Hostname: page-component-586b7cd67f-dsjbd Total loading time: 0 Render date: 2024-11-24T05:26:22.777Z Has data issue: false hasContentIssue false

Dysphagia: implications for older people

Published online by Cambridge University Press:  27 November 2013

N Miller*
Affiliation:
Institute of Health and Society, University of Newcastle upon Tyne, UK
J Patterson
Affiliation:
Institute of Health and Society, University of Newcastle upon Tyne, UK Sunderland Royal Hospital/University of Newcastle upon Tyne, UK
*
Address for correspondence: Nick Miller, Institute of Health and Society, Speech and Language Sciences, George VI Building, University of Newcastle upon Tyne, Newcastle upon Tyne NE1 7RU, UK. Email: [email protected]

Summary

Dysphagia represents a salient concern in many conditions prevalent in older people. There are direct implications for morbidity and mortality. The importance of recognizing and managing dysphagia in hospital and the community also extends to psychosocial impact and quality of life, as well as health, economic and ethical-legal issues. This review outlines reasons for the importance of recognizing and treating dysphagia. It then proceeds to look at recent developments in our understanding of the nature, assessment and management of dysphagia in older people. Whilst there are well-established practices in assessment and management, ongoing work continues to challenge the validity and reliability of many methods. These concerns are covered and directions for future developments highlighted.

Type
Review Article
Copyright
Copyright © Cambridge University Press 2013 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1Cichero, JAY, Altman, KW. Definition, prevalence and burden of oropharyngeal dysphagia: a serious problem among older adults worldwide and the impact on prognosis and hospital resources. In Cichero, J, Clave, P (eds), Stepping Stones to Living Well with Dysphagia, pp. 111; 2012.CrossRefGoogle ScholarPubMed
2Altman, KW, Yu, G-P, Schaefer, SD. Consequence of dysphagia in the hospitalized patient impact on prognosis and hospital resources. Arch Otolaryngol Head Neck Surg 2010; 136: 784–89.CrossRefGoogle ScholarPubMed
3Cabre, M, Serra-Prat, M, Palomera, E, Almirall, J, Pallares, R, Clavé, P. Prevalence and prognostic implications of dysphagia in elderly patients with pneumonia. Age Ageing 2010; 39: 3945.Google Scholar
4Bouchard, J, Presse, N, Ferland, G. Association between aspiration and malnutrition in patients from active geriatric units. Canadian J Dietetic Practice Res 2009; 70: 152–54.CrossRefGoogle ScholarPubMed
5Hibberd, J, Fraser, J, Chapman, C, McQueen, H, Wilson, A. Can we use influencing factors to predict aspiration pneumonia in the United Kingdom? Multidisciplinary Resp Med 2013; 8: 39.Google Scholar
6Masrur, S, Smith, EE, Saver, JL, Reeves, MJ, Bhatt, DL, Zhao, Xet al.Dysphagia screening and hospital-acquired pneumonia in patients with acute ischemic stroke: findings from Get with the Guidelines – Stroke. J Stroke Cerebrovasc Dis (in press); http://dx.doi.org/ 10.1016/j.jstrokecerebrovasdis.2012.11.013Google Scholar
7Robinson, DJ, Jerrard-Dunne, P, Greene, Z, Lawson, S, Lane, S, O'Neill, D. Oropharyngeal dysphagia in exacerbations of chronic obstructive pulmonary disease. Eur Geriatric Med 2011; 2: 201–3.Google Scholar
8van der Maarel-Wierink, CD, Vanobbergen, JNO, Bronkhorst, EM, Schols, JMGA, de Baat, C. Meta-analysis of dysphagia and aspiration pneumonia in frail elders. J Dent Res 2011; 90: 1398–404.CrossRefGoogle ScholarPubMed
9van der Maarel-Wierink, CD, Vanobbergen, JNO, Bronkhorst, EM, Schols, JMGA, de Baat, C. Risk factors for aspiration pneumonia in frail older people: a systematic literature review. J Am Medical Directors Assoc 2011; 12: 344–54.Google Scholar
10Crary, M, Humphrey, J, Carnaby-Mann, G, Sambandam, R, Miller, L, Silliman, S. Dysphagia, nutrition, and hydration in ischemic stroke patients at admission and discharge from acute care. Dysphagia 2013; 28: 6976.Google Scholar
11Serra-Prat, M, Palomera, M, Gomez, C, Sar-Shalom, D, Saiz, A, Montoya, JGet al.Oropharyngeal dysphagia as a risk factor for malnutrition and lower respiratory tract infection in independently living older persons: a population-based prospective study. Age Ageing 2012; 41: 376–81.CrossRefGoogle Scholar
12Patterson, J, Rapley, T, Carding, P, Wilson, J, McColl, E. Head and neck cancer and dysphagia; caring for carers. Psycho-Oncology 2013 (in press).CrossRefGoogle ScholarPubMed
13Penner, JL, McClement, S, Lobchuk, M, Daeninck, P. Family members’ experiences caring for patients with advanced head and neck cancer receiving tube feeding: a descriptive phenomenological study. J Pain Symptom Management 2012; 44: 563–71.CrossRefGoogle ScholarPubMed
