The Influence of a Dementia Diagnosis on Clinical Decision-Making in Dysphagia Management

The main objective of this survey was to determine the effects of a dementia diagnosis on dysphagia management by speech-language pathologists (SLP).

A survey of SLPs interested and/or working with individuals with dysphagia was conducted via a website. The SLPs viewed two written cases of patients with dysphagia, one with dementia and one without dementia. Both cases included a video capture of the patients' swallows. SLPs answered specific questions related to each case and video.

Frequency counts, McNemar's Test, and descriptive analysis of responses showed that participants were less likely to initiate dysphagia therapy (p < 0.001) or use rehabilitative swallowing strategies (p = 0.008) for individuals with dysphagia and a dementia diagnosis than for an individual with dysphagia without a dementia diagnosis. In addition, SLPs overidentified impairments and chose treatment targets not present.

Based on the current survey, SLPs displayed a bias when the diagnosis of dementia was present. The bias appears to exist regardless of experience or education. Not initiating treatment or not providing rehabilitative strategies may have detrimental effects on the health and quality-of-life of individuals with dementia.