The relationship between dysphagia and clinical and cognitive aspects in elderly patients presented with dementia

Deborah Rodrigues Pinheiro Lages

Pontifícia Universidade Católica de Campinas, São Paulo, Brasil.

Lineu Corrêa Fonseca

Pontifícia Universidade Católica de Campinas, São Paulo, Brasil.

† In memoriam.

Glória Maria Almeida Souza Tedrus

Pontifícia Universidade Católica de Campinas, São Paulo, Brasil.

Iara Bittante de Oliveira

Pontifícia Universidade Católica de Campinas, São Paulo, Brasil.

Corresponding address: Gloria Tedrus, Avenida John Boyd Dunlop - Jardim Ipaussurama, CEP: 13034-685 - Campunas, São Paulo, Brasil, E-mail: gloriatedrus@puc-campinas.edu.br

	AD (n=24)	VD (n=11)	p
Age (years)	80.5 (± 7.9)	70.9 (± 7.9)	0.003^a*
Sex: Women/Men	15/9	4/7	0.273^b
Level of education (years)	1.9 (±0.6)	2.4 (±0.8)	0.10^a
Disease duration (years)	3.4 (±2.6)	3.8 (±3.0)	0.714^a
MMSE (total score)	13 (6.4)	17 (±6.2)	0.092^a
VF animals	5.5 (±3.2)	6 (±2.1)	0.624^a
FAQ	24.4 (±5.6)	19.5 (±7.8)	0.083^a
CDR (total score)	1.8 (±0.6)	1.2 (±0.6)	0.02^a*
CDR: Classification
Mild (n=16)	7 (29.1%)	9 (81.8%)	0.013^c*
Moderate (n=14)	13 (54.1%)	1 (9.1%)
Severe (n=5)	4 (16.6%)	1 (9.1%)
Complaints of coughing/choking: yes/no	5/19	4/7	0.416^c

	Type of dementia			CDR
	AD (n=24)	VD (n=11)	p	Mild	Moderate	Severe	p
Oral phase	14 (58.3%)	7 (63.3%)	1.0^a	9	8	4	0.614^b
Anterior oral escape (water)	7 (29.1%)	3 (27.2%)	1.0^a	3	5	2	0.490^b
Anterior oral escape (pasty food)	-	-		-	-	-
Oral transit time (water)	4 (16.6%)	2 (18.1%)	1.0^a	1	2	3	0.019^b*
Oral transit time (pasty food)	4 (16.6%)	4 (36.3%)	0.226^a	3	3	2	0.606^b
Number of swallowings (water)	11 (45.8%)	4 (36.3%)	0.721^a	5	7	3	0.412^b
Number of swallowings (pasty food)	12 (50%)	5 (45.4%)	1.0^a	6	8	3	0.482^b
Residue in oral cavity	2 (8.3%)	-		-	2	-	0.204^b
Pharyngeal phase	16 (66.6%)	6 (54.5%)	0.708^a	8	9	5	0.179^b
Reflux (water and pasty food)	-	-		-	-	-
Laryngeal elevation (water)	10 (41.6%)	4 (36.3%)	1.0^a	3	8	3	0.036^b*
Laryngeal elevation (pasty food)	11 (45.8%)	-	0.721^a	3	8	4	0.02^b*
Coughing (water)	4 (16.6%)	3 (27.2%)	0.652^a	2	3	2	0.400^b
Coughing (pasty food)	5 (20.8%)	3 (27.2%)	0.685^a	3	4	1	0.700^b
Choking (water and pasty food)	-	-		-	-	-
Vocal quality (water)	11 (45.8%)	4 (36.3%)	0.721^a	5	6	4	0.157^b
Vocal quality (pasty food)	10 (41.6%)	3 (27.2%)	0.478^a	4	7	2	0.364^b
Cervical auscultation (water)	-	1 (9%)	0.314^a	-	-	1	0.046^b*
Cervical auscultation (pasty food)	-	-		-	-	-
Oxygen saturation (water)	1 (4.1%)	1 (9%)	0.536^a	1	1	-	1.0^b
Oxygen saturation (pasty food)	-	1 (9%)	0.314^a	-	-	1	0.046^b*
Cyanosis, bronchospasm (water)	-	2 (18.1%)	0.092^a	-	1	1	0.489^b
Cyanosis, bronchospasm (pasty food)	-	2 (18.1%))	0.092^a	-	1	1	0.489^b
Dysphagia	17 (70.8%))	8 (72.7%))	1.0^a	10	10	5	0.454^b

