Hostname: page-component-76fb5796d-wq484 Total loading time: 0 Render date: 2024-04-27T01:18:18.763Z Has data issue: false hasContentIssue false
  • English
  • Français

Characteristics of eating and swallowing problems in patients who have dementia with Lewy bodies

Published online by Cambridge University Press:  04 March 2009

Shunichiro Shinagawa ,
Hiroyoshi Adachi ,
Yasutaka Toyota ,
Takaaki Mori ,
Izumi Matsumoto ,
Ryuji Fukuhara  and
Manabu Ikeda
Shunichiro Shinagawa*
Affiliation:
Department of Psychiatry, Jikei University School of Medicine, Tokyo, Japan Department of Neuropsychiatry and Neuroscience, Ehime University Graduate School of Medicine, Ehime, Japan
Hiroyoshi Adachi
Affiliation:
Department of Neuropsychiatry and Neuroscience, Ehime University Graduate School of Medicine, Ehime, Japan Osaka University Health Care Center, Osaka, Japan
Yasutaka Toyota
Affiliation:
Department of Neuropsychiatry and Neuroscience, Ehime University Graduate School of Medicine, Ehime, Japan
Takaaki Mori
Affiliation:
Department of Neuropsychiatry and Neuroscience, Ehime University Graduate School of Medicine, Ehime, Japan
Izumi Matsumoto
Affiliation:
Department of Special Support School Education, Ehime University Graduate School of Education, Ehime, Japan
Ryuji Fukuhara
Affiliation:
Department of Neuropsychiatry and Neuroscience, Ehime University Graduate School of Medicine, Ehime, Japan
Manabu Ikeda
Affiliation:
Department of Neuropsychiatry and Neuroscience, Ehime University Graduate School of Medicine, Ehime, Japan Department of Psychiatry and Neuropathobiology, Faculty of Medical and Pharmaceutical Science, Kumamoto University, Kumamoto, Japan
*
Correspondence should be addressed to: Shunichiro Shinagawa, Department of Psychiatry, The Jikei University School of Medicine, 3-25-8 Nishi-shinbashi, Minato-ku, Tokyo, 105-8461, Japan. Phone: +81 3 3433 1111 ext 3301; Fax: +81 3 3437 0228. Email: shinagawa@jikei.ac.jp.
Get access Rights & Permissions [Opens in a new window]

Abstract

Background: Eating problems occur frequently in patients with dementia, and almost half of all patients with Parkinson's disease have such problems. It has therefore been assumed that eating problems are also common in patients with dementia with Lewy bodies (DLB). However, few systematic studies have investigated eating problems in DLB patients. The aim of this study was to clarify the frequency and characteristics of eating problems in patients with DLB.

Methods: We examined 29 consecutive patients with DLB and 33 with Alzheimer's disease (AD) in terms of age, sex, education, Mini-mental State Examination, clinical dementia rating (CDR), neuropsychiatric inventory (NPI), Unified Parkinson disease rating scale (UPDRS), fluctuations in cognition, and usage of neuroleptic drugs / antiparkinsonian drugs. We employed a comprehensive questionnaire comprising 40 items and compared the scores between the two groups.

Results: DLB patients showed significantly higher scores than AD patients for “difficulty in swallowing foods,” “difficulty in swallowing liquids,” “coughing or choking when swallowing,” “taking a long time to swallow,” “suffering from sputum,” “loss of appetite,” “need watching or help,” and “constipation”. Only the UPDRS score significantly affected the scores for “difficulty in swallowing foods,” “taking a long time to swallow” and “needs watching or help” score, whereas only the NPI score affected the score for “loss of appetite.” The scores for UPDRS, NPI and CDR significantly affected the scores for “difficulty in swallowing liquids.” No significant independent variables affected the scores for “coughing or choking when swallowing,” “suffering from sputum” and “constipation.”

Conclusion: Although DLB patients show many eating problems, the causes of each problem vary, and the severity of dementia or Parkinsonism is not the only determinant.

