IALP 2025

The Relationship Between Pharyngeal Swallowing Function and Hoehn & Yahr and Functional Oral Intake Scales in Parkinson`s Disease

Yumi Yamaguchi 1 M.D.,Ph.D.,Prof. Toshiro Umezaki 2,3 M.D.,Ph.D. Yoshikazu Kikuchi 1 M.D. Kazuo Adachi 2 M.D.,Ph.D.,Prof. Takashi Nakagawa 1
1Department of Otorhinolaryngology, Graduate School of Medical Sciences, Kyushu University, Japan
2Department of ENT, Voice & Swallowing Center, Fukuoka Sanno Hospital, Japan
3International University of Health and Welfare Graduate School, Japan

Objective

The aim of this study is to clarify the relationship between pharyngeal swallowing function and the Hoeh and Yahr scale (H-Y scale) and Functional oral intake scale (FOIS) in Parkinson`s patients.

Methods

Twenty-five Parkinson`s patients (mean age 72.9 years, 16 males and 9 females) who underwent videofluoroscopic examination of swallowing at our department from 2013 to 2024 were included. The control group consisted of 54 patients (mean age 72.5 years, 33 males and 21 females) without Parkinson`s disease. The presence of aspiration and cough reflex, laryngeal elevation delay time (LEDT), and pharyngeal clearance were evaluated on a 4-point scale, with no residual being 0, and the relationship between the H-Y scale and FOIS was examined retrospectively.

Results

The H-Y scale in the Parkinson`s disease group was Stage 1: 4 cases, 2: 7 cases, 3: 6 cases, 4: 6 cases, 5: 2 cases; FOIS was 2: 1 case, 3: 2 cases, 4: 8 cases, 5: 1 case, 6: 5 cases, 7: 8 cases. Aspiration was present in 14 patients, cough reflex was poor in 9 patients, clearance was 0:4, 1:11, 2:8, 3:2, and LEDT averaged 0.41 seconds. In the control group, 12 patients had aspiration, 6 had poor cough reflex, 0:19, 1:23, 2:9, 3:3 clearance, and LEDT averaged 0.33 seconds. The Parkinson`s disease group had significantly more cases of aspiration than the control group (P=0.008) and a significantly longer LEDT (P=0.005). In addition, H-Y scale and LEDT in the Parkinson`s disease group showed a positive correlation, but there was no relationship between H-Y scale and FOIS.

Conclusion

Patients with Parkinson`s disease had an increased risk of dysphagia as the disease progressed, but there was no association with oral intake status. These data indicate that some Parkinson`s patients are taking oral intake with a high risk of aspiration.

Learning Outcome

Understand the changes in swallowing function as Parkinson`s disease progresses and recognize the importance of evaluating swallowing function based on disease stage.