EVALUATION OF SWALLOWING AND NUTRITION STATUS IN PARKINSON’S DISEASE

Year 2025, Volume: 8 Issue: 1, 42 - 46, 04.03.2025

Erdi Şahin , Büşra Zorlu Üçüncüoğlu , Bedia Samancı , Başar Bilgiç , Haşmet Hanağası

https://doi.org/10.26650/JARHS2025-1538644

Abstract

Objective: One of the significant issues in Parkinson’s disease (PD) is the risk of malnutrition due to taste and smell alterations at the early stages and the later onset of dysphagia. Dysphagia can cause complications like aspiration, which may accelerate the progression of the disease. Our study evaluates swallowing difficulties and nutritional status using objective questionnaires in PD patients who did not report any issues with swallowing or feeding.

Material and Methods: Forty patients had undergone swallowing and feeding-related tests during their outpatient visits.

Results: There was no significant relationship between the Gugging Swallow Screening (GUSS) score and body mass index (BMI), whereas there was a positive correlation between BMI and Mini Nutritional Assessment-Short Form (MNA-SF) scores (r=0.489, p=0.001). Additionally, there was a positive correlation between GUSS and MNA-SF scores (r=0.397, p=0.011).

Conclusion: In this study, various degrees of swallowing and feeding disorders were identified in most of our patients who did not complain of such issues. Therefore, it is considered crucial to conduct objective assessments of swallowing and feeding during each visit for PD patients, even if not mentioned by the patients or their caregivers. This early detection of dysphagia and malnutrition risk and taking necessary measures is believed to be important for ensuring proper management.

Keywords

Parkinson’s disease, swallowing, nutrition, neurodegenerative disease

PARKİNSON HASTALIĞINDA YUTMA VE BESLENME DURUMUNUN DEĞERLENDİRİLMESİ

Abstract

Amaç: Parkinson hastalığında, en önemli problemlerden biri tat ve koku değişikliğine bağlı malnütrisyon riski ve ilerleyen dönemde ortaya çıkan disfajidir. Disfaji aspirasyon gibi komplikasyonlara neden olabilmekte, has talığın ilerleyişini hızlandırmaktadır. Bu çaışmanın amacı, kendisi ve bakım vereni, yutma ve beslenme bozukluğundan yakınmayan Parkinson hasta larında yutma güçlüğü ve beslenme durumunun değerlendirilmesidir.

Gereç ve Yöntemler: Poliklinik başvuruları esnasında yutma ve beslenme ile ilgili testleri yapılmış olan 40 hasta çalışmaya dâhil edilmiştir.

Bulgular: Hastaların BKİ ile GUSS skoru arasında anlamlı ilişki gözlenmez ken, BKİ ile MNA-SF skorları arasında pozitif korelasyon gözlendi (r=0,489, p=0,001). Ayrıca GUSS ve MNA-SF skorlarının da pozitif korelasyon göster diği bulundu (r=0,397, p=0,011).

Sonuç: Bu çalışmada yakınması olmayan hastaların büyük kısmında çeşitli derecelerde yutma ve beslenme bozuklukları saptanmıştır. Bu nedenle hasta ve yakınları tarafından dile getirilmese de Parkinson hastalarında her başvuruda yutma ve beslenme ile ilgili objektif değerlendirmelerin yapıl masının disfajinin ve malnütrisyon riskinin erkenden saptanması ve gerek li önlemlerin alınmasını sağlayacağından önemli olduğu düşünülmektedir.

