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

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.

• Authors: Jeri A Logemann, Gary Gensler, Joanne Robbins, Anne S Lindblad, Diane Brandt, Jacqueline A Hind, Steven Kosek, Karen Dikeman, Marta Kazandjian, Gary D Gramigna, Donna Lundy, Susan McGarvey-Toler, Patricia J Miller Gardner
• Journal: Journal of speech, language, and hearing research : JSLHR (J Speech Lang Hear Res) Vol. 51 Issue 1 Pg. 173-83 (Feb 2008) ISSN: 1092-4388 [Print] United States
• PMID: 18230864 (Publication Type: Journal Article, Randomized Controlled Trial)

Chemical References

• Solutions

Topics

• Aged
• Aged, 80 and over
• Deglutition
• Deglutition Disorders (diagnostic imaging, etiology, therapy)
• Dementia (complications)
• Female
• Fluoroscopy
• Humans
• Male
• Middle Aged
• Multivariate Analysis
• Parkinson Disease (complications)
• Pneumonia, Aspiration (prevention & control)
• Posture
• Solutions