Objective: To evaluate the diagnostic accuracy of bedside screening tests, mainly established for stroke patients, to detect Parkinson’s Disease (PD) related dysphagia.

Background: Dysphagia is a common symptom in Parkinson’s disease (PD), which occurs mainly at the late stage of the disease. Its occurrence is associated with higher mortality, particularly due to the risk of aspiration and subsequent chest infections. Validated screening tests to identify PD patients at risk of dysphagia who would benefit from further instrumental testing are still lacking.

Method: 33 PD patients recruited from a single centre were classified as dysphagic or non-dysphagic based on the gold-standard objective instrumental testing with fiberendoscopic evaluation of swallowing (FEES). A speech-language therapist blinded to the FEES results assessed all patients using bedside non-instrumental screening tests and questionnaires: SWAL-QoL, Drooling Severity and Frequency Scale, Paramatta Hospital’s Assessment of Dysphagia, Functional Oral Intake Scale, Any 2, and 150ml water swallowing test. We compared the diagnostic accuracy of bedside screening tests to detect dysphagia confirmed by FEES in PD.

Results: 9/33 PD patients were classified as dysphagic. Typical FEES findings in dysphagic cases were pharyngeal food residuals after swallowing and laryngeal penetration. The Drooling Severity and Frequency scale (area under the receiver operating characteristics curve (AUC): 0.83 (CI: 0.66-1.00); p=0.004) and the Paramatta Hospital’s Assessment of Dysphagia (AUC: 0.766 (CI: 0.56-0.98); p=0.020) had the highest accuracy to discriminate between PD patients with and without dysphagia.

Conclusion: We identified simple bedside screening test that might be useful in identifying PD patients at risk of dysphagia. Drooling could be a typical indicator of dysphagia in PD and cases with drooling should be further evaluated using instrumental testing.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/evaluation-of-bedside-screening-tests-to-detect-dysphagia-in-parkinsons-disease/