How Are Swallowing Problems Treated
The first step to addressing swallowing issues is to speak to a neurologist about getting an evaluation performed by a SLP. This professional will take a medical history and interview the person with PD about eating and swallowing.
This is typically followed by either a video X-ray or an endoscopic examination, so the medical specialist can observe the swallowing process as an individual sips liquid and eats food, as these substances flow from the mouth, down the throat and esophagus, to the stomach. With these tests it is possible to see where the trouble is occurring and to recommend therapies.
Follow the recommendations of the swallowing specialist, which may include the following:
- Exercise and Swallow Hard. Just as exercise can ease other PD-related movement difficulties, it can also help with swallowing. The Lee Silverman Voice Technique® helps a person exaggerate speaking and swallowing. Working with an SLP on an individualized program helps the person to swallow hard and move food from the mouth down the throat.
- Expiratory Muscle Strength Training. This therapy strengthens respiratory muscles, improves cough and swallowing and reduces aspiration.
- Change in food. Modifying liquids and solids can help. For people who find liquids get into the airway, liquids may need thickening. Taking bigger or smaller bites or sips or pureeing solid foods may help. First get an evaluation, so the SLP can recommend how to modify food and liquid.
Parkinson’s Disease Patients Versus Controls
To compare patients with Parkinson’s disease to control subjects, an ANOVA test for repeated measurements was used. The frequency band and the ear were treated as within-subject factors . The between-subjects factor, disease, is a two-level factor, distinguishing patients from controls. Sex was included as a between-subjects two-level factor, and age was included as a covariate factor. A complete factorial model was studied.
In such a comparison between two distinct populations, the sensitivity of the results mainly depends on the testretest and inter-subject fluctuations of the diagnostic technique. At low signal levels, typical of elderly and/or impaired subjects, the advanced DPOAE technique used in this study helps to reduce these uncertainties however, PTA may still prove more sensitive, because the typical change in DPOAE levels due to sensorineural hearing loss is 50% of the audiometric change in cross-section studies .
Correlations Among Assessments And Other Variables
contains statistically significant Pearson’s correlation values for pertinent variables and assessments. Participants’ age was significantly correlated with the pure tone average air conduction threshold for both the PD and control groups. Age was also correlated with RAVLT total score in the PD group but not in the control group . Significant correlations were found between age and several central auditory assessments for the control group. However, the PD group only exhibited a significant correlation between age and WIN test in the left ear . In all of these examples, greater age was associated with poorer performance on assessments.
In addition to age, pure tone average air conduction threshold also correlated significantly with several assessments: WIN test , Dichotic Digits Test in the right ear, and HHIA score for both groups GIN detection test in the right ear, SSW test, and spatial release from masking test for the control group and RAVLT score for the PD group . In all of these examples, greater PTA air conduction threshold was associated with poorer performance on assessments.
How Do I Know If I Have A Speech Or Voice Problem
- My voice makes it difficult for people to hear me.
- People have difficulty understanding me in a noisy room.
- My voice issues limit my personal and social life.
- I feel left out of conversations because of my voice.
- My voice problem causes me to lose income.
- I have to strain to produce voice.
- My voice clarity is unpredictable.
- My voice problem upsets me.
- My voice makes me feel handicapped.
- People ask, “What’s wrong with your voice?”
Assessments Of Pd Severity
The Hoehn and Yahr and Schwab and England scales were used to assess the stage and severity of PD for individuals in the patient group.
PD patients were also asked to rate their abilities during the past week for 12 activities such as swallowing, handwriting, dressing, hygiene, falling, salivating, turning in bed, walking, and cutting food .
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Age At Disease Onset Results In Distinct Speech Patterns
I made an appointment for Bev at the Audiology Foundation of America Balance & Hearing Institute when she visited me in Arizona last winter. The AFA is part of the Arizona School of Health Sciences at A.T. Still University, a university teaching institution where I was once employed.
I wanted to see if Bev just needed better hearing aids, or if there might be other options to improve her hearing. We learned from the AFA audiologist that Bevs hearing loss was permanent, and that more costly hearing aids wouldnt help, given her Parkinsons progression and her age. However, the audiologist did suggest that we try some assistive technology aids.
Why Is There A Delay
Parkinsons disease is a slow, progressive condition, said Simonet. We do not expect all symptoms to start at once from one day to another.
According to Simonet, there is a pre-diagnostic phase when the motor symptoms and non-motor symptoms of Parkinson’s emerge over time.
The researchers did suggest one possible reason for the delay in diagnosis.
Even if patients have classic signs of Parkinsons like tremors and memory problems, providers may have a harder time evaluating symptoms in patients from traditionally under-represented groups.
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Hearing Loss & Cognitive Decline
I will start off by discussing one factor that is rarely mentioned in discussions of cognitive decline in PD, but is a highly treatable contributor to cognitive difficulties hearing loss. Abundant research exists that supports the claim that hearing loss impacts cognitive function. The connection was recently highlighted in in the New York Times and in the Wall Street Journal.