Keywords

dementia with Lewy bodieseating problemsswallowing problemsextrapyramidal signsautonomic dysfunction
Type
Research Article
Information
International Psychogeriatrics , Volume 21 , Issue 3 , June 2009 , pp. 520 - 525
Copyright
Copyright © International Psychogeriatric Association 2009

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Ballard, C. et al. (1998). Neuroleptic sensitivity in dementia with Lewy bodies and Alzheimer's disease. Lancet, 351, 1032–1033.CrossRefGoogle ScholarPubMed
Bozeat, S. et al. (2000). Which neuropsychiatric and behavioural features distinguish frontal and temporal variants of frontotemporal dementia from Alzheimer's disease? Journal of Neurology, Neurosurgery and Psychiatry, 69, 178–186.CrossRefGoogle ScholarPubMed
Cummings, J. L. et al. (1994). The Neuropsychiatric Inventory: comprehensive assessment of psychopathology in dementia. Neurology, 44, 2308–2314.CrossRefGoogle ScholarPubMed
Fahn, S., Elton, R. and Members of the UPDRS Development Committee (1987). Recent Developments in Parkinson's Disease, Vol 2. Florham Park: Macmillan Health Care Information.Google Scholar
Feinberg, M. J. and Ekberg, O. (1994). Videofluoroscopy in elderly patients with aspiration: importance of evaluating both oral and pharyngeal stage of deglutition. American Journal of Roentgenology, 156, 293–296.CrossRefGoogle Scholar
Feinberg, M. J. et al. (1992). Deglutition in elderly patients with dementia: findings of videofluorographic evaluation and impact on staging and management. Radiology, 183, 811–814.CrossRefGoogle Scholar
Frissoni, G. B. et al. (1998). Overcoming eating difficulties in the severely demented. In Volicer, L. and Hurley, A. (eds.), Hospice Care for Patients with Advanced Progressive Dementia (pp. 48–67). New York: Springer Publishing Company.Google Scholar
Folstein, M. F., Folstein, S. E. and McHugh, P. R. (1975). “Mini-mental state”: a practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12, 189–198.CrossRefGoogle ScholarPubMed
Holm, B. and Soderhamn, O. (2003). Factors associated with nutritional status in a group on any early stage of dementia. Clinical Nutrition, 22, 385–389.CrossRefGoogle Scholar
Horimoto, Y. et al. (2003). Autonomic dysfunctions in dementia with Lewy bodies. Journal of Neurology, 250, 530–533.CrossRefGoogle ScholarPubMed
Hughes, C. P. et al. (1982). A new clinical scale for the staging of dementia. British Journal of Psychiatry, 140, 566–572.CrossRefGoogle ScholarPubMed
Ikeda, M. et al. (2002). Changes in appetite, food preference, and eating habits in frontotemporal dementia and Alzheimer's disease. Journal of Neurology, Neurosurgery and Psychiatry, 73, 371–376.CrossRefGoogle ScholarPubMed
Kindell, J. (2002). Feeding and Swallowing Disorders in Dementia. Oxford: Speechmark Publishing Ltd.Google Scholar
Liberman, A. N. et al. (1980). Dysphagia in Parkinson's disease. American Journal of Gastroenterology, 74, 157–160.Google Scholar
Logemann, J. A. (1998). Evaluation and Treatment of Swallowing Disorders, 2nd edn. 2nd edn. San Diego, CA: College Hill Press.CrossRefGoogle Scholar
McKeith, I. G. et al. (1996). Consensus guidelines for the clinical and pathologic diagnosis of dementia with Lewy bodies (DLB): report of the consortium on DLB international workshop. Neurology, 47, 1113–1124.CrossRefGoogle Scholar
McKeith, I. G. et al. (2005). Diagnosis and management of dementia with Lewy bodies. Third report of the DLB consortium. Neurology, 65, 1863–1872.CrossRefGoogle ScholarPubMed
McKeith, I. G. et al. (2006). More severe functional impairment in dementia with Lewy bodies than Alzheimer disease is related to extrapyramidal motor dysfunction. American Journal of Geriatric Psychiatry, 14, 582–588.CrossRefGoogle ScholarPubMed
McKhann, G. et al. (1984). Clinical diagnosis of Alzheimer's disease: report of the NINCDS-ADRDA Work Group under the auspices of Department of Health and Human Services Task Force on Alzheimer's Disease. Neurology, 34, 939–944.CrossRefGoogle ScholarPubMed
Raven, J. C., Court, J. H. and Raven, J. (1990). Manual for Raven's Coloured Progressive Matrices. Oxford: Oxford Psychologists Press.Google Scholar
Thaisetthawatkul, P. et al. (2004). Autonomic dysfunction in dementia with Lewy bodies. Neurology, 62, 1804–1809.CrossRefGoogle ScholarPubMed