Characteristics of eating and swallowing problems in patients who have dementia with Lewy bodies.
BACKGROUND
Eating problems occur frequently in patients with dementia, and almost half of all patients with Parkinson's disease have such problems. It has therefore been assumed that eating problems are also common in patients with dementia with Lewy bodies (DLB). However, few systematic studies have investigated eating problems in DLB patients. The aim of this study was to clarify the frequency and characteristics of eating problems in patients with DLB.


METHODS
We examined 29 consecutive patients with DLB and 33 with Alzheimer's disease (AD) in terms of age, sex, education, Mini-mental State Examination, clinical dementia rating (CDR), neuropsychiatric inventory (NPI), Unified Parkinson disease rating scale (UPDRS), fluctuations in cognition, and usage of neuroleptic drugs / antiparkinsonian drugs. We employed a comprehensive questionnaire comprising 40 items and compared the scores between the two groups.


RESULTS
DLB patients showed significantly higher scores than AD patients for "difficulty in swallowing foods," "difficulty in swallowing liquids," "coughing or choking when swallowing," "taking a long time to swallow," "suffering from sputum," "loss of appetite," "need watching or help," and "constipation". Only the UPDRS score significantly affected the scores for "difficulty in swallowing foods," "taking a long time to swallow" and "needs watching or help" score, whereas only the NPI score affected the score for "loss of appetite." The scores for UPDRS, NPI and CDR significantly affected the scores for "difficulty in swallowing liquids." No significant independent variables affected the scores for "coughing or choking when swallowing," "suffering from sputum" and "constipation."


CONCLUSIONS
Although DLB patients show many eating problems, the causes of each problem vary, and the severity of dementia or Parkinsonism is not the only determinant.
Shinagawa
Shunichiro
S
Department of Psychiatry, Jikei University School of Medicine, Tokyo, Japan. shinagawa@jikei.ac.jp
Adachi
Hiroyoshi
H
Toyota
Yasutaka
Y
Mori
Takaaki
T
Matsumoto
Izumi
I
Fukuhara
Ryuji
R
Ikeda
Manabu
M
D000368:Aged; D000369:Aged, 80 and over; D017028:Caregivers / Q000523:psychology / Q000706:statistics & numerical data; D003072:Cognition Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D015897:Comorbidity; D003680:Deglutition Disorders / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology; D001068:Feeding and Eating Disorders / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology; D005260:Female; D005518:Food Preferences; D015577:Geriatric Assessment; D006801:Humans; D020961:Lewy Body Disease / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology; D008297:Male; D009483:Neuropsychological Tests; D010300:Parkinson Disease / Q000175:diagnosis / Q000523:psychology; D015995:Prevalence; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires