title: Swallowing dysfunction and autonomic nervous system dysfunction in Alzheimer's disease: a scoping review of the evidence.
abstract: OBJECTIVE
  To describe, synthesize, and interpret literature on swallowing impairment (dysphagia) and autonomic nervous system (ANS) dysfunction in Alzheimer's disease (AD) and to identify gaps in the existing literature.
  
  
  METHODS
  Scoping review of literature covering several study designs.
  
  
  METHODS
  Literature review.
  
  
  METHODS
  Individuals with AD.
  
  
  METHODS
  Systematic searches of the PubMed, EBSCOhost, PsychINFO, Cochrane, EMBASE, and Scopus databases were conducted. Literature was identified and organized into categories. Studies were then evaluated using the Oxford Centre for Evidence-Based Medicine Levels of Evidence criteria. After evaluation, the literature was synthesized to form conclusions and identify knowledge gaps.
  
  
  RESULTS
  Ninety-five articles met the study criteria and were included in the review. Thirty-one studies examining dysphagia in AD provide preliminary evidence on the prevalence, nature, and treatment of dysphagia in AD; knowledge gaps were identified with respect to demographic characteristics, nature of dysphagia, functional significance, assessment, treatment, and underlying mechanisms of dysphagia in AD. Sixty-four studies of ANS dysfunction in AD were reviewed, of which 49 identified at least one variable reflecting ANS dysfunction in AD. Knowledge gaps were identified related to demographics, functional significance, and underlying neural mechanisms. No studies were found that examined both dysphagia and ANS dysfunction in AD.
  
  
  CONCLUSIONS
  Current evidence indicates that swallowing impairment, as well as ANS dysfunction, may occur in AD. Potential relationships between dysphagia and ANS dysfunction in AD have not been examined. Future research should explore the possibility that swallowing and ANS dysfunction in AD are related.
authors: Graduate Program of Health and Rehabilitation Sciences, Western University, London, Ontario, Canada.
authors: Rebecca H
authors: RH
authors: Affoo
authors: Brescia College, Western University, London, Ontario, Canada.
authors: Norine
authors: N
authors: Foley
authors: Department of Speech, Language and Hearing Sciences, University of Florida, Gainsville, Florida.
authors: John
authors: J
authors: Rosenbek
authors: School of Kinesiology, Western University, London, Ontario, Canada.|Department of Physiology and Pharmacology, Western University, London, Ontario, Canada.
authors: J
authors: J
authors: Kevin Shoemaker
authors: Graduate Program of Health and Rehabilitation Sciences, Western University, London, Ontario, Canada.|Department of Physiology and Pharmacology, Western University, London, Ontario, Canada.|Department of Otolaryngology, Western University, London, Ontario, Canada.|School of Communication Sciences and Disorders, Western University, London, Ontario, Canada.
authors: Ruth E
authors: RE
authors: Martin
mesh_terms: D000544:Alzheimer Disease / Q000503:physiopathology*; D001341:Autonomic Nervous System / Q000503:physiopathology*; D003680:Deglutition Disorders / Q000503:physiopathology* / Q000628:therapy*; D006801:Humans