ReviewPrevalence of oropharyngeal dysphagia in Parkinson’s disease: A meta-analysis
Introduction
Dysphagia is a problematic and sometimes dangerous feature of Parkinson’s disease (PD). Oropharyngeal dysphagia can have a negative impact on the quality of life [1], [2], and increases the risk of aspiration pneumonia, which is often the cause of death in PD [3], [4]. Knowing the actual prevalence of dysphagia as a function of disease severity is imperative, because this would alert clinicians to the need for timely assessment and treatment. Prevalence rates are available for hypokinetic dysarthria (70%) and drooling (56%) [5], [6], [7], which like dysphagia are known to be oral-motor disorders associated with PD. Unfortunately, prevalence rates for dysphagia are less apparent, with widely varying estimates [8]. We therefore performed a meta-analysis to estimate the prevalence of oropharyngeal dysphagia in PD.
Section snippets
Search strategy
We conducted a systematic PubMed literature search in February 2011 with the following search strategy: (“parkinson disease” [MeSH Terms] OR (“parkinson” [All Fields] AND “disease” [All Fields]) OR “parkinson disease” [All Fields] OR (“parkinson’s” [All Fields] AND “disease” [All Fields]) OR “parkinson’s disease” [All Fields]) AND (“deglutition disorders” [MeSH Terms] OR (“deglutition” [All Fields] AND “disorders” [All Fields]) OR “deglutition disorders” [All Fields] OR “dysphagia” [All
Results
The first search strategy revealed 350 articles, of which seven met the selection criteria [10], [11], [12], [13], [14], [15], [16], [17]. The second search revealed 274 articles, of which four were eligible for inclusion [18], [19], [20], [21], based on our criteria. Five studies were excluded, four because the diagnostic assessment or diagnosis of dysphagia was not clearly described [22], [23], [24], [25] and one because the study patients’ disease severity was limited to Hoehn & Yahr stage
Discussion
This meta-analysis shows that oropharyngeal dysphagia is prevalent in at least a third of PD patients, with prevalence rates depending on disease severity and assessment technique. Overall, PD patients are three times more likely to have swallowing disorders than healthy controls. This estimate seems robust, as the observed risk ratio was identical for both the subjective and objective assessments.
The studies which used subjective data were clinically and statistically heterogeneous. One
Acknowledgement
This research was supported by the department of Rehabilitation of the Radboud University Nijmegen Medical Centre and Prof. Bloem was supported by a ZonMw VIDI research grant (number 016.076.352).
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