June is National Dysphagia Awareness Month. Each day during the month of June, we will share a fact about dysphagia that is supported by research. We will include a citation for each fact if you are interested in learning more.
June 30: It has recently been recognized that late pharyngeal toxicity is the main barrier to winning the battle against head-and-neck cancer.
Citation: Xerostomia: 12-month changes in saliva production and its relationship to perception and performance of swallow function, oral intake, and diet after chemoradiation; Head Neck, 25 (2003), pp. 432–437; Int J Radiat Oncol Biol Phys, 53 (2002), pp. 4–5
June 29: Currently, only 50% of stroke patients are screened for dysphagia in Canada.
Citation: Canadian Stroke Network The quality of stroke care in Canada. Ottawa (ON): The Network; 2011
June 28: Dysphagia is a frequent symptom in myasthenia gravis and it eventually occurs in 15–40% of patients.
Citation: Llabrés, M., F. J. Molina-Martinez, and F. Miralles. “Dysphagia as the sole manifestation of myasthenia gravis.” Journal of neurology, neurosurgery & psychiatry 76.9 (2005): 1297-1300.
June 27: Patients unable to follow single-step verbal commands have a 57 and 48% increased risk for liquid and puree aspiration, respectively.
Citation: Leder SB, Suiter DM, Lisitano Warner H. Answering orientation questions and following single-step verbal commands: effect on aspiration status. Dysphagia. 2009;24(3):290–5
June 26: Pneumonia is the second most common cause for death in patient with Alzheimer’s dementia.
Citation: Beard CM, Kokmen E, Sigler C, Smith GE, Petterson T, O’Brien PC. Causeofdeath in Alzheimer’s disease. Ann Epidemiol. 1996;6(3):195–200.
June 25: Depression was strongly and independently associated with dysphagia in elderly patients living in a community setting in a recent study.
Citation: Holland, G., et al. “Prevalence and symptom profiling of oropharyngeal dysphagia in a community dwelling of an elderly population: a self‐reporting questionnaire survey.” Diseases of the Esophagus 24.7 (2011): 476-480.
June 24: In 2007, there were 188,000 procedures to place a percutaneous endoscopic gastrostomy (PEG) tube placement (sometimes called a G-Tube). 68% of those procedures were on patients age 65 and older.
Citation: Policy, Enteral Nutrition ASPEN Public. “Disease-related malnutrition and enteral nutrition therapy: A significant problem with a cost-effective solution.”Nutrition in Clinical Practice 25.5 (2010): 548-554.
June 23: One study shows that 36% of children with Down syndrome presented with dysphagia.
Citation: Field, D., M. Garland, and K. Williams. “Correlates of specific childhood feeding problems.” Journal of paediatrics and child health 39.4 (2003): 299-304.
June 22: A recent study showed that 94% of children with dysphagia aspirate silently (i.e., they do not sense when food/liquid go down the wrong tube) and in trace amounts.
Citation: Arvedson, Joan, et al. “Silent aspiration prominent in children with dysphagia.” International journal of pediatric otorhinolaryngology 28.2 (1994): 173-181.
June 21: In one study, 44/78 patients diagnosed with chronic obstructive pulmonary disease (COPD) showed penetration and/or aspiration on a video swallow study.
Citation: Good-Fratturelli, Misty D., Richard F. Curlee, and Jean L. Holle. “Prevalence and nature of dysphagia in VA patients with COPD referred for videofluoroscopic swallow examination.” Journal of communication disorders33.2 (2000): 93-110.
June 20: Post-discharge from rehabilitation, patients with severe traumatic brain injury are 79 times more likely to die from aspiration pneumonia compared to the general population
Citation: Howle AA, Nott MT, Baguley IJ. Aspiration pneumonia following severe traumatic brain injury: prevalence and risk factors for long-term mortality. Brain Impair. 2011;12(3):179–86.
June 19: Estimates of the proportion of persons with Parkinson’s disease experiencing dysphagia vary, with the available research suggesting that anywhere from 40% to 95% of persons with Parkinson’s have dysphagia.
Citation: Muller J, Wenning GK, Verny M, et al. Progression of dysarthria and dysphagia in postmortem-confirmed parkinsonian disorders. Arch Neurol. 2001;58(2):259–264.
June 18:No pharmacologic treatment for dysphagia has been successful for patients with amyotrophic lateral sclerosis.
Citation: ALS dysphagia pathophysiology: Differential botulinum toxin response; Restivo, Domenico A. MD, PhD; Casabona, Antonino PhD; Nicotra, Alessia MD, PhD; Zappia, Mario MD; Elia, Maurizio MD; Romano, Marcello C. MD; Alfonsi, Enrico MD; Marchese-Ragona, Rosario MD, PhD 2013
June 17: Aspiration – when food, liquids, or saliva enters the airway – without a cough (silent aspiration) further increases the incidence of pneumonia to 54% in stroke patients.
Citation: Relation between incidence of pneumonia and protective reflexes in post-stroke patients with oral or tube feeding. Nakajoh K, Nakagawa T, Sekizawa K, Matsui T, Arai H, Sasaki HJ Intern Med. 2000 Jan; 247(1):39-42.
June 16: 80-90% of new oropharyngeal cancers are HPV positive.
Citation: Johnson, J. (2016, February). Oropharyngeal Cancer in the Era of HPV. Session presented at the Post-Graduate Course: Something You Can Chew On: Evidence-based Dysphagia Clinical Care at the Dysphagia Research Society 2016 Annual Meeting, Tucson, AZ.
