Predictive clinical factors for penetration and aspiration in Parkinson's disease

Background Do the current swallow‐specific subquestions of neurological diagnostic tools reflect the objective swallowing function in Parkinson's disease (PD) patients or are clinical factors superior to predict critical aspiration? Methods In a cross‐sectional, observational study a total of 119 Parkinson outpatients were examined clinically and by flexible‐endoscopic evaluation of swallowing (FEES). Self‐reported dysphagia by subquestions of the MDS‐UPDRS and NMS questionnaire and history of subjective aspiration signs were collected. Key Results Nearly, all PD patients showed deglutition abnormalities in FEES (113/119) while only 12%‐27% of them reported swallowing problems in the swallow‐specific subquestions of neurological standard diagnostic tools (MDS‐UPDRS and NMS‐Quest), and the answers were heterogeneous and poorly reproducible. With a sensitivity of up to a maximum of 50%, self‐reported dysphagia is therefore no reliable tool for identifying dysphagia in PD. While most clinical parameters were linked to dysphagia to some extent, logistic regression analysis revealed high age (Odds Ratio (OR) 1.1 in years, 95% CI 1.03‐1.18, P