Aspiration pneumonia, which is often caused by a swallowing problem, also called dysphagia, is the leading cause of death for people with Parkinson's disease. When caught early and treated early, many hospitalizations and deaths could be prevented. Most people have never even heard of dysphagia, but it is a very dangerous problem which affects up to 90% of people with Parkinson's Disease.
I am a speech language pathologist who has been working with people with Parkinson's Disease for many years. I have worked mostly in home health care. I've been amazed over the years by how many times I have been sent to see a patient for slurred speech, low volume voice, memory problems, or word finding problems only to find out upon further evaluation that the patient has dysphagia and is at high risk of getting aspiration pneumonia which is the leading cause of death for people with PD! Nobody even suspected it. Not the doctor, not the nurse, not the patient, nobody. This has happened to me so many times. It makes me really wonder how many more patients are out there with this problem, who don't ever even know that's what is killing them, or that it probably could have been prevented with appropriate detection and treatment.
It is hard to detect dysphagia, because even the patients usually do not notice the problem. Dysphagia is a disorder of the swallowing mechanism. I always ask my patients if they are having any trouble swallowing, and they ALWAYS say "NO". Then, when I ask them more questions about it, like "Do you cough or clear your throat when you eat or drink?", "Do foods or pills get stuck in your throat?", or "Does your voice sound gurgly during meals?", then they start telling me about those problems and we find out they actually do have a swallowing problem! They just didn't realize those symptoms were related to their swallowing. Or, they may have had those symptoms for a very long time and they haven't noticed as they have very gradually become more frequent or more severe until what was initially an occasional nuisance has now evolved into a very dangerous problem. Plus, in about half of the cases, people have lost sensation in the swallowing mechanism and don't feel any problem at all, and may show little or no symptoms, even when they may have a very serious case of dysphagia.
If you or your loved one have Parkinson's Disease, I highly recommend you find a speech language pathologist who specializes in dysphagia and request a screening or an evaluation. Hopefully one day it will be an automatic protocol upon diagnosis and perhaps annually thereafter. In the care of a good speech language pathologist, many cases of dysphagia can be reversed, and at the very least, they can be managed to dramatically decrease the risk of aspiration pneumonia, choking, and death due to this problem.
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About the Author: Jolie Parker, M.S.CCC-SLP is a speech language pathologist who specializes in the treatment of dysphagia. She is a co-inventor of the PhagiaFlex device for dysphagia, which has been clinically shown to strengthen the swallow, improve esophageal opening and laryngeal elevation, and widen the UES during the swallow.