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Characteristics of eating and swallowing problems in patients who have dementia with Lewy bodies

Published online by Cambridge University Press:  04 March 2009

Shunichiro Shinagawa ,
Hiroyoshi Adachi ,
Yasutaka Toyota ,
Takaaki Mori ,
Izumi Matsumoto ,
Ryuji Fukuhara  and
Manabu Ikeda
Shunichiro Shinagawa*
Affiliation:
Department of Psychiatry, Jikei University School of Medicine, Tokyo, Japan Department of Neuropsychiatry and Neuroscience, Ehime University Graduate School of Medicine, Ehime, Japan
Hiroyoshi Adachi
Affiliation:
Department of Neuropsychiatry and Neuroscience, Ehime University Graduate School of Medicine, Ehime, Japan Osaka University Health Care Center, Osaka, Japan
Yasutaka Toyota
Affiliation:
Department of Neuropsychiatry and Neuroscience, Ehime University Graduate School of Medicine, Ehime, Japan
Takaaki Mori
Affiliation:
Department of Neuropsychiatry and Neuroscience, Ehime University Graduate School of Medicine, Ehime, Japan
Izumi Matsumoto
Affiliation:
Department of Special Support School Education, Ehime University Graduate School of Education, Ehime, Japan
Ryuji Fukuhara
Affiliation:
Department of Neuropsychiatry and Neuroscience, Ehime University Graduate School of Medicine, Ehime, Japan
Manabu Ikeda
Affiliation:
Department of Neuropsychiatry and Neuroscience, Ehime University Graduate School of Medicine, Ehime, Japan Department of Psychiatry and Neuropathobiology, Faculty of Medical and Pharmaceutical Science, Kumamoto University, Kumamoto, Japan
*
Correspondence should be addressed to: Shunichiro Shinagawa, Department of Psychiatry, The Jikei University School of Medicine, 3-25-8 Nishi-shinbashi, Minato-ku, Tokyo, 105-8461, Japan. Phone: +81 3 3433 1111 ext 3301; Fax: +81 3 3437 0228. Email: shinagawa@jikei.ac.jp.
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Abstract

Background: Eating problems occur frequently in patients with dementia, and almost half of all patients with Parkinson's disease have such problems. It has therefore been assumed that eating problems are also common in patients with dementia with Lewy bodies (DLB). However, few systematic studies have investigated eating problems in DLB patients. The aim of this study was to clarify the frequency and characteristics of eating problems in patients with DLB.

Methods: We examined 29 consecutive patients with DLB and 33 with Alzheimer's disease (AD) in terms of age, sex, education, Mini-mental State Examination, clinical dementia rating (CDR), neuropsychiatric inventory (NPI), Unified Parkinson disease rating scale (UPDRS), fluctuations in cognition, and usage of neuroleptic drugs / antiparkinsonian drugs. We employed a comprehensive questionnaire comprising 40 items and compared the scores between the two groups.

Results: DLB patients showed significantly higher scores than AD patients for “difficulty in swallowing foods,” “difficulty in swallowing liquids,” “coughing or choking when swallowing,” “taking a long time to swallow,” “suffering from sputum,” “loss of appetite,” “need watching or help,” and “constipation”. Only the UPDRS score significantly affected the scores for “difficulty in swallowing foods,” “taking a long time to swallow” and “needs watching or help” score, whereas only the NPI score affected the score for “loss of appetite.” The scores for UPDRS, NPI and CDR significantly affected the scores for “difficulty in swallowing liquids.” No significant independent variables affected the scores for “coughing or choking when swallowing,” “suffering from sputum” and “constipation.”

Conclusion: Although DLB patients show many eating problems, the causes of each problem vary, and the severity of dementia or Parkinsonism is not the only determinant.

Keywords

dementia with Lewy bodieseating problemsswallowing problemsextrapyramidal signsautonomic dysfunction
Type
Research Article
Information
International Psychogeriatrics , Volume 21 , Issue 3 , June 2009 , pp. 520 - 525
Copyright
Copyright © International Psychogeriatric Association 2009

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