One Johns Hopkins research study reviewed thousands of medical claims and demonstrated an association between hearing loss and an increased 10-year risk of dementia, falls, depression and heart attack. Research also suggests that improving hearing with hearing aids can improve cognitive function. One study showed that memory decline slowed in patients who started wearing hearing aids, highlighting the importance of detecting and treating hearing loss early.
The Lee Silverman Voice Treatment
The Lee Silverman Voice Treatment is the first speech treatment for PD proven to significantly improve speech after one month of treatment.
- Exercises taught in the LSVT method are easy to learn and typically have an immediate impact on communication.
- Improvements have been shown to last up to two years following treatment.
- LSVT methods have also been used with some success in treating speech and voice problems in individuals with atypical PD syndromes such as multiple-system atrophy and progressive supranuclear palsy .
- Must be administered four days a week for four consecutive weeks.
- On therapy days, perform LSVT exercises one other time during the day. On non-therapy days, perform LSVT exercises two times a day.
- Once you complete the four-week LSVT therapy, perform LSVT exercises daily to maintain your improved voice.
- Schedule six-month LSVT re-evaluations with your specialist to monitor your voice.
- If available in your area, participate in a speech group whose focus is on thinking loud.
- A Digital Sound Level Meter can help you monitor voice volume. Place the meter at arm distance to perform the measurement. Normal conversational volume ranges between 68-74dB.
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Types Of Eye Movements
There are three kinds of eye movements that can change with PD:
- Saccadic rapid eye movements direct us to gaze at a specific object or to read lines of print.
- Pursuit eye movements allow us to follow an object as it moves.
- Vergence eye movements allow us to move our eyes in different directions2
Changes to these eye movements due to Parkinsons can also result in different kinds of visual difficulties. The inability to control eye movements can lead to involuntary blinking, double vision and other motor issues that can affect visual acuity.
Dry eyes can be treated with drops or ointments, warm wet compresses, but are not generally cured. The blink reflex can be impacted by PD. This manifests as either a slowing of the reflex, appearing as inappropriate staring, dry or burning eyes and by reduced vision. Blepaharospasm and apraxia are two common eyelid motion issues. Blephararospasms are eyelid spasms that cannot be controlled, cause eyelids to squeeze, and can be relieved with Botox injections. Apraxia is a condition that makes it difficult to open eyes. There are specialized lid crutches and cosmetic tape that can be applied to hold the eyelids open.2
Biomed Research International Published Online May 4 2017
Parkinsons Disease affects approximately one million people in the US and about 10 million worldwide. The average age at onset is 60, and the prevalence increases with age. Since the majority of people over 60 also suffer from hearing loss, another health concern that increases with age. This means that a majority of patients who have Parkinson’s have significant HL that could worsen over time.
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Researchers Say It Is Important Doctors Are Aware Of The Signs So Patients Can Get A Timely Diagnosis And Early Help
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Hearing loss and epilepsy have been identified as early signs of Parkinsons disease, according to a new study that looked at the most diverse population to date.
Queen Mary University of London researchers say it is important doctors are aware of the signs, and when symptoms can appear, so patients can get a timely diagnosis and early help to manage their condition and improve quality of life.
Using health records from more than one million people living in east London between 1990 and 2018, researchers found that known symptoms associated with Parkinsons, including tremor and memory problems, can appear up to 10 and five years before diagnosis respectively.
This is the first study focusing on the pre-diagnostic phase of Parkinsons in such a diverse population with high socioeconomic deprivation but universal access to healthcare
They also uncovered two new features of the condition epilepsy and hearing loss, and were able to repeat these findings using additional data from the UK Biobank database.
Other Clues To Diagnosis
The study also noted that other conditionslike type 2 diabetes, high blood pressure, low blood pressure, constipation, depression, and erectile dysfunctionwere also more likely to be seen in people who were later diagnosed with Parkinsons.
Simonet said that providers may need to ask their patients about these symptoms as well.
Patients sometimes are not aware of non-motor symptomssuch as constipation, depression, or erectile dysfunctionbeing common manifestations of Parkinsons, said Simonet. Therefore, they will not report these symptoms to their GP. That is why direct questioning is so important.
When the researchers looked at medical records of patients with Parkinsons in the UK Biobank they saw the same findings.
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Living With Parkinson Disease
These measures can help you live well with Parkinson disease:
- An exercise routine can help keep muscles flexible and mobile. Exercise also releases natural brain chemicals that can improve emotional well-being.
- High protein meals can benefit your brain chemistry
- Physical, occupational, and speech therapy can help your ability to care for yourself and communicate with others
- If you or your family has questions about Parkinson disease, want information about treatment, or need to find support, you can contact the American Parkinson Disease Association.
Increased Awareness Needed To Avoid Diagnosis Delay
Dr Noyce said: “People see their GPs with symptoms but often dont get a diagnosis until 5 to 10 years after this. Tremor, for example, is one of the most recognisable symptoms of Parkinsons but was seen 10 years before eventual diagnosis in our study.”
