Oropharyngeal Dysphagia in Parkinson's Disease: An Analysis of Prevalence, Swallow Therapy Utilization, and Complication Rates.

OBJECTIVE

Oropharyngeal dysphagia (OD) is a common and challenging manifestation of Parkinson's disease (PD), associated with risks of malnutrition, aspiration, and reduced quality of life. This study investigates interventions, complications, and factors associated with swallow therapy utilization in a national cohort of individuals with PD and OD.

METHODS

In the All of Us database, we identified individuals with PD and OD using ICD-9 and ICD-10 codes. Rates of swallow evaluation, swallow therapy, malnutrition and/or gastrostomy placement, and aspiration pneumonia were evaluated. Chi-square tests compared characteristics and complication rates among those with versus without swallow therapy.

RESULTS

Of 2004 individuals with PD, 476 (23.8%) underwent a swallow evaluation. Two hundred twenty-one individuals (11.0%) were diagnosed with OD, with the majority being above 65 years of age (85.1%) and male (71.0%). Among those with OD, 58 (26.2%) received swallow therapy. Malnutrition and/or gastrostomy placement were documented in 44 (19.9%) individuals with PD and OD, and aspiration pneumonia occurred in 25 (11.3%) individuals. Factors associated with increased swallow therapy utilization were male sex (p < 0.001) and a history of malnutrition and/or gastrostomy placement (p = 0.04).

CONCLUSION

A small proportion of individuals with PD received swallow evaluation, and even among those with identified OD, few received swallow therapy. Complications including malnutrition, gastrostomy placement, and aspiration pneumonia were relatively common. These findings suggest a need for greater integration of swallowing evaluation and treatment into routine PD management.

LEVEL OF EVIDENCE: 3.