14Martino, R, Beaton, D, Diamant, NE. Perceptions of psychological issues related to dysphagia differ in acute and chronic patients. Dysphagia 2010; 25: 2634.CrossRefGoogle ScholarPubMed
15Klinke, M, Wilosn, M, Hafsteinsdottir, T, Jonsdottir, H. Recognizing new perspectives in eating difficulties following stroke: a concept analysis. Disability Rehabilitation 2013; 35: 1491–500.CrossRefGoogle ScholarPubMed
16Semenov, YR, Starmer, HM, Gourin, CG. The effect of pneumonia on short-term outcomes and cost of care after head and neck cancer surgery. Laryngoscope 2012; 122: 19942004.Google Scholar
17Tian, H, Abouzaid, S, Sabbagh, MN, Chen, W, Gabriel, S, Kahler, KHet al.Health care utilization and costs among patients with AD with and without dysphagia. Alzheimer Dis Assoc Disorders 2013; 27: 138–44.CrossRefGoogle ScholarPubMed
18Lee, SI, Yoo, JY, Kim, M, Ryu, JS. Changes of timing variables in swallowing of boluses with different viscosities in patients with dysphagia. Archives Physical Med Rehabil 2013; 94: 120–26.Google Scholar
19Choi, KH, Ryu, JS, Kim, MY, Kang, JY, Yoo, SD. Kinematic analysis of dysphagia: significant parameters of aspiration related to bolus viscosity. Dysphagia 2011; 26: 392–98.Google Scholar
20Umemoto, G, Tsuboi, Y, Kitashima, A, Furuya, H, Kikuta, T. Impaired food transportation in Parkinson's disease related to lingual bradykinesia. Dysphagia 2011; 26: 250–55.Google Scholar
21Hirota, N, Konaka, K, Ono, T, Tamine, K, Kondo, J, Hori, Ket al.Reduced tongue pressure against the hard palate on the paralyzed side during swallowing predicts dysphagia in patients with acute stroke. Stroke 2010; 41: 2982–84.CrossRefGoogle ScholarPubMed
22Gross, RD, Atwood, CW Jr, Ross, SB, Eichhorn, KA, Olszewski, JW, Doyle, PJ. The coordination of breathing and swallowing in Parkinson's disease. Dysphagia 2008; 23: 136–45.Google Scholar
23Gross, RD, Atwood, CW Jr, Ross, SB, Olszewski, JW, Eichhorn, KA. The coordination of breathing and swallowing in chronic obstructive pulmonary disease. Am J Resp Critical Care Med 2009; 179: 559–65.Google Scholar
24Troche, M, Huebner, I, Rosenbek, J, Okun, M, Sapienza, C. Respiratory-swallowing coordination and swallowing safety in patients with Parkinson's disease. Dysphagia 2011; 26: 218–24.Google Scholar
25Hammer, MJ, Murphy, CA, Abrams, TM. Airway somatosensory deficits and dysphagia in Parkinson's disease. J Parkinson's Dis 2013; 3: 3944.CrossRefGoogle ScholarPubMed
26Fukai, K, Takiguchi, T, Ando, Y, Aoyama, H, Miyakawa, Y, Ito, Get al.Critical tooth number without subjective dysphagia. Geriatr Gerontol Int 2011; 11: 482–87.Google Scholar
27Furuta, M, Komiya-Nonaka, M, Akifusa, S, Shimazaki, Y, Adachi, M, Kinoshita, Tet al.Interrelationship of oral health status, swallowing function, nutritional status, and cognitive ability with activities of daily living in Japanese elderly people receiving home care services due to physical disabilities. Community Dentistry Oral Epidemiol 2013; 41: 173–81.CrossRefGoogle ScholarPubMed
28Pace, CC, McCullough, GH. The association between oral microorgansims and aspiration pneumonia in the institutionalized elderly: review and recommendations. Dysphagia 2010; 25: 307–22.Google Scholar
29Tada, A, Miura, H. Prevention of aspiration pneumonia (AP) with oral care. Archives Gerontol Geriatr 2012; 55: 1621.Google Scholar
30Brodsky, MB, Abbott, KV, McNeil, MR, Palmer, CV, Grayhack, JP, Martin-Harris, B. Effects of divided attention on swallowing in persons with idiopathic Parkinson's disease. Dysphagia 2012; 27: 390400.Google Scholar
31Nobrega, AC, Rodrigues, B, Torres, AC, Scarpel, RD, Neves, CA, Melo, A. Is drooling secondary to a swallowing disorder in patients with Parkinson's disease? Parkinsonism Rel Disorders 2008; 14: 243–45.Google Scholar
32Steele, CM. The physiology of deglutition and the pathophysiology and complications of oropharyngeal dysphagia. In Cichero, J, Clave, P (eds), Stepping Stones to Living Well with Dysphagia, pp. 1317; 2012:Google Scholar
33Teismann, IK, Suntrup, S, Warnecke, T, Steinstraeter, O, Fischer, M, Floeel, Aet al.Cortical swallowing processing in early subacute stroke. BMC Neurol 2011; doi:10.1186/1471–2377–11–34.CrossRefGoogle ScholarPubMed
34Momosaki, R, Abo, M, Kakuda, W, Uruma, G. Which cortical area is related to the development of dysphagia after stroke? a single photon emission computed tomography study using novel analytic methods. Eur Neurol 2012; 67: 7480.Google Scholar
35Humbert, IA, German, RZ. New directions for understanding neural control in swallowing: the potential and promise of motor learning. Dysphagia 2013; 28: 110.Google Scholar
36Altman, KW. Oropharyngeal dysphagia pathophysiology, complications and science-based interventions. In Cichero, J, Clave, P (eds), Stepping Stones to Living Well with Dysphagia, pp. 119–26; 2012.CrossRefGoogle Scholar
