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Swallowing in behavioral variant frontotemporal dementia.

Sheilla de Medeiros Correia Marin1,2, Letícia Lessa Mansur2, Fabricio Ferreira de Oliveira1

  • 1Universidade Federal de São Paulo, Escola Paulista de Medicina, Departamento de Neurologia e Neurocirurgia, São Paulo SP, Brazil.

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Summary

Swallowing and feeding difficulties are common in behavioral variant frontotemporal dementia (bvFTD), worsening with disease progression. These issues correlate with cognitive decline and impact caregiver mealtime management.

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Area of Science:

  • Neurology
  • Gerontology
  • Speech-Language Pathology

Background:

  • Behavioral variant frontotemporal dementia (bvFTD) progression is associated with swallowing and feeding impairments.
  • These difficulties can significantly disrupt the anticipatory and oral preparatory phases of swallowing.

Purpose of the Study:

  • To comprehensively characterize swallowing problems and feeding situations in bvFTD patients.
  • To establish correlations between swallowing difficulties and patient functionality, executive functions, cognition, and behavior.

Main Methods:

  • Recruited consecutive outpatients with bvFTD across mild, moderate, and severe dementia stages.
  • Utilized standardized scales including the Mini-Mental State Examination, FTLD-modified CDR, NPI, FAB, ADL, Swallowing Rating Scale, and Assessment of Feeding and Swallowing Difficulties in Dementia.
  • Included caregivers in the screening process.

Main Results:

  • Thirty bvFTD patients and their caregivers participated.
  • Observed feeding and swallowing issues included messy eating, passivity, coughing, choking, and difficulties with specific food consistencies.
  • Swallowing problems significantly correlated with impaired functionality (p<0.05), cognition (p<0.05), executive dysfunction (p<0.01), and behavioral features (p<0.01).

Conclusions:

  • Feeding and swallowing problems like inappropriate eating speed, passivity, coughing, and choking emerge in mild bvFTD and worsen in severe stages.
  • These difficulties pose significant challenges for caregivers during mealtimes.
  • Swallowing impairments in bvFTD are closely linked to the progression of cognitive and behavioral decline.