Dysphagia in Alzheimer’s disease: a systematic review

Mira, Ana; Gonçalves, Rita; Rodrigues, Inês Tello

doi:10.1590/1980-5764-DN-2021-0073

Acessibilidade / Reportar erro

Brasil

Dementia & Neuropsychologia

Español English

Brasil

Español English

sumário « anterior atual seguinte »

Sumário

Views & Reviews • Dement. neuropsychol. 16 (3) • jul-sep 2022 • https://doi.org/10.1590/1980-5764-DN-2021-0073 copy

Dysphagia in Alzheimer’s disease: a systematic review

A disfagia na Doença de Alzheimer: uma revisão sistemática

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Dysphagia is described as a highly relevant comorbidity of Alzheimer’s disease (AD). However, there is a scarcity of studies aiming at the characteristics and progression of dysphagia. Objective: The objective of this study was to identify the specific characteristics, progression, and prevalence of dysphagia in AD. Methods: Publications were searched in the PubMed (MEDLINE), EBSCO, ScienceDirect, and BASE databases. Critical appraisal and evidence-level analysis were conducted using the Joanna Briggs Institute and Effective Public Health Practice Project’s (EPHPP) tools. Results: A total of 26 studies were reviewed. Symptoms begin in the early stage of AD, as oral phase impairments, and progress to pharyngeal symptoms and swallowing apraxia in the later stages of AD. Dysphagia progresses, as AD, along a continuum, with severity depending on individual variability. There were no studies found on prevalence. Conclusions: Dysphagia is a complex and important comorbidity in AD that impacts the quality of life. No recent publications on prevalence may imply that is not being coded as a potential cause for pneumonia deaths in AD.

Keywords:
Deglutition Disorders; Alzheimer Disease; Disease Progression; Prevalence

Dysphagia symptoms	CDR1	CDR2	CDR3
Swallowing apraxia			x
Prolonged oral stage/phase	x	x	x
Reduced lingual movement	x	x	x
Mastication inefficacy/bolus preparation	x	x	x
Oral residue after swallowing	x	x	x
Delayed swallowing reflex	x	x	x
Coughing/airway clearance	x	x	x
Chocking	x	x	x
Upper esophageal sphincter opening		x	x
Visible aspiration (FEES)		x	x
Need for verbal cues to initiate swallow reflex		x	x
Oral agnosia			x

Academia Brasileira de Neurologia, Departamento de Neurologia Cognitiva e Envelhecimento R. Vergueiro, 1353 sl.1404 - Ed. Top Towers Offices, Torre Norte, São Paulo, SP, Brazil, CEP 04101-000, Tel.: +55 11 5084-9463 | +55 11 5083-3876 - São Paulo - SP - Brazil
E-mail: revistadementia@abneuro.org.br | demneuropsy@uol.com.br

Acompanhe os números deste periódico no seu leitor de RSS

[1] Correspondence: Ana Mira; Email: Amira@Chua.Min-Saude.Pt.

