Oropharyngeal dysphagia profile in early versus late stage dementia

Abstract

Objective The aim of this study was to evaluate swallowing in early and late stage dementia cases referred to the swallowing clinic with oropharyngeal dysphagia in order to have a comprehensive view about their characteristic oropharyngeal dysphagia profile toward different food textures to address them in their rehabilitation program. Patients and Methods Fiber-optic endoscopic examination of swallowing (FEES) was conducted to evaluate formally the oropharyngeal stage of swallowing in 26 individuals diagnosed with early mild Alzheimer dementia and late severe Alzheimer dementia. The FEES protocol included symptoms of presentation, route of feeding, bedside evaluation using different textures followed by evaluation of the oral preparatory stage, and the pharyngeal stage through FEES. In addition to observing the ability of the patient to imitate various oromotor actions and ability to follow commands related to the oral phase of swallowing. Results For early stage dementia, all food consistencies were considered safe except for mixed consistencies, large volumes of thin liquids and jelly, while the safest consistencies to use with the late stage dementia cases for quality of life and pleasurable feeds were thickened liquids and jelly consistency. Conclusion Oropharyngeal dysphagia profiles in early stage Alzheimer dementia is different from late stage Alzheimer dementia indicating that the mechanism behind dysphagia is different in the two groups.

Chewing and Swallowing Abilities of Persons Living With Dementia: A Systematic Review of Psychometric Properties of Instruments

“…The test of masticating and swallowing solids ([TOMASS], Borders et al, 2021 ) was originally developed for use in patients with Parkinson’s disease. The Fiberoptic endoscopic examination of swallowing (FEES; Langmore et al, 2007 ; Leder et al, 2009 ; Rösler et al, 2015 ; Sheikhany et al, 2019 ; Suiter & Leder, 2007 ; Ward et al, 2020 ) was originally developed for patients whose level of dysphagia cannot be examined with traditional video-fluoroscopic method. For the remaining 14 instruments, the target populations in the original developer’s scholarly records could not be specified because information related to the development process, or the full texts of the developer’s records was not available.…”