June 15: It is reported that the prevalence of pediatric dysphagia is increasing due to improved survival rates of children born prematurely, with low birth weight, and with complex medical conditions
Citation: Arvedson, Joan C. “Assessment of pediatric dysphagia and feeding disorders: clinical and instrumental approaches.” Developmental disabilities research reviews 14.2 (2008): 118-127.
June 14: Gastroesophageal Reflux is the most common cause of solid food dysphagia
Citation: Peter Belafsky, NFOSD Webinar July 2015 “Most Common Causes of Solid Food Dysphagia.”
June 13: Approximately 50% of patients with Alzheimer’s dementia lose the ability to feed themselves within 8 years of their diagnosis.
Citation: Volicer L, Seltzer B, Rheaume Y, Karner J, Glennon M, Riley ME, et al. Eating difficulties in patients with probable dementia of the Alzheimer type. J Geriatr Psychiatr Neurol. 1989;2(4):188–95
June 12: It is estimated that every year in Canada there are 21,000 new elderly patients with dysphagia after stroke and 200,000 in the United States. Of these patients, as many as 10,000 in Canada and 100,000 in the US continue to experience dysphagia for months after the initial stroke event.
Citation: Screening for oropharyngeal dysphagia in stroke: insufficient evidence for guidelines.Martino R, Pron G, Diamant N Dysphagia. 2000 Winter; 15(1):19-30.
June 11: Dysphagia is causally linked with an increased risk of aspiration pneumonia; the incidence of which can be as high as 12% following severe TBI
Citation: Hansen TS, Larsen K, Engberg A. The association of functional oral intake and pneumonia in patients with severe traumatic brain injury. Arch Phys Med Rehabil. 2008;89:2114–20.
June 10: Oral stage deficits occur most frequently in patients with Parkinson’s disease and usually are the first indication of dysphagia in these patients.
Citation: Yorkston KM, Miller RM, Strand EA. Management of Speech and Swallowing in Degenerative Diseases. Austin, Texas: Pro-ed; 2004
June 9: Dysarthria (imprecise speech) and dysphagia are the most common clinical problems encountered in ALS , and can be observed as an initial symptom in 30% of patients (bulbar onset), with almost all patients developing speech and swallowing problems in later stages of the disease, even in those with spinal onset of symptoms, due to the involvement of both systems: spinal and bulbar.
Citation: da Costa Franceschini, Andressa, and Lucia Figueiredo Mourão. “Dysarthria and dysphagia in Amyotrophic Lateral Sclerosis with spinal onset: A study of quality of life related to swallowing.” NeuroRehabilitation 36.1 (2015): 127-134.
June 8: Infection with cancer-causing types of human papilloma virus, especially HPV-16, is a risk factor for some types of head and neck cancers, particularly oropharyngeal cancers that involve the tonsils or the base of the tongue
Citation: Chaturvedi AK, Engels EA, Pfeiffer RM, et al. Human papillomavirus and rising oropharyngeal cancer incidence in the United States. Journal of Clinical Oncology 2011; 29(32):4294–4301.
June 7: Patients with dysphagia after stroke have a 3-fold increased risk for aspiration pneumonia, and this risk is markedly increased to 11-fold in patients with confirmed aspiration on videofluoroscopy after stroke.
Citation: Dysphagia after stroke: incidence, diagnosis, and pulmonary complications. Martino R, Foley N, Bhogal S, Diamant N, Speechley M, Teasell R Stroke. 2005 Dec; 36(12):2756-63.
June 6: It has been reported that 25%-45% of typically developing children demonstrate feeding and swallowing problems.
Citation: Arvedson, 2008; Bernard-Bonnin, 2006; Brackett, Arvedson, & Manno, 2006; Burklow, Phelps, Schultz, McConnell, & Rudolph, 1998; Lefton-Greif, 2008; Linscheid, 2006; Manikam & Perman, 2000; Rudolph & Link, 2002
June 5: As the nation reflects on the great achievements of the late Muhammad Ali, we want to recognize him for his support of Parkinson’s research to help find a cure. Parkinson’s affects 1 million Americans and 8 million worldwide, and can lead to lethal falls and infections due to compromised balance and swallowing.
June 4: The degree of xerostomia corresponds with dysphagia experienced by the patients with head and neck cancer.
Citation: Dysphagia Section, Oral Care Study Group, Multinational Association of Supportive Care in Cancer (MASCC)/International Society of Oral Oncology (ISOO), Raber-Durlacher JE, Brennan MT, et al. Swallowing dysfunction in cancer patients. Supportive Care in Cancer. 2012;20(3):433-443. doi:10.1007/s00520-011-1342-2.
June 3: It is estimated that 45% of institutionalized patients with dementia suffer from dysphagia.
Citation: Sura L, Madhavan A, Carnaby G, Crary MA. Dysphagia in the elderly: management and nutritional considerations. Clinical Interventions in Aging. 2012;7:287-298. doi:10.2147/CIA.S23404.
June 2: Dysphagia is a common complication following TBI, with an incidence as high as 93 % in patients admitted to brain injury rehabilitation
Citation: Hansen TS, Engberg AW, Larsen K. Functional oral intake and time to reach unrestricted dieting for patients with traumatic brain injury. Arch Phys Med Rehabilitation. 2008;89:1556–62
June 1: Reports of pneumonia in patients with dysphagia after stroke range from 7% to 33%, with conservative estimates at 18%.
Citation: Dysphagia after stroke: incidence, diagnosis, and pulmonary complications. Martino R, Foley N, Bhogal S, Diamant N, Speechley M, Teasell R. Stroke. 2005 Dec; 36(12):2756-63.
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