment Index (GOHAI) and the Eating Assessment Tool (EAT-10) were included in the questionnaire survey for the measurement of OHRQoL and the screening of dysphagia. A score ≥3 on the EAT-10 was defined as suspected dysphagia. Oral examinations and oral diadochokinesis (ODK) measurements for the tongue-lip motor function evaluation were conducted. The inpatients with acute psychiatric symptoms, moderate and severe dementia, and cognitive impairment that affected their ability to communicate and relate their feelings were excluded. A chi-squared test, the Mann-Whitney U test, and linear regression analysis were used for the analysis.ResultsA total of 100 (64.5%) psychiatric inpatients (49 males and 51 females) participated in this study. The means±SDs for age, the decayed missing filled teeth (DMFT) index, and GOHAI score were 67.3±14.5, 20.6±6, and 49.7±7.9, respectively. The mean ODK scores were less than 3 times/sec for all syllables. The percentage of the participants with suspected dysphagia was 45.0%. Tooth loss and suspected dysphagia were significantly associated with low GOHAI scores. The EAT-10 score was significantly correlated with the GOHAI score only after adjusting for age and sex (β=-0.725, 95% CI:-0.97, -0.64).ConclusionsIn hospitalized psychiatric patients, impaired oral health in the older subjects was more pronounced compared with that among general adults. Tooth loss and swallowing function were associated with OHRQoL. Therefore, oral care for the recovery of occlusal and swallowing functions may be needed to improve OHRQoL among psychiatric patients.

show abstract

Dysphagia in Alzheimer's disease

Cited by 55 publications

References 45 publications

Relationship Between Cognitive Function and Dysphagia After Stroke

Relationship Between Cognitive Function and Dysphagia After Stroke

Opioid Use After Hospital Care due to Hip Fracture Among Community-Dwelling Persons With and Without Alzheimer’s Disease

Associations between Age, Oral Health-Related Quality of Life, and Oral and Swallowing Function among Psychiatric Inpatients in Japan : a cross-sectional study

Contact Info

Product

Resources

About