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In Aging 2016:DovepressDovepressOropharyngeal dysphagia in older personsinterventions, although 20 did not aspirate at all. Sufferers showed much less aspiration with honey-thickened liquids, followed by nectar-thickened liquids, followed by chin down posture intervention. On the other hand, the individual preferences had been different, along with the probable advantage from one of the interventions showed individual patterns together with the chin down maneuver becoming much more effective in individuals .80 years. Around the long-term, the pneumonia incidence in these individuals was lower than expected (11 ), displaying no benefit of any intervention.159,160 Taken together, dysphagia in dementia is typical. About 35 of an unselected group of dementia patients show signs of liquid aspiration. Dysphagia progresses with escalating cognitive impairment.161 Therapy must get started early and should take the cognitive aspects of eating into account. Adaptation of meal consistencies may be advisable if accepted by the patient and caregiver.Table three Patterns of oropharyngeal dysphagia in Parkinson’s diseasePhase of swallowing Oral Frequent findings Repetitive pump movements of your tongue Oral residue Premature spillage Piecemeal deglutition Residue in valleculae and pyriform sinuses Aspiration in 50 of dysphagic individuals Somatosensory deficits Lowered spontaneous swallow (48 vs 71 per hour) Hypomotility Spasms Many contractionsPharyngealesophagealNote: Data from warnecke.Dysphagia in PDPD has a prevalence of approximately 3 within the age group of 80 years and older.162 About 80 of all individuals with PD encounter dysphagia at some stage of the disease.163 More than half of your subjectively asymptomatic PD patients already show signs of oropharyngeal swallowing dysfunction when assessed by objective instrumental tools.164 The typical latency from initial PD symptoms to extreme dysphagia is 130 months.165 One of the most useful predictors of relevant dysphagia in PD are a Hoehn and Yahr stage .3, drooling, weight-loss or body mass index ,20 kg/m2,166 and dementia in PD.167 You can find mainly two distinct questionnaires validated for the detection of dysphagia in PD: the Swallowing Disturbance Questionnaire for Parkinson’s illness patients164 with 15 concerns plus the Munich Dysphagia Test for Parkinson’s disease168 with 26 questions. The 50 mL Water Swallowing Test is neither reproducible nor predictive for severe OD in PD.166 As a result, a modified water test assessing maximum swallowing volume is recommended for screening purposes. In clinically unclear circumstances instrumental techniques including Charges or VFSS needs to be applied to evaluate the precise nature and severity of dysphagia in PD.169 The most frequent symptoms of OD in PD are listed in Table 3. No common recommendation for therapy approaches to OD might be given. The adequate choice of tactics depends upon the individual pattern of dysphagia in each and every patient. Sufficient therapy can be thermal-tactile stimulation and compensatory maneuvers like effortful swallowing. In general, thickened liquids have been shown to be much more PubMed ID:http://www.ncbi.nlm.nih.gov/pubmed/20531479 helpful in reducing the amount of liquid aspirationClinical Interventions in Aging 2016:in comparison with chin tuck maneuver.159 The Lee Silverman Voice Treatment (LSVT? may enhance PD dysphagia, but data are rather limited.171 3,5,7-Trihydroxyflavone Expiratory muscle strength training enhanced laryngeal elevation and reduced severity of aspiration events in an RCT.172 A rather new strategy to therapy is video-assisted swallowing therapy for patients.