Alzheimer's Dysphagia

Many types of dementia have been identified, but one type of dementia, Alzheimer’s disease (AD), accounts for a majority of the worldwide dementia cases. AD is often associated with deterioration of the medial temporal lobe, memory impairments initially, and progressive cognitive decline associated with executive dysfunction, personality changes and neuropsychiatric disturbances.

An abridged list of cognitive functions affected in the Alzheimer's type dementias:

1. Information processing

2. Psychomotor efficiency

3. Attention

4. Memory and learning

5. Problem solving

6. Motor Speed

7. Vocabulary/General or Global intelligence

8. Visuoconstruction

9. Visual perception

10. Somatosensory examination

11. Mental flexibility

12. Executive function

The role of the Five Systems on deglutition

1. Cognitive strategies for executing neurological functions

2. Adapting behaviors for safe deglutition under various conditions

3. Adjusting body positions

4. Perceiving the body as a unit

5. Perceiving the entire eating experiences as a unit

Did you know, upwards of 80% of AD patients suffering from cognitive dysfunction and neuropsychiatric disturbances, such as hallucinations and clinical depression, have dysphagia and significant changes in eating habits?

The overall rates of eating disturbances: 24.5% in moderate to severe AD patients, 15.2% in mild AD patients, 19.8% in MCI patients, and only 6% in healthy aged adults (Kai et al., 2015).

AD is also associated with a specific type of breakdown of the Five Systems of Dysphagia.

1. Delayed pharyngeal swallow onset

2. Reduced lingual movement

3. Difficulty with oral preparation of the bolus

4. Pharyngeal clearance

5. Upper esophageal sphincter opening

6. Visible aspiration on instrumentation evaluations

If you are a SLP and would like to explore additional continuing education opportunities on these subjects, check us out at dysphagiamanagement.com/ce-courses to learn more!

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