Dysphagia for Medication Common Among Patients With Parkinson Disease

Dysphagia for medication was present in more than two-thirds of patients with Parkinson disease (PD) in a study published in npj Parkinson’s Disease.

“Dysphagia for medication is common in PD and can affect both swallowing efficiency, ie the ability to swallow medications completely, and swallowing safety, ie the ability to protect the airway,” wrote corresponding author Bendix Labeit, MD, of University Hospital Muenster in Germany, and study coauthors.

The study included 66 patients with Parkinson’s disease in Germany who underwent flexible endoscopic evaluation of swallowing, which included swallowing tablets and capsules of various sizes.

Nearly 70% of patients demonstrated difficulty swallowing medication at some level, according to the study. Patients tended to be able to swallow capsules of any size more efficiently than tablets.

In a linear regression model, the presence of dysphagia significantly predicted motor complications in patients per the Movement Disorder Society Unified Parkinson’s Disease Rating Scale (MDS-UPDRS) part IV.

A score of 1 or higher on MDS-UPDRS items related to swallowing (items 2.3 and 2.4) may predict dysphagia for medication and signals the need for a more detailed investigation in patients, the study found.

“Dysphagia for medication should be evaluated independently of normal bolus oropharyngeal dysphagia, as the 2 moderately correlate, but may differ substantially in individual cases,” wrote researchers. “If there is evidence of impaired swallowing or food intake in the MDS-UPDRS items 2.3 and 2.4, further diagnostic workup is advised, as this is a predictor of dysphagia for medication with moderate sensitivity and specificity.”

Reference:
Labeit B, Berkovich E, Claus I, et al. Dysphagia for medication in Parkinson's disease. NPJ Parkinsons Dis. 2022;8(1):156. doi: 10.1038/s41531-022-00421-9