The Association Between Dysphagia Symptoms, DIGEST Scores, and Severity Ratings in Individuals with Parkinson’s Disease

Noorani, Mehak; Bolognone, Rachel K.; Graville, Donna J.; Palmer, Andrew D.

doi:10.1007/s00455-023-10555-4

Cited by 5 publications

(2 citation statements)

References 56 publications

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“…The results of our study are largely consistent with a VFSS study on 20 PD patients in which the DIGEST was used to investigate associations with dysphagia symptoms and global severity ratings of dysphagia [18]. Consistent with the results of our study, an association between the DIGEST (total score and efficiency subscore) and the FOIS was shown.…”

Section: Discussionsupporting

confidence: 91%

“…Although the DIGEST has been used in neurological patients in individual studies (e.g. PD [18], amyotrophic lateral sclerosis [19,20], and oculopharyngeal muscular dystrophy [21]), no comprehensive validation study has been conducted in this patient population, and to our knowledge, no endoscopic study has used the DIGEST-FEES. Specifically, PD patients may have unique dysphagia mechanisms such as oropharyngeal freezing [22], oropharyngeal bradykinesia [23], alterations in respiratory-swallow coordination [24,25], lingual pressure dysfunction [26][27][28] or decreased capacity for cognitive cortical processing [29].…”

Section: Introductionmentioning

confidence: 99%

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Validation of the DIGEST-FEES as a Global Outcome Measure for Pharyngeal Dysphagia in Parkinson’s Disease

Labeit,

Lapa,

Muhle

et al. 2023

Dysphagia

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Flexible Endoscopic Evaluation of Swallowing (FEES) is one of two diagnostic gold standards for pharyngeal dysphagia in Parkinson's disease (PD), however, validated global outcome measures at the patient level are widely lacking. The Dynamic Imaging Grade of Swallowing Toxicity for Flexible Endoscopic Evaluation of Swallowing (DIGEST-FEES) represents such an outcome measure but has been validated primarily for head and neck cancer collectives. The objective of this study was, therefore, to investigate the validity of the DIGEST-FEES in patients with PD. Content validity was evaluated with a modified Delphi expert survey. Subsequently, 66 FEES videos in PD patients were scored with the DIGEST-FEES. Criterion validity was determined using Spearman's correlation coefficient between the DIGEST-FEES and the Penetration-Aspiration Scale (PAS), the Yale-Residue-Rating-Scale, the Functional-Oral-Intake-Scale (FOIS), and the swallowing-related Unified-Parkinson-Disease-Rating-Scale (UPDRS) items. Inter-rater reliability was determined using 10 randomly selected FEES-videos examined by a second rater. As a result, the overall DIGEST-FEES-rating exhibited significant correlations with the Yale-Valleculae-Residue-Scale (r = 0.84; p < 0.001), the Yale-Pyriform-Sinus-Residue-Scale (r = 0.70; p < 0.001), the FOIS (r = − 0.55, p < 0.001), and the UPDRS-Swallowing-Item-Score (r = 0.42, p < 0.001). Further, the DIGEST-FEES-safety subscore correlated with the PAS (r = 0.63, p < 0.001). Inter-rater reliability was high for the overall DIGEST-FEES rating (quadratic weighted kappa of 0.82). Therefore, DIGEST-FEES is a valid and reliable score to evaluate overall pharyngeal dysphagia severity in PD. Nevertheless, the modified Delphi survey identified domains where DIGEST-FEES may need to be specifically adapted to PD or neurological collectives in the future.

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Section: Discussionsupporting

confidence: 91%

Section: Introductionmentioning

confidence: 99%

Validation of the DIGEST-FEES as a Global Outcome Measure for Pharyngeal Dysphagia in Parkinson’s Disease

Labeit,

Lapa,

Muhle

et al. 2023

Dysphagia

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Prevalence of Dysphagia and Risk of Malnutrition in Elderly Living in Nursing Homes

Engberg,

Rångevall,

Eriksson

et al. 2024

Dysphagia

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Swallowing difficulties commonly co-occur with malnutrition in the elderly. However, there is no consensus on which assessment tools to use, and thus reported prevalence varies. The aim of this study was to survey the prevalence of dysphagia and risk of malnutrition in elderly people in nursing homes, evaluate the possible associations between swallowing function and malnutrition and survey whether there were associations between self-perceived function and the results of a screening of dysphagia. A total of 35 residents (aged 67–100 years old) without serious cognitive impairment in the general wards of two nursing homes in Gothenburg were investigated. Swallowing ability was assessed with the Gugging Swallowing Screen (GUSS) test, self-rated swallowing ability with the 4QT and the Swedish Eating Assessment Tool-10 (S-EAT-10) and risk of malnutrition with the Minimal Eating Observation and Nutrition Form-Version 2 (MEONF-II). Eleven participants (31.4%) exhibited dysphagia according to the GUSS and 10 participants (29.4%) showed moderate or high risk of malnutrition. In total 16 (46%) participants reported abnormal swallowing on 4QT and 14 (40%) participants reported abnormal swallowing on S-EAT-10. However, less than half of these had dysphagia according to the GUSS. No association was found between swallowing ability measured by the GUSS and risk of malnutrition, although a tendency towards a weak association was noted, or self-rated swallowing ability measured by the 4QT and S-EAT-10. The study found that approximately one-third of the tested participants presented with signs of dysphagia as measured with the screening instrument GUSS, even though only a few were known to have any difficulties prior to testing. This highlights that dysphagia is probably more prevalent than patients themselves and caregivers are aware of, thus, screening is of importance, to enable safer nutritional intake.

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Reliability and Confidence of Dynamic Imaging Grade of Swallowing Toxicity (DIGEST) Rating Among Research and Clinical Speech Pathologists Before and After Implementation of a Training Manual: A Multi-site Study

Barbon,

Warneke,

Ledger

et al. 2024

Dysphagia

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The Association Between Dysphagia Symptoms, DIGEST Scores, and Severity Ratings in Individuals with Parkinson’s Disease

Cited by 5 publications

References 56 publications

Validation of the DIGEST-FEES as a Global Outcome Measure for Pharyngeal Dysphagia in Parkinson’s Disease

Validation of the DIGEST-FEES as a Global Outcome Measure for Pharyngeal Dysphagia in Parkinson’s Disease

Prevalence of Dysphagia and Risk of Malnutrition in Elderly Living in Nursing Homes

Reliability and Confidence of Dynamic Imaging Grade of Swallowing Toxicity (DIGEST) Rating Among Research and Clinical Speech Pathologists Before and After Implementation of a Training Manual: A Multi-site Study

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