, Volume 25, Issue 3, pp 216–220 | Cite as

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

  • Li Pyn Leow
  • Maggie-Lee Huckabee
  • Tim Anderson
  • Lutz Beckert
Original Article


This prospective, cross-sectional study evaluated the impact of dysphagia on quality of life in healthy ageing and in subjects with Parkinson’s disease (PD) using the Swallowing Quality of Life (SWAL-QOL) questionnaire. Sixteen healthy young adults (8 males, mean age = 25.1 years) and 16 healthy elders (8 males, mean age = 72.8 years) were recruited. Thirty-two subjects with idiopathic PD (mean age = 68.5 years) were recruited from a movement disorders clinic. The severity of PD was staged using the Hoehn and Yahr scale. Results revealed that elders experienced symptoms of dysphagia more frequently than young adults but the overall SWAL-QOL scores were not significantly different. Subjects with PD who experienced dysphagia reported greatly reduced QOL, and significant differences were found in all but one subsection of the SWAL-QOL. Disease progression detrimentally impacts QOL, with subjects in later-stage PD experiencing further reduction in the desire to eat, difficulty with food selection, and prolonged eating duration. These features, which increase with disease severity, are likely to impact negatively upon nutritional status, which is already under threat from PD-related dysphagia.


Quality of life Ageing Parkinson’s disease Deglutition Deglutition disorders 


  1. 1.
    Ekberg O, Feinberg MJ. Altered swallowing function in elderly patients without dysphagia: radiologic findings in 56 cases. AJR Am J Roentgenol. 1991;156:1181–4.PubMedGoogle Scholar
  2. 2.
    Ekberg O, Hamdy S, Woisard V, Wuttge-Hannig A, Ortega P. Social and psychological burden of dysphagia: its impact on diagnosis and treatment. Dysphagia. 2002;17:139–46.CrossRefPubMedGoogle Scholar
  3. 3.
    Langmore SE. Issues in the management of dysphagia. Folia Phoniatr Logop. 1999;51:220–30.CrossRefPubMedGoogle Scholar
  4. 4.
    Jacobsson C, Axelsson K, Osterlind PO, Norberg A. How people with stroke and healthy older people experience the eating process. J Clin Nurs. 2000;9:255–64.CrossRefPubMedGoogle Scholar
  5. 5.
    Gustafsson B. The experiential meaning of eating, handicap, adaptedness, and confirmation in living with esophageal dysphagia. Dysphagia. 1995;10:68–85.CrossRefPubMedGoogle Scholar
  6. 6.
    Lai SM, Studenski S, Duncan PW, Perera S. Persisting consequences of stroke measured by the Stroke Impact Scale. Stroke. 2002;33:1840–4.CrossRefPubMedGoogle Scholar
  7. 7.
    Tolep K, Kelsen SG. Effect of aging on respiratory skeletal muscles. Clin Chest Med. 1993;14:363–78.PubMedGoogle Scholar
  8. 8.
    de Luis DA, Izaola O, de Mateo ML, Cuellar L, Terroba MC, Aller R. Quality of life, dietary intake in elderly patients with dysphagia. Nutrition. 2006;22:584.CrossRefPubMedGoogle Scholar
  9. 9.
    Hobson JP, Edwards NI, Meara RJ. The Parkinson’s Disease Activities of Daily Living Scale: a new simple and brief subjective measure of disability in Parkinson’s disease. Clin Rehabil. 2001;15:241–6.CrossRefPubMedGoogle Scholar
  10. 10.
    Miller N, Noble E, Jones D, Burn D. Life with communication changes in Parkinson’s disease. Age Ageing. 2006;35:235–9.CrossRefPubMedGoogle Scholar
  11. 11.
    Playfer JR. Depression, cognition and quality of life in parkinsonian patients. Age Ageing. 1999;28:333–4.CrossRefPubMedGoogle Scholar
  12. 12.
    Miller N, Noble E, Jones D, Burn D. Hard to swallow: dysphagia in Parkinson’s disease. Age Ageing. 2006;35:614–8.CrossRefPubMedGoogle Scholar
  13. 13.
    Slawek J, Derejko M, Lass P. Factors affecting the quality of life of patients with idiopathic Parkinson’s disease—a cross-sectional study in outpatient clinic attendees. Parkinsonism Relat Disord. 2005;11:465–8.CrossRefPubMedGoogle Scholar
  14. 14.
    McHorney CA, Robbins J, Lomax K, Rosenbek JC, Chignell K, Kramer AE, et al. The SWAL-QOL and SWAL-CARE outcomes tool for oropharyngeal dysphagia in adults: III. Documentation of reliability and validity. Dysphagia. 2002;17:97–114.CrossRefPubMedGoogle Scholar
  15. 15.
    Coates C, Bakheit AM. Dysphagia in Parkinson’s disease. Eur Neurol. 1997;38:49–52.CrossRefPubMedGoogle Scholar
  16. 16.
    Hoehn MM, Yahr MD. Parkinsonism: onset, progression and mortality. Neurology. 1967;17:427–42.PubMedGoogle Scholar
  17. 17.
    McHorney CA, Bricker DE, Robbins J, Kramer AE, Rosenbek JC, Chignell KA. The SWAL-QOL outcomes tool for oropharyngeal dysphagia in adults: II. Item reduction and preliminary scaling. Dysphagia. 2000;15:122–33.PubMedGoogle Scholar
  18. 18.
    Likert R. A technique for the measurement of attitudes. Arch Psychol. 1932;140:5–55.Google Scholar
  19. 19.
    Huckabee ML, Pelletier CA. Oral nutrition interventions for dysphagia, management of adult neurogenic dysphagia. San Diego, CA: Singular Publishing Group; 1999.Google Scholar
  20. 20.
    Lorefalt B, Granerus AK, Unosson M. Avoidance of solid food in weight losing older patients with Parkinson’s disease. J Clin Nurs. 2006;15:1404–12.CrossRefPubMedGoogle Scholar
  21. 21.
    Plowman-Prine EK, Sapienza CM, Okun MS, Pollock SL, Jacobson C, Wu SS, et al. The relationship between quality of life and swallowing in Parkinson’s disease. Mov Disord. 2009;24:1352–8.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2009

Authors and Affiliations

  • Li Pyn Leow
    • 1
    • 3
  • Maggie-Lee Huckabee
    • 2
    • 3
  • Tim Anderson
    • 3
    • 4
  • Lutz Beckert
    • 5
  1. 1.Department of Speech TherapyTan Tock Seng HospitalSingaporeSingapore
  2. 2.Department of Communication DisordersUniversity of CanterburyChristchurchNew Zealand
  3. 3.Van der Veer Institute for Parkinson’s and Brain ResearchChristchurchNew Zealand
  4. 4.Department of MedicineUniversity of OtagoChristchurchNew Zealand
  5. 5.Department of Respiratory MedicineUniversity of OtagoChristchurchNew Zealand

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