37Macht, M, Wimbish, T, Clark, BJ, Benson, AB, Burnham, EL, Williams, Aet al.Postextubation dysphagia is persistent and associated with poor outcomes in survivors of critical illness. Critical Care 2011; 15: R231.CrossRefGoogle ScholarPubMed
38Siska, PA, Ponnappan, RK, Hohl, JB, Lee, JY, Kang, JD, Donaldson, WF III. Dysphagia after anterior cervical spine surgery a prospective study using the swallowing-quality of life questionnaire and analysis of patient comorbidities. Spine 2011; 36: 1387–91.Google Scholar
39Kalb, S, Reis, MT, Cowperthwaite, MC, Fox, DJ, Lefevre, R, Theodore, Net al.Dysphagia after anterior cervical spine surgery: incidence and risk factors. World Neurosurgery 2012; 77: 183–87.Google Scholar
40Danto, J, DiCapua, J, Nardi, D, Pekmezaris, R, Moise, G, Lesser, Met al.Multiple cervical levels: increased risk of dysphagia and dysphonia during anterior cervical discectomy. J Neurosurg Anesthesiol 2012; 24: 350–55.Google Scholar
41Ruoppolo, G, Schettino, I, Frasca, V, Giacomelli, E, Prosperini, L, Cambieri, Cet al.Dysphagia in amyotrophic lateral sclerosis: prevalence and clinical findings. Acta Neurologica Scandinavica 2013 (in press). doi: 10.1111/ane.12136CrossRefGoogle ScholarPubMed
42Miller, N, Allcock, L, Hildreth, AJ, Jones, D, Noble, E, Burn, DJ. Swallowing problems in Parkinson disease: frequency and clinical correlates. J Neurol Neurosurg Psychiatry 2009; 80: 1047–49.CrossRefGoogle ScholarPubMed
43O'Sullivan, SS, Massey, LA, Williams, DR, Silveira-Moriyama, L, Kempster, PA, Holton, JLet al.Clinical outcomes of progressive supranuclear palsy and multiple system atrophy. Brain 2008; 131: 1362–72.Google Scholar
44Suntrup, S, Teismann, I, Bejer, J, Suttrup, I, Winkels, M, Mehler, Det al.Evidence for adaptive cortical changes in swallowing in Parkinson's disease. Brain 2013; 136: 726–38.Google Scholar
45Aldridge, K, Taylor, N. Dysphagia is a common and serious problem for adults with mental illness: a systematic review. Dysphagia 2012; 27: 124–37.Google Scholar
46Alagiakrishnan, K, Bhanji, RA, Kurian, M. Evaluation and management of oropharyngeal dysphagia in different types of dementia: A systematic review. Archives Gerontol Geriatr 2013; 56: 19.CrossRefGoogle ScholarPubMed
47Brodsky, M, Abbott, K, McNeil, M, Palmer, C, Grayhack, J, Martin-Harris, B. Effects of divided attention on swallowing in persons with idiopathic Parkinson's disease. Dysphagia 2012; 27: 390400.Google Scholar
48Han, M, Ohnishi, H, Nonaka, M, Yamauchi, R, Hozuki, T, Hayashi, Tet al.Relationship between dysphagia and depressive states in patients with Parkinson's disease. Parkinsonism Rel Disorders 2011; 17: 437–39.Google Scholar
49Holland, G, Jayasekeran, V, Pendleton, N, Horan, M, Jones, M, Hamdy, S. Prevalence and symptom profiling of oropharyngeal dysphagia in a community dwelling of an elderly population: a self-reporting questionnaire survey. Diseases Esophagus 2011; 24: 476–80.CrossRefGoogle Scholar
50Daniels, SK, Schroeder, MF, DeGeorge, PC, Corey, DM, Foundas, AL, Rosenbek, JC. Defining and measuring dysphagia following stroke. Am J Speech Lang Pathol 2009; 18: 7481.Google Scholar
51Ding, RY, Logemann, JA. Patient self-perceptions of swallowing difficulties as compared to expert ratings of videofluorographic studies. Folia Phoniatr Logop 2008; 60: 142–50.Google Scholar
52Bayés-Rusiñol, À, Forjaz, MJ, Ayala, A, Crespo, MC, Prats, A, Valles, Eet al.[Awareness of dysphagia in Parkinson's disease]. Rev Neurologia 2011; 53: 664–72.Google Scholar
53Cheon, S-M, Ha, M-S, Park, MJ, Kim, JW. Non-motor symptoms of Parkinson's disease: prevalence and awareness of patients and families. Parkinsonism Rel Dis 2008; 14: 286–90.Google Scholar
54Serra-Prat, M, Hinojosa, G, Lopez, D, Juan, M, Fabre, E, Voss, DSet al.Prevalence of oropharyngeal dysphagia and impaired safety and efficacy of swallow in independently living older persons. J Am Geriatr Soc 2011; 59: 186–87.Google Scholar
55Roy, N, Stemple, J, Merrill, RM, Thomas, L. Dysphagia in the elderly: Preliminary evidence of prevalence, risk factors, and socioemotional effects. Annals Otol Rhinol Laryngol 2007; 116: 858–65.Google Scholar
56Nogueira, D, Reis, E. Swallowing disorders in nursing home residents: how can the problem be explained? Clin Interventions Aging 2013; 8: 221–27.Google Scholar
57NICE. Stroke rehabilitation: long term rehabilitation after stroke. London, UK: National Institute for Health and Care Excellence, 2013.Google Scholar
58SIGN. Management of Patients with Stroke: Identification and Management of Dysphagia SIGN Guideline 119. Published by the Scottish Intercollegiate Guidelines Network; 2010. Available at: http://www.signacuk/guidelines/published/indexhtml#CHDGoogle Scholar