	MMSE
	N. (normal vs altered)			p
Laryngeal elevation (water)	21 x 14	Temporal orientation	1.6 (±1.7) x 0.5 (±0.7)	0.021*
	21 x 14	Attention and calculation	1.2 (±1.7) x 0.2 (±0.4)	0.016*
	21 x 14	Language	6.5 (±1.8) x 4.9 (±2.0)	0.026*
	21 x 14	Total score	16.4 (±6.6) x 10.9 (±4.9)	0.008*
Laryngeal elevation (pasty food)	20 x 15	Temporal orientation	1.7 (±1.7) x 0.5 (±0.7)	0.012*
	20 x 15	Spatial orientation	3.6 (±1.5) x 2.4 (±1.6)	0.039*
	20 x 15	Immediate Memory	2.7 (±0.6) x 2.0 (±1.1)	0.032*
	20 x 15	Attention and calculation	1.3 (±1.7) x 0.2 (±0.4)	0.013*
	20 x 15	Language	6.8 (±1.0) x 4.6 (±2.3)	0.003*
	20 x 15	Total score	17.3 (±5.6) x 10.2 (±5.5)	0.001*
Coughing (water)	28 x 7	Evocation	0.9 (±1.5) x 0.2 (±0.4)	0.001*
Coughing (pasty food)	27 x 8	Attention and calculation	1.0 (±1.5) x 0.2 (±0.4)	0.038*
Cyanosis, bronchospasm (water)	33 x 2	Temporal orientation	1.2 (±1.5) x 0.0 (±0.0)	<0.000*
	33 x 2	Attention and calculation	0.8 (±1.4) x 0.0 (±0.0)	0.002*
	33 x 2	Drawing of a pentagon	0.2 (±0.4) x 0.0 (±0.0)	0.006*
Oxygen saturation (water)	33 x 2	Immediate Memory	3.0 (±0.0) x 2.3 (±0.9)	0.001*
Oxygen saturation (water)	33 x 2	Language	7.0 (±0.0) x 5.8 (±2.0)	0.003*
Vocal quality (water)	20 x 15	Attention and calculation	1.3 (±1.7) x 0.2 (±0.4)	0.013*
Vocal quality (pasty food)	22 x 13	Calculation and attention	1.2 (±1.6) x 0.1 (±0.3)	0.008*
Vocal quality (pasty food)	22 x 13	Drawing of a pentagon	0.3 (±0.4) x 0.0 (±0.0)	0.005*

	NPI-C
	Changes in appetite, weight, eating habits			Changes in eating behavior			Frequent request of food and/or drink
	No	Yes	p	No	Yes	p	No	Yes	p
CDR
Mild	10	6	0.044^a*	16	0	0.046^a*	13	3	0.023^a*
Moderate	8	6		14	0		11	3
Severe	0	5		04	1		1	4
Signs of dysphagia
Absent	9	9	0.007^a*	10	0	1.0^a	9	16	0.21^a
Present	1	16	0.007^a*	24	1	1.0^a	1	9	0.21^a
Oral phase
Normal	10	4	0.086^a	14	0	1.0^a	11	3	0.704^a
Altered	8	13	0.086^a	20	1	1.0^a	14	7	0.704^a
Pharyngeal phase
Normal	10	3	0.003^a*	13	0	1.0^a	11	2	0.59^a
Altered	8	14	0.003^a*	21	1	1.0^a	14	8	0.59^a
FAQ	22.5 (±6.7)	28.5 (±0.7)	<0.000^b*	22.7 (±6.7)	30.0	0.293^b	21.5 (±7.3)	26.4 (±3.2)	0.01^b*

Brasil