Dysphagia Management in Individuals With Parkinson Disease and Cognitive Dysfunction: A Scoping Review

To examine dysphagia management options for individuals with Parkinson's disease (PD), with attention to the inclusion of individuals with co-occurring cognitive dysfunction across all levels of severity.

This scoping review was completed using Preferred Reporting Items for Systematic Reviews and Meta-Analyses - Scoping Review guidelines. A comprehensive search across 7 databases (PubMed, CINAHL, Web of Science, Cochrane Database of Systematic Reviews, ClinicalTrials.gov, Scopus, and Embase) was conducted using predefined search terms.

The inclusion criteria focused on studies addressing dysphagia management in PD, including behavioral interventions, medical and surgical treatments, and stimulation interventions. Observational studies that did not include individuals with PD or dysphagia interventions were excluded.

The data extraction template compiled study details, sample characteristics, dysphagia interventions, and cognitive-based exclusion criteria.

Of 13,614 identified studies, 48 were included in the final analysis, addressing interventions for dysphagia management in PD. Among these 4 studies did not exclude individuals with cognitive dysfunction, of which 3 were case studies with a single participant. Of 25 behavioral intervention studies included, 17 explicitly excluded individuals based on their cognitive abilities, whereas 5 did not report cognitive criteria. Among 9 surgical and medical intervention studies, 6 excluded participants because of cognitive functioning, and 3 did not provide information regarding cognitive status. Similarly, of 14 stimulation-based intervention studies, 5 excluded individuals with cognitive impairment, and 8 did not report cognitive-related criteria.

There is limited information available guiding clinicians in the management of dysphagia in patients with both PD and cognitive dysfunction. This review aims to guide future research by highlighting the need for development of evidence-based dysphagia rehabilitation protocols for individuals with PD and with cognitive impairments.