59Excellence NIfC. Improving Outcomes in Head and Neck Cancers. 2004 [cited 26 July 2013]; available at: www.nice.org.ukGoogle Scholar
60Trust SGHN. Tracheostomy Guidelines. 2013 [cited 27 July 2013]; available at: http://www.stgeorges.nhs.uk/trachindex.aspGoogle Scholar
61Bryant, KN, Finnegan, E, Berbaum, K. VFS Interjudge reliability using a free and directed search. Dysphagia 2012; 27: 5363.CrossRefGoogle ScholarPubMed
62Tohara, H, Nakane, A, Murata, S, Mikushi, S, Ouchi, Y, Wakasugi, Yet al.Inter- and intra-rater reliability in fibroptic endoscopic evaluation of swallowing. J Oral Rehabil 2010; 37: 884–91.CrossRefGoogle ScholarPubMed
63Takahashi, N, Kikutani, T, Tamura, F, Groher, M, Kuboki, T. Videoendoscopic assessment of swallowing function to predict the future incidence of pneumonia of the elderly. J Oral Rehabil 2012; 39: 429–37.CrossRefGoogle ScholarPubMed
64Martin-Harris, B, Brodsky, MB, Michel, Y, Castell, DO, Schleicher, M, Sandidge, Jet al.MBS Measurement tool for swallow impairment – MBSimp: establishing a standard. Dysphagia 2008; 23: 392405.CrossRefGoogle ScholarPubMed
65Murguia, M, Corey, DM, Daniels, SK. Comparison of sequential swallowing in patients with acute stroke and healthy adults. Archives Physical Med Rehabil 2009; 90: 1860–65.Google Scholar
66Hind, JA, Gensler, G, Brandt, DK, Gardner, PJM, Blumenthal, L, Gramigna, GDet al.Comparison of trained clinician ratings with expert ratings of aspiration on videofluoroscopic images from a randomized clinical trial. Dysphagia 2009; 24: 211–17.Google Scholar
67Macht, M, Wimbish, T, Clark, BJ, Benson, AB, Burnham, EL, Williams, Aet al.Diagnosis and treatment of post-extubation dysphagia: results from a national survey. J Critical Care 2012; 27: 578–86.CrossRefGoogle ScholarPubMed
68Sharp, HM, Shega, JW. Feeding tube placement in patients with advanced dementia: the beliefs and practice patterns of speech-language pathologists. Am J Speech Lang Pathol 2009; 18: 222–30.Google Scholar
69Cocks, N, Ferreira, H. What Information do UK speech and language therapists use when making oral versus nonoral feeding recommendations for adults with oropharyngeal dysphagia? Dysphagia 2013; 28: 4357.CrossRefGoogle Scholar
70Archer, SK, Wellwood, I, Smith, CH, Newham, DJ. Dysphagia therapy in stroke: a survey of speech and language therapists. Int J Lang Commun Disord 2013 (in press). doi: 10.1111/1460–6984.12006.Google Scholar
71Bours, GJJW, Speyer, R, Lemmens, J, Limburg, M, De Wit, R. Bedside screening tests vs. videofluoroscopy or fibreoptic endoscopic evaluation of swallowing to detect dysphagia in patients with neurological disorders: systematic review. J Adv Nurs 2009; 65: 477–93.Google Scholar
72Umay, E, Unlu, E, Saylam, G, Cakci, A, Korkmaz, H. Evaluation of dysphagia in early stroke patients by bedside, endoscopic, and electrophysiological methods. Dysphagia 2013 (in press). doi: 10.1007/s00455-013-9447-z.Google Scholar
73Patterson, JM, Hildreth, A, McColl, E, Carding, PN, Hamilton, D, Wilson, JA. The clinical application of the 100 ml water swallow test in head and neck cancer. Oral Oncology 2011; 47: 180–84.Google Scholar
74Clavé, P, Arreola, V, Romea, M, Medina, L, Palomera, E, Serra-Prat, M. Accuracy of the volume-viscosity swallow test for clinical screening of oropharyngeal dysphagia and aspiration. Clinical Nutrition 2008; 27: 806–15.Google Scholar
75Martino, R, Silver, F, Teasell, R, Bayley, M, Nicholson, G, Streiner, DLet al.The Toronto Bedside Swallowing Screening Test (TOR-BSST): development and validation of a dysphagia screening tool for patients with stroke. Stroke 2009; 40: 555–61.Google Scholar
76Antonios, N, Carnaby-Mann, G, Crary, M, Miller, L, Hubbard, H, Hood, Ket al.Analysis of a physician tool for evaluating dysphagia on an inpatient stroke unit: the modified Mann Assessment of Swallowing Ability. J Stroke Cerebrovasc Dis 2010; 19: 4957.CrossRefGoogle Scholar
77Gonzalez-Fernandez, M, Sein, MT, Palmer, JB. Clinical experience using the Mann assessment of swallowing ability for identification of patients at risk for aspiration in a mixed-disease population. Am J Speech Lang Pathol 2011; 20: 331–36.Google Scholar
78Leder, SB, Suiter, DM, Warner, HL, Acton, LM, Siegel, MD. Safe initiation of oral diets in hospitalized patients based on passing a 3-ounce (90cc) water swallow challenge protocol. QJM 2012; 105: 257–63.Google Scholar
79Schepp, SK, Tirschwell, DL, Miller, RM, Longstreth, WT. Swallowing screens after acute stroke: a systematic review. Stroke 2012; 43: 869–71.Google Scholar
80Turner-Lawrence, DE, Peebles, M, Price, MF, Singh, SJ, Asimos, AW. A feasibility study of the sensitivity of emergency physician dysphagia screening in acute stroke patients. Annals Emergency Med 2009; 54: 344–48.CrossRefGoogle ScholarPubMed