Year	Journal	Author(s)	Publication	Incidence of dysphagia (%) (samples)
2010	Arquivos Neuropsiquiatria	Correia et al⁹9 Correia SM, Morillo LS, Jacob Filho W, Mansur LL. Swallowing in moderate and severe phases of Alzheimer’s disease. Arq Neuro-Psiquiatr. 2010;68(6):855-61. https://doi.org/10.1590/s0004-282x2010000600005 https://doi.org/10.1590/s0004-282x201000...	Swallowing in moderate and severe phases of Alzheimer’s disease	27.8–71.9
2012	Geriatrics Gerontology International	Edahiro et al.³⁷37 Edahiro A, Hirano H, Yamada R, Chiba Y, Watanabe Y, Tonogi M, et al. Factors affecting independence in eating among elderly with Alzheimer’s disease. Geriatr Gerontol Int. 2012;12(3):481-90. https://doi.org/10.1111/j.1447-0594.2011.00799.x https://doi.org/10.1111/j.1447-0594.2011...	Factors affecting independence in eating among elderly with Alzheimer’s disease	2.4–87.3
2013	European Psychiatry	Heun et al.³⁵35 Heun R, Schoepf D, Potluri R, Natalwala A. Alzheimer’s disease and co-morbidity: increased prevalence and possible risk factors of excess mortality in a naturalistic 7-year follow-up. Eur Psychiatry. 2013;28(1):40-8. https://doi.org/10.1016/j.eurpsy.2011.06.001 https://doi.org/10.1016/j.eurpsy.2011.06...	Alzheimer’s disease and comorbidity: increased prevalence and possible risk factors of excess mortality in a naturalistic 7-year follow-up	11
2013	Alzheimer’s Disease Association Disorders	Tian et al.³⁶36 Tian H, Abouzaid S, Sabbagh MN, Chen W, Gabriel S, Kahler KH, et al. Health care utilization and costs among patients with AD with and without dysphagia. Alzheimer Dis Assoc Disord. 2013;27(2):138-44. https://doi.org/10.1097/WAD.0b013e318258cd7d https://doi.org/10.1097/WAD.0b013e318258...	Health care utilization and costs among patients with AD with and without dysphagia	5.4
2014	Revista. Latino-Americana Enfermagem	Goes et al.³⁰30 Goes VF, Mello-Carpes PB, Oliveira LO, Hack J, Magro M, Bonini JS. Evaluation of dysphagia risk, nutritional status and caloric intake in elderly patients with Alzheimer’s. Rev Lat Am Enfermagem. 2014;22(2):317-24. https://doi.org/10.1590/0104-1169.3252.2418 https://doi.org/10.1590/0104-1169.3252.2...	Evaluation of dysphagia risk, nutritional status, and caloric intake in elderly patients with Alzheimer’s disease	86
2014	Geriatrics Gerontology International	Sato et al.¹⁴14 Sato E, Hirano H, Watanabe Y, Edahiro A, Sato K, Yamane G, et al. Detecting signs of dysphagia in patients with Alzheimer’s disease with oral feeding in daily life. Geriatr Gerontol Int. 2014;14(3):549-55. https://doi.org/10.1111/ggi.12131 https://doi.org/10.1111/ggi.12131...	Detecting signs of dysphagia in patients with Alzheimer’s disease with oral feeding in daily life	12.8–41
2015	Journal of Clinical Nursing	Chen et al.²⁸28 Chen LL, Li H, Lin R, Zheng JH, Wei YP, Li J, et al. Effects of a feeding intervention in patients with Alzheimer’s disease and dysphagia. J Clin Nurs. 2016;25(5-6):699-707. https://doi.org/10.1111/jocn.13013 https://doi.org/10.1111/jocn.13013...	Effects of a feeding intervention in patients with Alzheimer’s disease and dysphagia	100
	PLoS ONE	Kai et al.³⁸38 Kai K, Hashimoto M, Amano K, Tanaka H, Fukuhara R, Ikeda M. Relationship between eating disturbance and dementia severity in patients with Alzheimer’s disease. PLoS One. 2015;10(8):e0133666. https://doi.org/10.1371/journal.pone.0133666 https://doi.org/10.1371/journal.pone.013...	Relationship between eating disturbance and dementia severity in patients with Alzheimer’s disease	81.4
	Turkish Journal of Medical Sciences	Yildiz et al.³⁴34 Yildiz D, Büyükkoyuncu Pekel N, Kiliç AK, Tolgay EN, Tufan F. Malnutrition is associated with dementia severity and geriatricsyndromes in patients with Alzheimer disease. Turk J Med Sci. 2015;45(5):1078-81. https://doi.org/10.3906/sag-1406-76 https://doi.org/10.3906/sag-1406-76...	Malnutrition is associated with dementia severity and geriatric syndromes in patients with Alzheimer’s disease	5.4–36
2016	Journal of Nursing Home Research Sciences	Miranda et al ³¹31 Miranda D, Cardoso R, Gomes R, Guimarães I, Abreu DDE, Godinho C, et al. Undernutrition in institutionalized elderly patients with neurological diseases: comparison between different diagnostic criteria. J Nurs Res. 2016;2:76-82. https://doi.org/10.14283/jnhrs.2016.11 https://doi.org/10.14283/jnhrs.2016.11...	Undernutrition in institutionalized elderly patients with neurological diseases: comparison between different diagnostic criteria	63
	Clinical Neurophysiology	Seçil et al.²⁰20 Seçil Y, Arıcı S˛, Incesu TK, Gürgör N, Beckmann Y, Ertekin C. Dysphagia in Alzheimer’s disease. Neurophysiol Clin Neurophysiol. Neurophysiol Clin. 2016;46(3):171-8. https://doi.org/10.1016/j.neucli.2015.12.007 https://doi.org/10.1016/j.neucli.2015.12...	Dysphagia in Alzheimer’s disease	75
	Medicine	Tang et al.³⁹39 Tang Y, Lin X, Lin X, Zheng W, Zheng Z, Lin Z, et al. Therapeutic efficacy of neuromuscular electrical stimulation and electromyographic biofeedback on Alzheimer’s disease patients with dysphagia. Medicine (Baltimore). 2017;96(36):e8008. https://doi.org/10.1097/MD.0000000000008008 https://doi.org/10.1097/MD.0000000000008...	Therapeutic efficacy of neuromuscular electrical stimulation and electromyographic biofeedback on Alzheimer’s disease patients with dysphagia	100
2018	Dementia and Neuropsychologia	Mastroianni and Forgerini⁴⁰40 Mastroianni P de C, Forgerini M. Drug administration adjustments for elderly patients with dysphagia: a case report. Dement Neuropsychol. 2018;12(1):97-100. https://doi.org/10.1590/1980-57642018dn12-010015 https://doi.org/10.1590/1980-57642018dn1...	Drug administration adjustments for elderly patients with dysphagia	100
2019	Journal of Parenteral and Enteral Nutrition	Ozsurekci et al.³²32 Özsürekci C, Arslan SS, Demir N, ÇalıS˛kan H, S˛engül Ayçiçek G, Kılınç HE, et al. Timing of dysphagia screening in alzheimer’s dementia. JPEN J Parenter Enteral Nutr. 2020;44(3):516-24. https://doi.org/10.1002/jpen.1664 https://doi.org/10.1002/jpen.1664...	Timing of dysphagia screening in Alzheimer’s dementia	98.7
2019	Singapore Medical Journal	Shea et al.⁴¹41 Shea Y, Lee S, Shum A, Chiu P, Chu L, Chan H. Chinese patients with Lewy body dementia had shorter survival and developed complications earlier than those with Alzheimer’s disease. Singapore Med J. 2020;61(10):551-8. https://doi.org/10.11622/smedj.2019103 https://doi.org/10.11622/smedj.2019103...	Chinese patients with Lewy body dementia had shorter survival and developed complications earlier than those with Alzheimer’s disease	12.9