title: Dysphagia in stroke, neurodegenerative disease, and advanced dementia.
abstract: Aspiration risk from dysphagia increases with central and peripheral neurologic disease. Stroke, microvascular ischemic disease, a spectrum of neurodegenerative diseases, and advancing dementia all have unique aspects. However, there are distinct commonalities in this population. Increasing nutritional requirements to stave off oropharyngeal muscular atrophy and a sedentary lifestyle further tax the patient's abilities to safely swallow. This article reviews stroke, muscular dystrophy, myasthenia gravis, multiple sclerosis, amyotrophic lateral sclerosis, Parkinson's disease, and advanced dementia. Approaches to screening and evaluation, recognizing sentinel indicators of decline that increase aspiration risk, and options for managing global laryngeal dysfunction are also presented.
authors.affiliation: Department of Otolaryngology Head & Neck Surgery, Eugen Grabscheid MD Voice Center, The Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1189, New York, NY 10029, USA. Electronic address: kenneth.altman@mountsinai.org.
authors.forename: Kenneth W
authors.initials: KW
authors.lastname: Altman
authors.forename: Amanda
authors.initials: A
authors.lastname: Richards
authors.forename: Leanne
authors.initials: L
authors.lastname: Goldberg
authors.forename: Steven
authors.initials: S
authors.lastname: Frucht
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: McCabe
mesh_terms: D000367:Age Factors; D003680:Deglutition Disorders / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000523:psychology / Q000628:therapy; D003704:Dementia / Q000150:complications*; D019468:Disease Management; D006801:Humans; D016743:Mental Competency; D009422:Nervous System Diseases / Q000150:complications*; D009752:Nutritional Status; D053120:Respiratory Aspiration / Q000517:prevention & control*; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index; D013284:Stomatognathic System / Q000503:physiopathology; D020521:Stroke / Q000150:complications*
keywords: Dementia; Dysphagia; Multiple sclerosis; Muscular dystrophy; Myasthenia gravis; Neurodegenerative disease; Stroke