Dr Simonet added: “It’s important that primary care practitioners are aware of the links and understand how early the symptoms of Parkinsons can appear, so that patients can get a timely diagnosis and doctors can act early to help manage the condition.”
In this East London population, conditions like hypertension and type 2 diabetes were associated with increased odds of developing Parkinsons disease, the researchers said, adding that they also observed a stronger association with memory complaints within this population than previously described.
Dr Noyce emphasised: “If were able to diagnose Parkinsons earlier, we have a real opportunity to intervene early and offer treatments that could improve quality of life for patients.” We may even “perhaps be in the position to slow down or cure Parkinsons in the future”.
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Cite this: Dr Rob Hicks MBBS DRCOG MRCGP. Hearing Loss and Epilepsy Identified As Early Signs of Parkinson’s Disease – Medscape – Mar 07, 2022.
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How Are Speech Problems Treated
There are many options to help improve your speech. A speech-language pathologist can help you pick the right approaches for you. Speech-language pathologists are trained health care professionals who specialize in evaluating and treating people with speech, swallowing, voice, and language problems.
Ask your doctor for a referral to a speech-language pathologist. It is also important to contact your health insurance company to find out what therapy and procedures are eligible for reimbursement and to find a list of SLPs covered by your plan. Finally, visit a SLP who has experience treating people with PD.
What Are The Symptoms Of Parkinson Disease
Parkinson disease symptoms usually start out mild, and then progressively get much worse. The first signs are often so subtle that many people don’t seek medical attention at first. These are common symptoms of Parkinson disease:
- Tremors that affect the face and jaw, legs, arms, and hands
- Slow, stiff walking
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Does Parkinson’s Make You Lose Your Voice
. Just so, does Parkinson’s affect the throat?
People with Parkinson’s may notice changes in or difficulty chewing, eating, speaking or swallowing. Just as PD affects movement in other parts of the body, it also affects the muscles in the face, mouth and throat that are used in speaking and swallowing.
Secondly, is Aphasia a symptom of Parkinson’s? Aphasia, for example as the result of an infarct, can affect the grammatical ability itself, meaning that the patient can no longer conjugate a verb. With Parkinson’s patients, this specific grammatical ability is not affected but rather the underlying executive function.
Subsequently, question is, does Parkinson’s disease cause hearing loss?
It is well known that aging is related to hearing loss. However Parkinson’s disease also affects the cochlea, which is the sensory organ of hearing. Inadequate dopamine can thus lead to damage to the cochlea and result in hearing loss.
What do Parkinson’s patients usually die from?
But the most common cause of death in those with Parkinson’s is pneumonia, because the disease impairs patients‘ ability to swallow, putting them at risk for inhaling or aspirating food or liquids into their lungs, leading to aspiration pneumonia.
Hearing Aids For Tv Phone
The audiologist suggested Bev try portable wireless speakers or wireless earbuds when watching television. The speakers connect to the TV via an HDMI cable and send the signal directly to the hearing aid so the increased volume wont disturb others. Earbuds also transmit the sound directly from the TV to the hearing aids so that the volume and clarity can be adjusted.
Its important that the wireless system be compatible with the brand of hearing aid thats being used. Phone or cable network providers might even offer discounts and help with installation.
The audiologist also suggested Bev try amplifiers that can increase volume levels on either landline or mobile phones. Many states offer telephone programs, called Telecommunications Equipment Distribution Programs, that provide free or low-cost equipment to those who qualify. Bev got a landline telephone amplifier installed for free.
The audiologist also suggested some behavioral tips that Bev could use to help her with her hearing problems, such as asking people she is talking with to speak slower and to repeat themselves, if needed. Bev often says, Everyone talks too fast, and it makes it harder to hear and understand what they are saying.
More resources and information can be found at the directory of organizations for the National Institute on Deafness and Other Communication Disorders.
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Neurons Are Fickle Electric Fields Are More Reliable For Information
To investigate the association between risk factors and prediagnostic presentations of PD in an ethnically diverse UK population with high socioeconomic deprivation but universal access to health care.
Design, Setting, and Participants
A nested case-control study was conducted using electronic health care records on 1016277 individuals from primary care practices in East London to extract clinical information recorded between 1990 and February 6, 2018. The data were analyzed between September 3, 2020, and September 3, 2021. Individuals with a diagnosis of PD were compared with controls without PD or other major neurological conditions.
Main Outcomes and Measures
A matched analysis and an unmatched analysis were undertaken using multivariable logistic regression to determine associations between risk factors and prediagnostic presentations to primary care with subsequent diagnosis of PD. Three time periods were analyzed separately and together.
This study provides data suggesting that a range of comorbidities and symptoms are encountered in primary care settings before PD diagnosis in an ethnically diverse and deprived population. Novel temporal associations were observed for epilepsy and hearing loss with subsequent development of PD. The prominence of memory symptoms suggests an excess of cognitive dysfunction in early PD in this population or difficulty in correctly ascertaining symptoms in traditionally underrepresented groups.