Article/Report  |   February 2008
A Randomized Study of Three Interventions for Aspiration of Thin Liquids in Patients With Dementia or Parkinson’s Disease
 
Author Affiliations & Notes
  • Jeri A. Logemann
    Northwestern University, Evanston, IL
  • Gary Gensler
    The EMMES Corporation, Rockville, MD
  • JoAnne Robbins
    University of Wisconsin, Madison, WI
  • Anne S. Lindblad
    The EMMES Corporation, Rockville, MD
  • Diane Brandt
    The EMMES Corporation, Rockville, MD
  • Jacqueline A. Hind
    William S. Middleton VA Medical Center, Madison, WI
  • Steven Kosek
    Minneapolis VA Medical Center, Minneapolis, MN
  • Karen Dikeman
    New York Hospital Medical Center – Queens, Flushing, NY
  • Marta Kazandjian
    New York Hospital Medical Center – Queens, Flushing, NY
  • Gary D. Gramigna
    VA Boston Healthcare System, Roxbury, MA
  • Donna Lundy
    University of Miami Medical Center, Miami, FL
  • Susan McGarvey-Toler
    Richard L. Roudebush VA Medical Center, Indianapolis, IN
  • Patricia J. Miller Gardner
    Communication Sciences and Disorders Clinical Trials Research Group, American Speech-Language-Hearing Association, Rockville, MD
  • Contact author: Jeri A. Logemann, Department of Communication Sciences and Disorders, Northwestern University, 2240 Campus Drive, #3-358, Evanston, IL 60208. E-mail: j-logemann@northwestern.edu.
Article Information
Swallowing, Dysphagia & Feeding Disorders / Special Populations / Older Adults & Aging / Speech
Article/Report   |   February 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, February 2008, Vol. 51, 173-183. doi:10.1044/1092-4388(2008/013)
History: Received May 24, 2006 , Accepted June 2, 2007
 
Journal of Speech, Language, and Hearing Research, February 2008, Vol. 51, 173-183. doi:10.1044/1092-4388(2008/013)
History: Received May 24, 2006; Accepted June 2, 2007
Web of Science® Times Cited: 70

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.

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