Objective: To determine when individuals with Parkinson disease (PD) perceive impairment of swallowing as it relates to time since diagnosis. 

Background: Dysphagia, and particularly silent aspiration, are known to exist in individuals with PD.  Reduced coordination, range of motion and accuracy of oral motor movements contribute to delayed initiation of the oral phase of swallowing and impaired timing of the pharyngeal swallow. To date it is unclear when, during the progression of PD, dysphagia begins.  The aim of this study was to determine the relationship between individual perception of dysphagia via the Dysphagia Handicap Index (DHI), a self-reported patient outcomes measure, and time since diagnosis of PD.

Methods: One hundred eighty three patients with Parkinson’s disease and no diagnosis of cognitive impairment, other neurological impairment or head and neck surgery completed the DHI.  Of the participants, 77 (42%) were female and 106 (58%) were male.  The mean age was 70.3 years with a range of 35 to 93 years.  The mean duration of PD was 5.7 years with a range of 0 to 25 years.  The patients were divided into three groups based on their duration of PD; 0-4 years (n=87, 48%), 5-9 years (n=70, 38%) and 10+ years (n=26, 14%).  Demographic and DHI information were compared among these three duration groups using chi-squared tests (gender), analysis of variance (ANOVA) methods (age and DHI scores) and Wilcoxon two sample tests (self-severity score).  Since all three pairwise comparisons of duration were of interest, an alpha level of 0.05 was used for all comparisons.  No adjustments were made for multiple comparisons. 

Results: There were no significant differences in gender distribution or age among the three PD duration groups.  Also, there were no significant differences among the duration groups for the physical score.  However, the differences between the longest duration (10+ years) and the other two duration groups (0-4 years and 5-9 years) were significant for emotional (0.013, 0.003), functional ( 0.009, 0.006) and total score sub-sets of the DHI (0.017, 0.007), as well as for the self-severity score (0.004, 0.006).

Conclusions: Self-perception of the emotional and functional handicapping effects of dysphagia in individuals with PD becomes significantly worse with longer duration of disease. 

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MDS Abstracts - https://www.mdsabstracts.org/abstract/self-perception-of-dysphagia-in-parkinson-disease/