A randomized study of three interventions for aspiration of thin liquids in patients with dementia or Parkinson's disease.

Publication Type
Journal Article
Year of Publication
Logemann, Jeri A; Gensler, Gary; Robbins, JoAnne; Lindblad, Anne S; Brandt, Diane; Hind, Jacqueline A; Kosek, Steven; Dikeman, Karen; Kazandjian, Marta; Gramigna, Gary D; Lundy, Donna; McGarvey-Toler, Susan; Miller Gardner, Patricia J
J Speech Lang Hear Res
Date Published
2008 Feb
Aged; Aged, 80 and over; deglutition; Deglutition Disorders; dementia; Female; Fluoroscopy; Humans; Male; Middle Aged; Multivariate Analysis; Parkinson Disease; Pneumonia, Aspiration; Posture; Solutions

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.