Objective: To describe the prevalence of sialorrhea and drooling in Parkinson’s Disease (PD) patients of the COPARK study, to find factors associated to these conditions, and to assess its impact on Health-related Quality of life (HRQoL).

Background: Sialorrhea and drooling are bothersome features of PD.

Method: We studied 671 ambulatory non-demented PD patients and 177 sex- and age-matched outpatients from the COPARK database. Patients and controls were examined by a neurologist using a standardized and structured interview. For this study, we defined: a) “sialorrhea” as an excess of saliva in the buccal cavity (i.e., UPDRS item #6 “Salivation”= 1 or 2); b) “drooling” as saliva excess leading to drooling, potentially requiring treatment (i.e., UPDRS item #6= 3 or 4). These definitions were applied to “ON” and “OFF” conditions. SCOPA-Aut item #2 “drooling” score was also available for a subgroup of PD and controls. HRQoL was assessed by the PDQ-39 and SF-36 scales. We also analyzed 24-months follow-up data, which was only available for 401/683 PD patients (59%).

Results: In PD, sialorrhea and drooling were present in 237 out of 671 (35.3%) and 17/671 (2.5%) cases in the “ON” condition. UPDRS item #6 score was significantly worse in the “OFF” condition as compared to the “ON” condition (0.87±0.07 vs 0.53±0.05, n=229, p<0.001). SCOPA-Aut item #2 was significantly higher in PD patients compared to controls (0.70±0.06 n=576 vs 0.30±0.04 n=146, p<0.001). The multivariate ordinal regression identified the following factors significantly and independently related to sialorrhea and drooling in the “ON” condition: female gender (OR, 95%CI= 0.42, 0.29-0.59), PD duration > 5 years (1.8,1.3-2.5), symptomatic OH (2.0,1.2-3.3), UPDRS II+III > 26 (2.5,1.7-3.5), and dysphagia (2.5,1.6-3.7). Additionally, ordinal logistic regression identified social support and communication from the PDQ-39 as the only HRQoL subdomains significantly associated with sialorrhea and drooling. UPDRS #6 scores in the “ON” condition increased significantly after 24-months (p<0.05). Differences in the “OFF” conditions were not significantly different.

Conclusion: Sialorrhea and drooling are more frequent in PD than in controls, and are aggravated in the “OFF” condition. Interestingly, dysautonomia was also related to these conditions, besides the well-known relationship with dysphagia and disease severity. These conditions significantly worsened HRQoL.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/prevalence-impact-and-factors-associated-with-excessive-buccal-saliva-in-the-copark-database/