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A Systematic Review of the Prevalence of Oropharyngeal Dysphagia in Stroke, Parkinson’s Disease, Alzheimer’s Disease, Head Injury, and Pneumonia

Abstract

Oropharyngeal dysphagia is a common condition after stroke, Parkinson’s disease (PD), and Alzheimer’s disease (AD), and can cause serious complications including malnutrition, aspiration pneumonia, and premature mortality. Despite its high prevalence among the elderly and associated serious complications, dysphagia is often overlooked and under-diagnosed in vulnerable patient populations. This systematic review aimed to improve understanding and awareness of the prevalence of dysphagia in susceptible patient populations. MEDLINE, EMBASE, the Cochrane library, PROSPERO, and disease-specific websites were systematically searched for studies reporting oropharyngeal dysphagia prevalence or incidence in people with stroke, PD, AD, traumatic brain injury, and community-acquired pneumonia, from the USA, Canada, France, Germany, Italy, Spain, UK, Japan, China, and regional studies. The quality of study descriptions were assessed based on STROBE guidelines. A total of 1207 publications were identified and 33 met inclusion criteria: 24 in stroke, six in PD, two in traumatic brain injury, and one in patients with traumatic brain injury. Dysphagia was reported in 8.1–80 % of stroke patients, 11–81 % of PD, 27–30 % of traumatic brain injury patients, and 91.7 % of patients with community-acquired pneumonia. No relevant studies of dysphagia in AD were identified. This review demonstrates that dysphagia is highly prevalent in these populations, and highlights discrepancies between studies, gaps in dysphagia research, and the need for better dysphagia management starting with a reliable, standardized, and validated method for oropharyngeal dysphagia identification.

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Acknowledgments

CT determined the study concept and design. JK contributed to the searches, selected the references, and carried out the data extraction and quality assessment. JK and EG carried out the analysis and interpretation of the data, with input from CT and RS. EG drafted the manuscript with critical revision for important intellectual content from CT and RS. We would also like to acknowledge Sheila Ubamadu who carried out the systematic searches.

Funding

This work was funded by Nestlé Health Science.

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Correspondence to Elizabeth Gemmell.

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Claire Takizawa is an employee of Nestlé Health Science. Elizabeth Gemmell and at the time of submission James Kenworthy, are employed by PHMR Ltd. and Nestle Health Science funded the research that is reported in this paper. Renée Speyer has received funding from industry Nestlé Health Science, Fresenius-Kabi, Nutricia, Speech Pathology Australia, the European Society for Swallowing Disorders, and the Korean Dysphagia Society.

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Takizawa, C., Gemmell, E., Kenworthy, J. et al. A Systematic Review of the Prevalence of Oropharyngeal Dysphagia in Stroke, Parkinson’s Disease, Alzheimer’s Disease, Head Injury, and Pneumonia. Dysphagia 31, 434–441 (2016). https://doi.org/10.1007/s00455-016-9695-9

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  • DOI: https://doi.org/10.1007/s00455-016-9695-9

Keywords

  • Oropharyngeal dysphagia
  • Stroke
  • Epidemiology
  • Parkinson’s disease
  • Head injury