Journal Article

Oropharyngeal swallow physiology and swallowing-related quality of life in underweight patients with concomitant advanced chronic obstructive pulmonary disease

Paoletti, Luca, Martin-Harris, Bonnie, Strange, Charlie, Garand, Kendrea L, Hopkins-Rossabi, Theresa

2018

Overview

Swallowing impairment (dysphagia) has been associated with COPD and may contribute to exacerbations of this chronic and progressive disease. Further, risk of mortality increases with concomitant presence of cachexia in the COPD population. The purpose of this prospective study was to depict oropharyngeal swallowing physiology in underweight patients with stable but advanced-stage COPD. Ten underweight patients with stable but advanced COPD underwent a modified barium swallow study. Analysis of oropharyngeal swallowing function was completed using the standardized Modified Barium Swallow Impairment Profile and the Penetration-Aspiration Scale. Scores from the Dysphagia Handicap Index and 10-item Eating Assessment Tool were collected to assess patient perception of swallowing difficulty. Findings were compared to age- and sex-matched healthy controls. Significantly higher MBSImP oral total scores ( =0.007) were observed in COPD patients compared to matched controls, but no difference was observed in pharyngeal total scores ( =0.105). Patients with COPD had significantly higher maximum PAS scores compared with controls ( =0.030). There was no significant difference in EAT-10 or DHI scores between patients with COPD and controls ( =0.41 and =0.08, respectively). Underweight patients with severe but stable COPD present with dysphagia that may not be recognized by the patient. Further investigation is needed to elucidate the interaction between the respiratory-swallowing systems, how muscular weakness may contribute to swallowing impairment, and responsiveness to swallowing treatment.

• Publisher: Dove Medical Press Limited,Dove Medical Press Ltd,Dove Press,Dove Medical Press
• Subject: Activities of Daily Living / Aged / Aged, 80 and over / Airway management / and underweight / Barium / Body mass index / Cachexia / Cancer / Case-Control Studies / Chronic obstructive lung disease / Chronic obstructive pulmonary disease / Clinical Trial Report / Clinical trials / COPD / Deglutition / Deglutition disorders / Deglutition Disorders - diagnostic imaging / Deglutition Disorders - etiology / Deglutition Disorders - physiopathology / Dysphagia / Female / Hand Strength / Health aspects / Humans / Lung diseases / Male / MBSImP / Medical research / Middle Aged / Mortality / Patients / Physiological aspects / Physiology / Prospective Studies / Pulmonary Disease, Chronic Obstructive - complications / Pulmonary Disease, Chronic Obstructive - physiopathology / Quality of Life / Random Allocation / Reproducibility of Results / Respiratory tract diseases / swallowing impairment / Thinness - complications / Thinness - physiopathology / underweight