Evaluation of Swallowing and Cough Function in Older Patients With Parkinson′s Disease

Introduction With population aging, the number of older patients with Parkinson′s disease (PD) is rapidly increasing. Aspiration pneumonia is a major cause of morbidity and mortality in this population. This study is aimed at characterizing swallowing and cough functions in older patients with PD using a multidimensional assessment. Methods This exploratory analysis used baseline data from an interventional cohort study investigating cervical percutaneous interferential current stimulation in patients with PD at Hoehn and Yahr Stages 2–4. Assessments included handgrip strength, calf circumference, tongue pressure, peak expiratory flow (PEF), 1% citric acid cough test, and videofluoroscopic examination. Factors were compared between patients aged ≥ 75 years (older group) and those aged < 75 years (nonolder group). Results Twenty‐five patients were evaluated (mean age, 72.0 ± 5.9 years; nine women), including nine older patients. The older group demonstrated lower handgrip strength, calf circumference, and PEF. PEF was significantly associated with age, sex, body mass index, handgrip strength, calf circumference, cough test results, and hemoglobin levels. Changes observed after the 8‐week intervention did not differ significantly between the groups. Conclusion Older patients with PD exhibit a marked reduction in PEF, suggesting impaired airway clearance associated with sarcopenia‐related and generalized physical vulnerability. Rehabilitation strategies targeting impaired airway clearance, including respiratory and generalized muscle strengthening and optimizing overall nutritional status, may be critical in this population. Trial Registration Japan Registry of Clinical Trials: jRCTs062220013