title: Swallowing impairment and pulmonary dysfunction in Parkinson's disease: the silent threats.
abstract: BACKGROUND
  Swallowing disorders and respiratory impairment are frequent in Parkinson's disease (PD) patients, and aspiration pneumonia remains the leading cause of death among these subjects.
  
  
  OBJECTIVE
  The objective of this study was to investigate whether there is an association between pulmonary impairment and swallowing dysfunction in PD patients.
  
  
  METHODS
  A cross-sectional study with a comparison group was conducted with PD patients. Subjects were submitted to demographic questionnaires and underwent spirometric and videofluorographic assessments. Significance level was considered at 95% (p<0.05).
  
  
  RESULTS
  Among 35 PD patients, 40% presented with swallowing complaints. However, 22% of the clinically asymptomatic patients presented airway food penetration when submitted to videofluoroscopy. In 20% of PD patients material entered the airways and there was contact with the vocal folds in 7%. However, there was an efficient cleaning with residue deglutition in almost all patients. No penetration/aspiration was detected among the controls. Respiratory parameters were below the normal predicted values in PD patients when compared to the healthy controls.
  
  
  CONCLUSIONS
  These data suggest an association between pulmonary dysfunction and swallowing impairment in PD patients; even in patients without swallowing complaints, impaired pulmonary function can be detected.
authors.affiliation: Division of Neurology and Epidemiology, Federal University of Bahia, Brazil. Electronic address: menezes.lari@gmail.com.
authors.forename: Larissa
authors.initials: L
authors.lastname: Monteiro
authors.affiliation: Health Sciences Institute, Federal University of Bahia, Brazil.
authors.forename: Adelmir
authors.initials: A
authors.lastname: Souza-Machado
authors.affiliation: Division of Neurology and Epidemiology, Federal University of Bahia, Brazil.
authors.forename: Patrícia
authors.initials: P
authors.lastname: Pinho
authors.affiliation: Division of Neurology and Epidemiology, Federal University of Bahia, Brazil.
authors.forename: Marília
authors.initials: M
authors.lastname: Sampaio
authors.affiliation: Division of Neurology and Epidemiology, Federal University of Bahia, Brazil.
authors.forename: Ana Caline
authors.initials: AC
authors.lastname: Nóbrega
authors.affiliation: Division of Neurology and Epidemiology, Federal University of Bahia, Brazil.
authors.forename: Ailton
authors.initials: A
authors.lastname: Melo
mesh_terms: D000368:Aged; D003430:Cross-Sectional Studies; D003680:Deglutition Disorders / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology*; D005260:Female; D005541:Forced Expiratory Volume / Q000502:physiology; D006801:Humans; D008171:Lung Diseases / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology*; D016037:Single-Blind Method
keywords: Deglutition; Dysphagia; Parkinson's disease; Pulmonary function; Respiratory dysfunction; Swallowing