A Randomized Study of Three Interventions for Aspiration of Thin Liquids in Patients with Dementia or Parkinson's Disease
02/2008
Journal Article
Authors:
Logemann, J.A.;
Gensler, G.;
Robbins, J.;
Lindblad, A.S.;
Brandt, D.;
Hind, J.A.;
Kosek, S.;
Dikeman, K.;
Kazandjian, M.;
Gramigna, G.D.;
Lundy, D.;
McGarvey-Toler, S.;
Gardner, P.J.Miller
Secondary:
J Speech Lang Hear Res
Volume:
51
Pagination:
173-183
URL:
http://www.ncbi.nlm.nih.gov/pubmed/18230864
Keywords:
Aged; deglutition; Deglutition Disorders; dementia; Female; Fluoroscopy; Male; Middle Aged; Multivariate Analysis; Parkinson Disease; Pneumonia-Aspiration; Posture; Solutions
Abstract:
PURPOSE: This study was designed to identify which of 3 treatments for aspiration on thin liquids-chin-down posture, nectar-thickened liquids, or honey-thickened liquids-results in the most successful immediate elimination of aspiration on thin liquids during the videofluorographic swallow study in patients with dementia and/or Parkinson's disease. METHOD: This randomized clinical trial included 711 patients ages 50 to 95 years who aspirated on thin liquids as assessed videofluorographically. All patients received all 3 interventions in a randomly assigned order during the videofluorographic swallow study. RESULTS: Immediate elimination of aspiration on thin liquids occurred most often with honey-thickened liquids for patients in each diagnostic category, followed by nectar-thickened liquids and chin-down posture. Patients with most severe dementia exhibited least effectiveness on all interventions. Patient preference was best for chin-down posture followed closely by nectar-thickened liquids. CONCLUSION: To identify best short-term intervention to prevent aspiration of thin liquid in patients with dementia and/or Parkinson's disease, a videofluorographic swallow assessment is needed. Evidence-based practice requires taking patient preference into account when designing a dysphagic patient's management plan. The longer-term impact of short-term prevention of aspiration requires further study.