81Edmiaston, J, Connor, LT, Loehr, L, Nassief, A. Validation of a dysphagia screening tool in acute stroke patients. Am J Critical Care 2010; 19: 357–64.Google Scholar
82Wilkinson, AH, Burns, SL, Witham, MD. Aspiration in older patients without stroke: A systematic review of bedside diagnostic tests and predictors of pneumonia. Eur Geriatr Med 2012; 3: 145–52.Google Scholar
83Daniels, S. Letter by Daniels regarding article ‘Silent aspiration risk is volume-dependent’. Dysphagia 2012; 27: 294.Google Scholar
84Osawa, A, Maeshima, S, Tanahashi, N. Water-swallowing test: screening for aspiration in stroke patients. Cerebrovasc Dis 2013; 35: 276–81.CrossRefGoogle ScholarPubMed
85Daniels, SK, Anderson, JA, Willson, PC. Valid items for screening dysphagia risk in patients with stroke: a systematic review. Stroke 2012; 43: 892–97.Google Scholar
86Waito, A, Bailey, G, Molfenter, S, Zoratto, D, Steele, C. Voice-quality abnormalities as a sign of dysphagia: validation against acoustic and videofluoroscopic data. Dysphagia 2011; 26: 125–34.CrossRefGoogle ScholarPubMed
87Bruijn, M, Rinkel, RPM, Cnossen, I, Witte, B, Langendijk, J, Leemans, CRet al.Associations between voice quality and swallowing function in patients treated for oral or oropharyngeal cancer. Support Care Cancer 2013; 21: 2025–32.Google Scholar
88Chang, H-Y, Torng, P-C, Wang, T-G, Chang, Y-C. Acoustic voice analysis does not identify presence of penetration/aspiration as confirmed by videofluoroscopic swallowing study. Archives Physical Med Rehabil 2012; 93: 1991–94.CrossRefGoogle Scholar
89Malandraki, GA, Hind, JA, Gangnon, R, Logemann, JA, Robbins, J. The utility of pitch elevation in the evaluation of oropharyngeal dysphagia: preliminary findings. Am J Speech Lang Pathol 2011; 20: 262–68.Google Scholar
90Sarraf Shirazi, S, Buchel, C, Daun, R, Lenton, L, Moussavi, Z. Detection of swallows with silent aspiration using swallowing and breath sound analysis. Med Biol Eng Comput 2012; 50: 1261–68.CrossRefGoogle ScholarPubMed
91Sato, M, Tohara, H, Iida, T, Wada, S, Inoue, M, Ueda, K. Simplified cough test for screening silent aspiration. Archives Physical Med Rehabil 2012; 93: 1982–86.Google Scholar
92Miles, A, Huckabee, M-L. Intra- and inter-rater reliability for judgement of cough following citric acid inhalation. Int J Speech-Language Pathol 2013;15: 209–15.Google Scholar
93Miles, A, Zeng, ISL, McLauchlan, H, Huckabee, M-L. Cough reflex testing in dysphagia following stroke: a randomized controlled trial. J Clin Med Res 2013; 5: 222–33.Google Scholar
94Pitts, T, Troche, M, Mann, G, Rosenbek, J, Okun, MS, Sapienza, C. Using voluntary cough to detect penetration and aspiration during oropharyngeal swallowing in patients with Parkinson disease. Chest 2010; 138: 1426–31.Google Scholar
95Bianchi, C, Baiardi, P, Khirani, S, Cantarella, G. Cough peak flow as a predictor of pulmonary morbidity in patients with dysphagia. Am J Physical Med Rehabil 2012; 91: 783–88.Google Scholar
96Garon, BR, Sierzant, T, Ormiston, C. Silent aspiration: results of 2000 video fluoroscopic evaluations. J Neurosci Nursing 2009; 41: 178–85.Google Scholar
97Frey, KL, Ramsberger, G. Comparison of outcomes before and after implementation of a water protocol for patients with cerebrovascular accident and dysphagia. J Neurosci Nursing 2011; 43: 165–71.Google Scholar
98Karagiannis, MJP, Chivers, L, Karagiannis, TC. Effects of oral intake of water in patients with oropharyngeal dysphagia. BMC Geriatrics 2011; 11: 9. doi:10.1186/1471-2318-11-9.Google Scholar
99Carlaw, C, Finlayson, H, Beggs, K, Visser, T, Marcoux, C, Coney, Det al.Outcomes of a pilot water protocol project in a rehabilitation setting. Dysphagia 2012; 27: 297306.Google Scholar
100Ewan, V, Perry, JD, Mawson, T, McCracken, G, Brown, AN, Newton, Jet al.Detecting potential respiratory pathogens in the mouths of older people in hospital. Age Ageing 2010; 39: 122–25.Google Scholar
101Pace, C, McCullough, G. The association between oral microorganisms and aspiration pneumonia in the institutionalized elderly: review and recommendations. Dysphagia 2010; 25: 307–22.Google Scholar
102van der Maarel-Wierink, CD, Vanobbergen, JNO, Bronkhorst, EM, Schols, JMGA, de Baat, C. Oral health care and aspiration pneumonia in frail older people: a systematic literature review. Gerodontology 2013; 30: 39.Google Scholar
103Abe, S, Ishihara, K, Adachi, M, Okuda, K. Tongue-coating as risk indicator for aspiration pneumonia in edentate elderly. Archives Gerontol Geriatr 2008; 47: 267–75.Google Scholar
104Hansen, T, Kjaersgaard, A, Faber, J. Measuring elderly dysphagic patients’ performance in eating – a review. Disability Rehabil 2011; 33: 1931–40.Google Scholar
