The mediator effect of cognition on the relationship between brain lesion location and dysphagia in patients with stroke: Applying a structural equation model

Dehaghani, Shiva Ebrahimian; Yadegari, Fariba; Asgari, Ali; Bagheri, Zahra

doi:10.1111/joor.12722

Cited by 16 publications

(17 citation statements)

References 33 publications

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“…The high incidence of silent aspiration may be due to poor sensation, which can be suspected in many patients. Impaired cognition and awareness were common in these patients and probably had an impact on swallowing function, as seen in previous studies [ 32 , 33 ].…”

Section: Discussionsupporting

confidence: 70%

Characterization of dysphagia and laryngeal findings in COVID-19 patients treated in the ICU—An observational clinical study

et al. 2021

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Background Dysphagia appears to be common in patients with severe COVID-19. Information about the characteristics of dysphagia and laryngeal findings in COVID-19 patients treated in the intensive care unit (ICU) is still limited. Objectives The aim of this study was to evaluate oropharyngeal swallowing function and laryngeal appearance and function in patients with severe COVID-19. Method A series of 25 ICU patients with COVID-19 and signs of dysphagia were examined with fiberendoscopic evaluation of swallowing (FEES) during the latter stage of ICU care or after discharge from the ICU. Swallowing function and laryngeal findings were assessed with standard rating scales from video recordings. Results Pooling of secretions was found in 92% of patients. Eleven patients (44%) showed signs of silent aspiration to the trachea on at least one occasion. All patients showed residue after swallowing to some degree both in the vallecula and hypopharynx. Seventy-six percent of patients had impaired vocal cord movement. Erythema of the vocal folds was found in 60% of patients and edema in the arytenoid region in 60%. Conclusion Impairment of oropharyngeal swallowing function and abnormal laryngeal findings were common in this series of patients with severe COVID-19 treated in the ICU. To avoid complications related to dysphagia in this patient group, it seems to be of great importance to evaluate the swallowing function as a standard procedure, preferably at an early stage, before initiation of oral intake. Fiberendoscopic evaluation of swallowing is preferred due to the high incidence of pooling of secretion in the hypopharynx, silent aspiration, and residuals. Further studies of the impact on swallowing function in short- and long-term in patients with COVID-19 are warranted.

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Section: Discussionsupporting

confidence: 70%

Characterization of dysphagia and laryngeal findings in COVID-19 patients treated in the ICU—An observational clinical study

et al. 2021

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“…With regard to disease phase, three articles reported an association between swallowing disorders and the acute phase 6,19,22 . Meta‐analysis of this relationship yielded an OR of 3.23 and 95%CI of 2.33–4.48, indicating a significant association.…”

Section: Resultsmentioning

confidence: 99%

“…Nine studies used the Mini‐Mental Status Examination (MMSE) to assess cognitive disorder, 7,10,16–22 and one study used the Montreal Cognitive Assessment 6 …”

Section: Resultsmentioning

confidence: 99%

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Association between swallowing disorders and cognitive disorders in adults: a systematic review and meta‐analysis

2021

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There is no consensus regarding the association between dysphagia and cognition. The aim of this study was to quantitatively and qualitatively analyze the available evidence on the direction and strength of the association between dysphagia and cognition. PubMed, Scopus, Embase, and Web of Science were searched for studies about the association between dysphagia and cognition. A random effects model was used to determine weighted odds ratios and 95% confidence intervals. Sensitivity analysis was performed to determine the impact of each individual study on the pooled results. A total of 1427 participants showed that some cognitive disorders were significantly associated with dysphagia (odds ratio = 3.23, 95% confidence interval: 2.33–4.48). The association between cognition and swallowing disorders suggests that multiple neuroanatomical systems are involved in these two functions.

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“…In this regard, Ebrahimian et al found that cognitive deficits played a role in dysphagia occurrence after stroke. Considering the varying nature of swallowing problems in patients with cognitive disorders and stroke-induced dysphagia (6), the symptoms of dysphagia may encompass irregular meal times to progressive weight loss. On the other hand, in primary dysphagia, symptoms include longer feeding periods, multiple swallows, smaller bites, and prolonged chewing (7).…”

Section: Introductionmentioning

confidence: 99%

Evaluating the Role of Cognitive Function in the Occurrence of Dysphagia in Patients with Dementia: A Study Protocol

Dehaghani

Jafari

Lotfi

2021

Middle East J Rehabil Health Stud

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Background: Dysphagia is commonly seen in patients with severe dementia and increases the risk of mortality. The nature of the swallowing disorders caused by cognitive difficulties differs from post-stroke dysphagia. The relationship between dysphagia and cognitive function is vital for determining the best diagnostic and treatment plan for dementia-associated dysphagia. Objectives: In the current research, we suggest a model to identify the role of cognitive function in the occurrence of dysphagia in dementia patients. Methods: Ninety patients with dementia will be recruited in this experimental research. Dysphagia is screened and confirmed using the albertinen dementia dysphagia screening (ADDS) and the video fluoroscopic swallowing exam (VFSE). Also, cognitive function will be assessed by the mini-mental status examination (MMSE). The information related to dysphagic and non-dysphagic patients will be entered into structural equation models. Finally, the direct and indirect (i.e., via cognition) relationships between brain lesions and dysphagia will be evaluated. Results: The present study will provide evidence regarding the role of cognitive function in dysphagia occurrence in individuals with dementia in a structural equation model. Also, differences in performance (presence or absence of movement disorders) will be assessed in different types of dementia using another model. Conclusions: Moreover, the relative sensitivity of various cognitive domains to dysphagia will be determined in a separate model.

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The mediator effect of cognition on the relationship between brain lesion location and dysphagia in patients with stroke: Applying a structural equation model

Cited by 16 publications

References 33 publications

Characterization of dysphagia and laryngeal findings in COVID-19 patients treated in the ICU—An observational clinical study

Characterization of dysphagia and laryngeal findings in COVID-19 patients treated in the ICU—An observational clinical study

Association between swallowing disorders and cognitive disorders in adults: a systematic review and meta‐analysis

Evaluating the Role of Cognitive Function in the Occurrence of Dysphagia in Patients with Dementia: A Study Protocol

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