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aspiration and Parkinson's Disease


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#1 Guest__*

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Posted 11 February 2009 - 03:10 PM

I have recently been doing some research about dysphagia in Parkinson's disease and I have come across quite a few sources that aspiration pneumonia is one of the leading causes of death in patients with PD, is this accurate?

#2 Dr. Bassich

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Posted 12 February 2009 - 04:20 PM

It is hard to answer your question with a “yes” or “no” answer. People do not die of Parkinson’s disease --- they die of complications or other coexisting medical problems (stroke, heart attack, cancer). As the disease progresses to late stages, nutrition becomes an important management issue because of swallowing problems. Carepartners and persons with Parkinson disease are faced with important issues and must make crucial decisions. It is good that you are doing some research now to prepare you to make these decisions.

Yes, aspiration pneumonia is one of the causes of death in persons with PD. But it is also a leading cause of death in persons without PD.

As persons progress with any degenerative disease, their ability to swallow becomes significantly impaired, and their diet is restricted to thickened liquids and pureed foods. Hydration becomes an important issue. I encourage you to look into the Frazier Water Protocol at the following website:

http://www.jhsmh.org...sp_waterpro.asp

Research has demonstrated that persons who aspirate and have good oral hygiene have less risk of developing aspiration pneumonia.

Yoneyama, T., Yoshida, M., Ohrui, T., Mukaiyama, H., Okamoto, H., Hosiba, K., Iharia, S., Yanagisawa, S., Ariumi,S., Morita, T., Mizuno, Y., Ohsawa, T., Akagawa, Y., Hashimoto, K., & Sasaki, H. (2002).
Oral care reduces pneumonia in older patients in nursing homes. Journal of American Geriatrics Society, 50(3):430-433.

Aggressive oral care should be provided to persons who are unable to clean their own teeth and mouths so that pathogenic bacteria are less likely to contaminate their saliva – thereby contaminating the lungs if aspirated. The Frazier Water Prot0col Oral Hygiene Program is done twice a day as follows: Mix 2 oz of hydrogen peroxide and 2 oz of water. Using a toothbrush, scrub the teeth, cheeks, gums, and tongue for two minutes.

Another resource I would recommend to help you and your family prepare for making important decisions is Hard Choices for Loving People by Hank Dunn (available through http://www.hardchoices.com/). This paperback provides invaluable information about end of life issues.

I hope these resources are helpful to you!

Celia J. Bassich, Ph.D., CCC-SLP
Speech Pathology Faculty Member
Allied Team Training for Parkinson Disease, NPF




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