Perceived changes to swallowing in people with Parkinson's disease

Aims:To describe the relationship between perceived swallowing difficulties in people with Parkinson's disease with disease-specific measures, carers' perceptions of swallowing problems and control participant responses.
Method:In total, 119 people with Parkinson's disease, their carers and matched controls answered a specifically prepared functional swallowing changes questionnaire. People with Parkinson's completed a water-swallowing test. Motor status, cognition and mood were also assessed.
Results:People with Parkinson's disease scored poorer than controls (p <0.001) on the questionnaire. Those reporting swallowing problems scored poorer than those who did not (p <0.01). However, of 74 people with Parkinson's who perceived no swallowing problem, 32 fell below the 50th percentile on the water-swallowing test, while 41 fell below cut-off scores on the questionnaire. There was a weak correlation between drinking speeds and questionnaire totals. Carers' evaluations correlated with their partners' (r = 0.796) but they perceived changes as less severe (p <0.03).
Conclusions:Despite reduced swallowing efficiency, some people with Parkinson's can successfully compensate. A sizeable proportion, however, remain unaware of swallowing problems when asked simply ‘Do you have a problem?’, but indicate difficulties with more specific questions. The present questionnaire provides a guide for gaining such insights for diagnosis, education and outcomes.