105Westergren, A, Lindholm, C, Mattsson, A, Ulander, K. Minimal eating observation form: reliability and validity. J Nutrition Health Aging 2009; 13: 611.Google Scholar
106Lambert, HC, Gisel, EG, Groher, ME, Abrahamowicz, M, Wood-Dauphinee, S. Psychometric testing of the McGill Ingestive Skills Assessment. Am J Occupational Therapy 2006; 60: 409–19.Google Scholar
107Silbergleit, A, Schultz, L, Jacobson, B, Beardsley, T, Johnson, A. The Dysphagia Handicap Index: development and validation. Dysphagia 2012; 27: 4652.Google Scholar
108McHorney, CA, Robbins, J, Lomax, K, Rosenbek, JC, Chignell, K, Kramer, AEet al.The SWAL-QOL and SWAL-CARE outcomes tool for oropharyngeal dysphagia in adults: III. Documentation of reliability and validity. Dysphagia 2002; 17: 97114.Google Scholar
109Chen, AY, Frankowski, R, Bishop-Leone, J, Hebert, T, Leyk, S, Lewin, Jet al.The development and validation of a dysphagia-specific quality-of-life questionnaire for patients with head and neck cancer: the M.D. Anderson Dysphagia Inventory. Archives Otolaryngol Head Neck Surg 2001; 127: 870–76.Google Scholar
110Chen, P-H, Golub, JS, Hapner, ER, Johns, MM III. Prevalence of perceived dysphagia and quality-of-life impairment in a geriatric population. Dysphagia 2009; 24: 16.Google Scholar
111Belafsky, PC, Mouadeb, DA, Rees, CJ, Pryor, JC, Postma, GN, Allen, Jet al.Validity and reliability of the Eating Assessment Tool (EAT-10). Ann Otol Rhinol Laryngol 2008; 117: 919–24.Google Scholar
112Leow, LP, Huckabee, M-L, Anderson, T, Beckert, L. The impact of dysphagia on quality of life in ageing and Parkinson's disease as measured by the Swallowing Quality of Life (SWAL-QOL) Questionnaire. Dysphagia 2010; 25: 216–20.Google Scholar
113Wilson, JA, Carding, PN, Patterson, JM. Dysphagia after nonsurgical head and neck cancer treatment: patients’ perspectives. Otolaryngol Head Neck Surg 2011; 145: 767–71.Google Scholar
114Crary, M, Sura, L, Carnaby, G. Validation and demonstration of an isolated acoustic recording technique to estimate spontaneous swallow frequency. Dysphagia 2013; 28: 8694.Google Scholar
115Steele, C, Sejdić, E, Chau, T. Non-invasive detection of thin-liquid aspiration using dual-axis swallowing accelerometry. Dysphagia 2013; 28: 105–12.Google Scholar
116Vaiman, M, Eviatar, E. Surface electromyography as a screening method for evaluation of dysphagia and odynophagia. Head Face Med 2009; 5: 9.Google Scholar
117Altman, KW. Dysphagia evaluation and care in the hospital setting: the need for protocolization. Otolaryngol Head Neck Surg 2011; 145: 895–98.CrossRefGoogle ScholarPubMed
118Lakshminarayan, K, Tsai, AW, Tong, X, Vazquez, G, Peacock, JM, George, MGet al.Utility of dysphagia screening results in predicting poststroke pneumonia. Stroke 2010; 41: 2849–54.Google Scholar
119Yeh, S-J, Huang, K-Y, Wang, T-G, Chen, Y-C, Chen, C-H, Tang, S-Cet al.Dysphagia screening decreases pneumonia in acute stroke patients admitted to the stroke intensive care unit. J Neurol Sci 2011; 306: 3841.Google Scholar
120Ickenstein, GW, Riecker, A, Höhlig, C, Müller, R, Becker, U, Reichmann, Het al.Pneumonia and in-hospital mortality in the context of neurogenic oropharyngeal dysphagia (NOD) in stroke and a new NOD step-wise concept. J Neurol 2010; 57: 1492–99.Google Scholar
121Wilson, RD, Howe, EC. A cost-effectiveness analysis of screening methods for dysphagia after stroke. PM&R 2012; 4: 273–82.Google Scholar
122King, J, Ligman, K. Patient non-compliance with swallowing recommendations: reports from speech-language pathologists. Contemporary Issues Commun Sci Disorders 2011; 38: 5360.Google Scholar
123Foley, N, Teasell, R, Salter, K, Kruger, E, Martino, R. Dysphagia treatment post stroke: a systematic review of randomised controlled trials. Age Ageing 2008; 37: 258–64.Google Scholar
124Vitale, CA, Berkman, CS, Monteleoni, C, Ahronheim, JC. Tube feeding in patients with advanced dementia: knowledge and practice of speech-language pathologists. J Pain Symptom Management 2011; 42: 366–78.CrossRefGoogle ScholarPubMed
125Butler, S, Pelletier, C, Steele, C. Compensatory strategies and techniques. In Shaker, R, Easterling, C, Belafsky, PC, Postma, GN (eds), Manual of Diagnostic and Therapeutic Techniques for Disorders of Deglutition, pp. 299316. Springer, New York; 2013.Google Scholar
126Lazarus, C. Mendelson Maneuver and Masako Maneuver. In Shaker, R, Easterling, C, Belafsky, PC, Postma, GN (eds), Manual of Diagnostic and Therapeutic Techniques for Disorders of Deglutition, pp. 269–80. Springer, New York; 2013.Google Scholar
127Smith, SK, Roddam, H, Sheldrick, H. Rehabilitation or compensation: time for a fresh perspective on speech and language therapy for dysphagia and Parkinson's disease? Int J Lang Commun Disord 2012 (in press). doi: 10.1111/j.1460–6984.2011.00093.x.CrossRefGoogle ScholarPubMed
