A randomized study of three interventions for aspiration of thin liquids in patients with dementia or Parkinson's disease

Jeri A. Logemann, Gary Gensler, Jo Anne Robbins, Anne S. Lindblad, Diane Brandt, Jacqueline A. Hind, Steven Kosek, Karen Dikeman, Marta Kazandjian, Gary D. Gramigna, Donna Lundy, Susan McGarvey-Toler, Patricia J. Miller Gardner

Research output: Contribution to journalArticle

206 Scopus citations

Abstract

Purpose: This study was designed to identify which of 3 treatments for aspiration on thin liquids - chin-down posture, nectar-thickened liquids, or honey-thickened liquids - results in the most successful immediate elimination of aspiration on thin liquids during the videofluorographic swallow study in patients with dementia and/or Parkinson's disease. Method: This randomized clinical trial included 711 patients ages 50 to 95 years who aspirated on thin liquids as assessed videofluorographically. All patients received all 3 interventions in a randomly assigned order during the videofluorographic swallow study. Results: Immediate elimination of aspiration on thin liquids occurred most often with honey-thickened liquids for patients in each diagnostic category, followed by nectar-thickened liquids and chin-down posture. Patients with most severe dementia exhibited least effectiveness on all interventions. Patient preference was best for chin-down posture followed closely by nectar-thickened liquids. Conclusion: To identify best short-term intervention to prevent aspiration of thin liquid in patients with dementia and/or Parkinson's disease, a videofluorographic swallow assessment is needed. Evidence-based practice requires taking patient preference into account when designing a dysphagic patient's management plan. The longer-term impact of short-term prevention of aspiration requires further study.

Original languageEnglish (US)
Pages (from-to)173-183
Number of pages11
JournalJournal of Speech, Language, and Hearing Research
Volume51
Issue number1
DOIs
StatePublished - Feb 1 2008

Keywords

  • Aspiration
  • Dementia
  • Parkinson's disease
  • Posture
  • Thickened liquids

ASJC Scopus subject areas

  • Rehabilitation
  • Health Professions(all)
  • Linguistics and Language

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    Logemann, J. A., Gensler, G., Robbins, J. A., Lindblad, A. S., Brandt, D., Hind, J. A., Kosek, S., Dikeman, K., Kazandjian, M., Gramigna, G. D., Lundy, D., McGarvey-Toler, S., & Miller Gardner, P. J. (2008). A randomized study of three interventions for aspiration of thin liquids in patients with dementia or Parkinson's disease. Journal of Speech, Language, and Hearing Research, 51(1), 173-183. https://doi.org/10.1044/1092-4388(2008/013)