July 08, 2019
Just over one in every four patients with Parkinson disease demonstrated a substantially impaired ability to swallow pills, according to a study published online in Parkinsonism & Related Disorders.
Researchers used flexible endoscopic evaluation of swallowing to assess the ability of 118 patients with Parkinson’s disease and 32 control subjects to swallow medication. Overall, 28% of participants with Parkinson disease demonstrated dysphagia for pills compared with 16% of controls.
“Higher disease severity was associated with more problems with swallowing pills, but Parkinson’s disease patients with short disease duration (<2 years), low H&Y [Hoehn and Yahr] stage (1–2), and younger age (<70 years) were also affected (each at least in 20%),” researchers reported.
Among the four types of placebo bills used in the assessment, capsules proved the easiest to swallow. On the other end of the spectrum, oval tablets were the most difficult to swallow. Patients typically had swallowing difficulty with just one type of pill, according to the study.
Some 48% of patients with pill dysphagia showed aspiration of water. Consequently, dissolving tablets in water may risky for many patients, researchers pointed out.
Lack of dopaminergic response was not associated with pill dysphagia, the study found.
“An assessment of pill swallowing using flexible endoscopic evaluation of swallowing is suggested at least in patients reporting swallowing problems,” researchers concluded. “Capsules might be preferentially used when dysphagia is suspected.”
Buhmann C, Bihler M, Emich K, et al. Pill swallowing in Parkinson's disease: a prospective study based on flexible endoscopic evaluation of swallowing [Published online February 4, 2019]. Parkinsonism Relat Disord. 2019;62:51-56. doi: 10.1016/j.parkreldis.2019.02.002