128Wheeler-Hegland, K, Ashford, J, Frymark, T, McCabe, D, Mullen, R, Musson, Net al.Evidence-based systematic review: oropharyngeal dysphagia behavioral treatments. Impact of dysphagia treatment on normal swallow function. J Rehabil Res Dev 2009; 46: 185–94.Google Scholar
129Baylow, HE, Goldfarb, R, Taveira, CH, Steinberg, RS. Accuracy of clinical judgment of the chin-down posture for dysphagia during the clinical/bedside assessment as corroborated by videofluoroscopy in adults with acute stroke. Dysphagia 2009; 24: 423–33.Google Scholar
130Huckabee, M-L, Macrae, P. Effortful Swallow. In Shaker, R, Easterling, C, Belafsky, PC, Postma, GN (eds), Manual of Diagnostic and Therapeutic Techniques for Disorders of Deglutition, pp. 281–98. Springer, New York: 2013.Google Scholar
131Leder, S, Judson, B, Sliwinski, E, Madson, L. Promoting safe swallowing when puree is swallowed without aspiration but thin liquid is aspirated: nectar is enough. Dysphagia 2013; 28: 5862.Google Scholar
132Agency, NPS. Dysphagia diet food textures descriptors. 2012 [cited 31 July 2013]; available at: http://www.bda.uk.com/publications/statements/NationalDescriptorsTexture-ModificationAdults.pdfGoogle Scholar
133Sdravou, K, Walshe, M, Dagdilelis, L. Effects of carbonated liquids on oropharyngeal swallowing measures in people with neurogenic dysphagia. Dysphagia 2012; 27: 240–50.Google Scholar
134Beck, AM, Holst, M, Rasmussen, HH. Oral nutritional support of older (65 years+) medical and surgical patients after discharge from hospital: systematic review and meta-analysis of randomized controlled trials. Clinical Rehabil 2013; 27: 1927.Google Scholar
135Beck, AM, Kjær, S, Hansen, BS, Storm, RL, Thal-Jantzen, K, Bitz, C. Follow-up home visits with registered dietitians have a positive effect on the functional and nutritional status of geriatric medical patients after discharge: a randomized controlled trial. Clinical Rehabil 2013; 27: 483–93.Google Scholar
136Geeganage, C, Beavan, J, Ellender, S, Bath, PMW. Interventions for dysphagia and nutritional support in acute and subacute stroke. Cochrane Database Syst Rev 2012; 10.Google Scholar
137Abbott, RA, Whear, R, Thompson-Coon, J, Ukoumunne, OC, Rogers, M, Bethel, Aet al.Effectiveness of mealtime interventions on nutritional outcomes for the elderly living in residential care: a systematic review and meta-analysis. Ageing Res Rev 2013 (in press). doi: org/10.1016/j.arr.2013.06.002.Google Scholar
138Logemann, JA, Rademaker, A, Pauloski, BR, Kelly, A, Stangl-McBreen, C, Antinoja, Jet al.A randomized study comparing the shaker exercise with traditional therapy: a preliminary study. Dysphagia 2009; 24: 403–11.Google Scholar
139Easterling, C. Shaker Exercise. In Shaker, R, Easterling, C, Belafsky, PC, Postma, GN (eds), Manual of Diagnostic and Therapeutic Techniques for Disorders of Deglutition, pp. 257–68. Springer, New York; 2013.Google Scholar
140Troche, MS, Okun, MS, Rosenbek, JC, Musson, N, Fernandez, HH, Rodriguez, Ret al.Aspiration and swallowing in Parkinson disease and rehabilitation with EMST: a randomized trial. Neurology 2010; 75: 1912–19.Google Scholar
141Steele, CM, Bailey, GL, Polacco, REC, Hori, SF, Molfenter, SM, Oshalla, Met al.Outcomes of tongue-pressure strength and accuracy training for dysphagia following acquired brain injury. Int J Speech-Language Pathol 2013 (in press). doi: 10.3109/17549507.2012.752864.Google Scholar
142Kang, J-H, Park, R-Y, Lee, S-J, Kim, J-Y, Yoon, S-R, Jung, K-I. The effect of bedside exercise program on stroke patients with dysphagia. Ann Rehabil Med 2012; 36: 512–20.Google Scholar
143Hind, J, Robbins, J. Oropharyngeal strengthening and rehabilitation of deglutitive disorders. In Shaker, R, Easterling, C, Belafsky, PC, Postma, GN (eds), Manual of Diagnostic and Therapeutic Techniques for Disorders of Deglutition, pp. 237–55. Springer, New York; 2013.Google Scholar
144Regan, J, Walshe, M, Tobin, WO. Immediate effects of thermal-tactile stimulation on timing of swallow in idiopathic Parkinson's disease. Dysphagia 2010; 25: 207–15.Google Scholar
145Doeltgen, SH, Dalrymple-Alford, J, Ridding, MC, Huckabee, ML. Differential effects of neuromuscular electrical stimulation parameters on submental motor-evoked potentials. Neurorehabil Neural Repair 2010; 24: 519–27.Google Scholar
146Carnaby-Mann, GD, Crary, MA. Examining the evidence on neuromuscular electrical stimulation for swallowing – a meta-analysis. Archives Otolaryngol Head Neck Surg 2007; 133: 564–71.Google Scholar
147Clark, H, Lazarus, C, Arvedson, J, Schooling, T, Frymark, T. Evidence-based systematic review: effects of neuromuscular electrical stimulation on swallowing and neural activation. Am J Speech Lang Pathol 2009; 18: 361–75.Google Scholar
