A randomized study of three interventions for aspiration of thin liquids in patients with dementia or Parkinson's disease.
OBJECTIVE
This study was designed to identify which of 3 treatments for aspiration on thin liquids-chin-down posture, nectar-thickened liquids, or honey-thickened liquids-results in the most successful immediate elimination of aspiration on thin liquids during the videofluorographic swallow study in patients with dementia and/or Parkinson's disease.


METHODS
This randomized clinical trial included 711 patients ages 50 to 95 years who aspirated on thin liquids as assessed videofluorographically. All patients received all 3 interventions in a randomly assigned order during the videofluorographic swallow study.


RESULTS
Immediate elimination of aspiration on thin liquids occurred most often with honey-thickened liquids for patients in each diagnostic category, followed by nectar-thickened liquids and chin-down posture. Patients with most severe dementia exhibited least effectiveness on all interventions. Patient preference was best for chin-down posture followed closely by nectar-thickened liquids.


CONCLUSIONS
To identify best short-term intervention to prevent aspiration of thin liquid in patients with dementia and/or Parkinson's disease, a videofluorographic swallow assessment is needed. Evidence-based practice requires taking patient preference into account when designing a dysphagic patient's management plan. The longer-term impact of short-term prevention of aspiration requires further study.
Logemann
Jeri A
JA
Department of Communication Sciences and Disorders, Northwestern University, 2240 Campus Drive, #3-358, Evanston, IL 60208, USA. j-logemann@northwestern.edu
Gensler
Gary
G
Robbins
Joanne
J
Lindblad
Anne S
AS
Brandt
Diane
D
Hind
Jacqueline A
JA
Kosek
Steven
S
Dikeman
Karen
K
Kazandjian
Marta
M
Gramigna
Gary D
GD
Lundy
Donna
D
McGarvey-Toler
Susan
S
Miller Gardner
Patricia J
PJ
D000368:Aged; D000369:Aged, 80 and over; D003679:Deglutition; D003680:Deglutition Disorders / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy*; D003704:Dementia / Q000150:complications*; D005260:Female; D005471:Fluoroscopy; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010300:Parkinson Disease / Q000150:complications*; D011015:Pneumonia, Aspiration / Q000517:prevention & control*; D011187:Posture; D012996:Solutions
D012996:Solutions