Simple clinical tests may predict severe oropharyngeal dysphagia in Parkinson's disease.
OBJECTIVE
To determine if simple screening tests can predict severe oropharyngeal dysphagia in subjects with Parkinson's disease.


METHODS
Forty-five subjects (26 females) of average age 75 (range: 65-94) who were classified as Modified Hoehn and Yahr stages 2 to 5 were enrolled. The presence of oropharyngeal dysphagia was assessed by a symptom questionnaire, 50 ml water swallowing test and videofluroscopic swallowing study.


RESULTS
Six of the subjects had severe oropharyngeal dysphagia in videofluroscopic swallowing study. Subsequent multivariate analysis showed that 3 factors could independently predict severe oropharyngeal dysphagia. These included higher Modified Hoehn and Yahr stage (P = 0.042), low Body mass index (P = 0.014), and increased difficulty in keeping food or drink in the mouth (P = 0.047). The regression model had a positive predictive power of 96% (sensitivity: 83.3%, specificity: 97.4%).


CONCLUSIONS
A combination of 3 simple clinical parameters may be useful for screening for severe oropharyngeal dysphagia as shown radiologically in subjects with Parkinson's disease.
Lam
Kuen
K
Department of Medicine and Geriatrics, Caritas Medical Centre, Hong Kong. lam_kuen@yahoo.com.hk
Lam
Florence Kwai Yi
FK
Lau
Kwok Kwong
KK
Chan
Yiu Kay
YK
Kan
Elaine Yee Ling
EY
Woo
Jean
J
Wong
Fat Kee
FK
Ko
Andrew
A
D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D003680:Deglutition Disorders / Q000175:diagnosis*; D005260:Female; D006723:Hong Kong; D006801:Humans; D008297:Male; D008403:Mass Screening; D009460:Neurologic Examination; D010300:Parkinson Disease / Q000175:diagnosis*; D011446:Prospective Studies; D012307:Risk Factors