148Humbert, IA, Michou, E, MacRae, PR, Crujido, L. Electrical stimulation and swallowing: how much do we know? Seminars Speech Language 2012; 33: 203–16.Google Scholar
149Michou, E, Mistry, S, Rothwell, J, Hamdy, S. Priming pharyngeal motor cortex by repeated paired associative stimulation: implications for dysphagia neurorehabilitation. Neurorehabil Neural Repair 2013; 27: 355–62.Google Scholar
150Khedr, E, Abo-Elfetoh, N, Rothwell, J. Treatment of post-stroke dysphagia with repetitive transcranial magnetic stimulation. Acta Neurologica Scandinavica 2009; 119: 155–61.Google Scholar
151Shigematsu, T, Fujishima, I, Ohno, K. Transcranial direct current stimulation improves swallowing function in stroke patients. Neurorehabil Neural Repair 2013; 27: 363–69.Google Scholar
152Repici, A, Hassan, C, Sharma, P, Conio, M, Siersema, P. Systematic review: the role of self-expanding plastic stents for benign oesophageal strictures. Alimentary Pharmacol Therapeutics 2010; 31: 1268–75.Google Scholar
153Stegemann, S, Gosch, M, Breitkreutz, J. Swallowing dysfunction and dysphagia is an unrecognized challenge for oral drug therapy. Int J Pharmaceutics 2012; 430: 197206.Google Scholar
154Leder, SB, Lazarus, CL, Suiter, DM, Acton, LM. Effect of orogastric tubes on aspiration status and recommendations for oral feeding. Otolaryngol Head Neck Surg 2011; 144: 372–75.CrossRefGoogle ScholarPubMed
155Gomes, CAR Jr, Lustosa, SAS, Matos, D, Andriolo, RB, Waisberg, DR, Waisberg, J. Percutaneous endoscopic gastrostomy versus nasogastric tube feeding for adults with swallowing disturbances. Cochrane Database Syst Rev 2012; 3.Google Scholar
156Beavan, J, Conroy, SP, Harwood, R, Gladman, JRF, Leonardi-Bee, J, Sach, Tet al.Does looped nasogastric tube feeding improve nutritional delivery for patients with dysphagia after acute stroke? A randomised controlled trial. Age Ageing 2010; 39: 624–30.Google Scholar
157Sobotka, L, Schneider, SM, Berner, YN, Cederholm, T, Krznaric, Z, Shenkin, Aet al.ESPEN Guidelines on parenteral nutrition: Geriatrics. Clinical Nutrition 2009; 28: 461–66.Google Scholar
158Kurien, M, McAlindon, ME, Westaby, D, Sanders, DS. Percutaneous endoscopic gastrostomy (PEG) feeding. BMJ 2010; 340: c2414.Google Scholar
159Johansson, AEM, Johansson, U. Relatives’ experiences of family members’ eating difficulties. Scand J Occupational Therapy 2009; 16: 2532.Google Scholar
160Smith, HA, Kindell, J, Baldwin, RC, Waterman, D, Makin, AJ. Swallowing problems and dementia in acute hospital settings: practical guidance for the management of dysphagia. Clinical Med 2009; 9: 544–48.Google Scholar
161Regnard, C, Leslie, P, Crawford, H, Matthews, D, Gibson, L. Gastrostomies in dementia: bad practice or bad evidence? Age Ageing 2010; 39: 282–84.Google Scholar
162Chen, H-L, Shih, S-C, Bair, M-J, Lin, IT, Wu, C-H. Percutaneous endoscopic gastrostomy in the enteral feeding of the elderly. Int J Gerontol 2011; 5: 135–38.Google Scholar
163Candy, B, Sampson, EL, Jones, L. Enteral tube feeding in older people with advanced dementia: findings from a Cochrane systematic review. Int J Palliative Nursing 2009; 15: 396404.Google Scholar
164Sampson, EL, Candy, B, Jones, L. Enteral tube feeding for older people with advanced dementia. Cochrane Database Syst Rev 2009; 2.Google Scholar
165Clarke, G, Harrison, K, Holland, A, Kuhn, I, Barclay, S. How are treatment decisions made about artificial nutrition for individuals at risk of lacking capacity? A systematic literature review. Plos One 2013; 16: 8.Google Scholar
166RCP. Oral feeding difficulties and dilemmas: a guide to practical care particularly towards end of life. London, UK: Royal College of Physicians; 2010.Google Scholar
167Sandman, L, Bolmsjo, IA, Westergren, A. Ethical considerations of refusing nutrition after stroke. Nursing Ethics 2008; 15: 147–59.Google Scholar
168Kaizer, F, Spiridigliozzi, A-M, Hunt, M. Promoting shared decision-making in rehabilitation: development of a framework for situations when patients with dysphagia refuse diet modification recommended by the treating team. Dysphagia 2012; 27: 8187.Google Scholar
169Becker, R, Nieczaj, R, Egge, K, Moll, A, Meinhardt, M, Schulz, R-J. Functional dysphagia therapy and PEG treatment in a clinical geriatric setting. Dysphagia 2011; 26: 108–16.Google Scholar
170Hirst Lisa, J. Table 151.1, Comparison of videofluoroscopy with FEES and manometry, chapter 151, Functional investigation of the upper GI tract. In Scott-Brown's Otolaryngology, Head and Neck Surgery, 7th edn, editors: MJ Gleeson, G Browning, M Burton, R Clarke, J Hibbert, N Jones, V Lund, L Luxon, J Watkinson.Google Scholar