Keywords

Parkinson hastalığı, yutma, nütrisyon, nörodejeneratif hastalık

References

• Gökçal E, Gür VE, Selvitop R, Babacan Yıldız G, Asil T. Motor and non-motor symptoms in Parkinson’s Disease: Effects on quality of life, Noro Pskiyatr Ars 2017;54(2):143-8. google scholar
• Chaudhuri KR, Martinez-Martin P, Schapira HVA, Stochhi F, Sethi K, Odin P et al. International multicenter pilot study of the first comprehensive self-completed nonmotor symptoms questionnaire for Parkinson’s disease: The NMSQuest study. Mov Disord 2006;21;7:916-23. google scholar
• Emre M, Hanağası H, Şahin H. Yazıcı J. Istanbul Faculty of Medicine Neurology Book Movement Disorders Chapter. Istanbul;Murat Emre 2019.p.301-67. google scholar
• Garcia-Ruiz PJ, Chaudhuri KR, Martinez-Martin P. Non-motor symptoms of Parkinson’s disease a review from the past. J Neurol Sci 2014;338:30-3. google scholar
• Turkish Neurology Society and Turkish Parkinson’s Disease Association Parkinson’s Disease and Movement Disorders Study Group. Ankara, Ayse Bora Tokcaer 2023.p.35-83. google scholar
• Chaudhuri KR, Healy DG, Schapira AH. Non-motor symptoms of Parkinson’s disease: Diagnosis and management. Lancet Neurol 2006;5:235-45. google scholar
• Naidu Y, Chaudhuri KR. Early Parkinson’s disease and non motor issues. J Neurol 2008;255:33-8. google scholar
• Chen H, Zhang SM, Schwarzschild MA, Hernan MA, Willett WC, Ascherio A. Obesity and the risk of Parkinson’s disease. Am J Epidemiol 2004;159(6);547-55. google scholar
• Aiello M, Eleopra R, Rumiati RI. Body weight and food intake in Parkinson’s disease. A review of the association to non-motor symptoms. 2015;84;04-211. google scholar
• Beyer PL, Palarino M, Michalenk D, Busenbark K, Koller W. Weight change and body composition in patients with Parkinson’s Disease. J Am Diet Assoc 1995;95;979-83. google scholar
• Barichella, M, Cereda E, Pezzoli G. Major nutritional issues in the management of Parkinson’s disease. Mov Disord 2009;24(13);1881-92. google scholar
• Foley NC, Marti RE, Salter KL, Teasell RW. A review of the relationship between dysphagia and malnutrition following stroke. J Rehabil Med 2009;41(9);707-13. google scholar
• Nozaki S, Saito T, Matsumura T, Miyai I, Kang J. Relationship between weight loss and dysphagia in patients with Parkinson’s disease. Rinsho Shinkeigaku 1999;39(10);1010-14. google scholar
• Hughes AJ, Daniel SE, Kilford L, Lees AJ. Accuracy of clinical daignosis of idiopathic Parkinson’s disease. A clinico-pathological study of 100 cases. J Neurol Neurosurg Psychiatry 1992;55:181-4. google scholar
• Trapl M, Enderle P, Nowotny M, Teuschl Y, Matz K, Dachenhausen A et al. Dysphagia bedside screening for acute-stroke patients: the Gugging Swallowing Screen. Stroke 2007;38(11);2948-52. google scholar
• Bauer JM, Vogl T, Wicklein S, Trogner J, Muhlberg W, Sieber CC. Comparison of the mini nutritional assessment, subjective global assessment, and nutritional risk screening (NRS 2002) for nutritional screening and assessment in geriatric hospital patients. Z Gerontol Geriatr 2005;38(5);322-7. google scholar
• Coelho M, Marti MJ, Tolosa E, Ferreira JJ, Valldeoriola F, Rosa M, et al. Late-stage Parkinson’s disease: the Barcelona and Lisbon cohort. J Neurol 2010;257(9):1524-32. google scholar
• Kalf JG, de Swart BJ, Bloem BR, Munneke M. Prevalence of oropharyngeal dysphagia in Parkinson’s disease: a meta-analysis. Parkinsonism Relat Disorders 2012;18(4):311-5. google scholar
• Burgos R, Breton I, Cereda E, Desport JC, Dziewas R, Genton L et al. ESPEN guideline clinical nutrition in neurology. Clin Nutr 2018;37:354-96. google scholar
• Müller J, Wenning GK, Verny M, McKee A, Chaudhuri KR, Jellinger K et al. Progression of dysarthria and dysphagia in postmoertem confirmed parkinsonian disorders. Arrc Neurol 2001;58(2):259-64. google scholar
• Umemoto G, Furuya H. Management of dysphagia in patients 994 with Parkinson’s disease and related disorders. Intern Med 2020;59(1):7-14. google scholar
• Coelho M, Marti MJ, Tolosa E, Ferreira JJ, Valldeoriola F, Rosa M et al. Late-stage 1000 Parkinson’s disease: the Barcelona and Lisbon cohort. J Neurol 2010;257(9):1524-32. google scholar
• Fuh J, Lee RC, Wang J, Lin CH, Wang PN, Chiang JH et al. Swallowing difficulty in Parkinson’s disease. Clin Neurol Neurosurg 1997;99(2):106-12. google scholar
• Pflug C, Bihler M, Emich K, Niessen A, Nienstedt JC, Flugel T et al. Critical dysphagia is common in Parkinson disease and occurs even in early stages: a prospective cohort study. Dysphagia 2018;33(1):41-50. google scholar
• Kalf JG, Swart BJM, Bloem BR, Munneke M. Prevalence of oropharyngeal dysphagia in Parkinson’s disease: a meta analysis. Parkinsonism Relat Disord 2012;18(4):311-5. google scholar
• Rosenbek JC, Troche MS. Progressif neurologic disease and dysphagia (including Parkinson’s disease, multiple sclerosis, amyotrophic lateral sclerosis, myasthenia gravis, post-polio syndrome) In: Shaker R, Belafsky PC, Postma GN, Easterling C, editors. Principles of deglutition: a multidisciplinary text for swallowing and its disorders. San Diego:Springer; 2013.p.395-409. google scholar