Swallowing Dysfunction and Autonomic Nervous System Dysfunction in Alzheimer's Disease: A Scoping Review of the Evidence

Authors

  • Rebecca H. Affoo MClSc,

    1. Graduate Program of Health and Rehabilitation Sciences, Western University, London, Ontario, Canada
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  • Norine Foley MSc,

    1. Brescia College, Western University, London, Ontario, Canada
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  • John Rosenbek PhD,

    1. Department of Speech, Language and Hearing Sciences, University of Florida, Gainsville, Florida
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  • J. Kevin Shoemaker PhD,

    1. School of Kinesiology, Western University, London, Ontario, Canada
    2. Department of Physiology and Pharmacology, Western University, London, Ontario, Canada
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  • Ruth E. Martin PhD

    Corresponding author
    1. Graduate Program of Health and Rehabilitation Sciences, Western University, London, Ontario, Canada
    2. Department of Physiology and Pharmacology, Western University, London, Ontario, Canada
    3. Department of Otolaryngology, Western University, London, Ontario, Canada
    4. School of Communication Sciences and Disorders, Western University, London, Ontario, Canada
    • Address correspondence to Ruth E. Martin, Room 2568 Elborn College, Western University, London, ON, Canada N6G 1H1. E-mail: remartin@uwo.ca

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Abstract

Objectives

To describe, synthesize, and interpret literature on swallowing impairment (dysphagia) and autonomic nervous system (ANS) dysfunction in Alzheimer's disease (AD) and to identify gaps in the existing literature.

Design

Scoping review of literature covering several study designs.

Setting

Literature review.

Participants

Individuals with AD.

Measurements

Systematic searches of the PubMed, EBSCOhost, PsychINFO, Cochrane, EMBASE, and Scopus databases were conducted. Literature was identified and organized into categories. Studies were then evaluated using the Oxford Centre for Evidence-Based Medicine Levels of Evidence criteria. After evaluation, the literature was synthesized to form conclusions and identify knowledge gaps.

Results

Ninety-five articles met the study criteria and were included in the review. Thirty-one studies examining dysphagia in AD provide preliminary evidence on the prevalence, nature, and treatment of dysphagia in AD; knowledge gaps were identified with respect to demographic characteristics, nature of dysphagia, functional significance, assessment, treatment, and underlying mechanisms of dysphagia in AD. Sixty-four studies of ANS dysfunction in AD were reviewed, of which 49 identified at least one variable reflecting ANS dysfunction in AD. Knowledge gaps were identified related to demographics, functional significance, and underlying neural mechanisms. No studies were found that examined both dysphagia and ANS dysfunction in AD.

Conclusion

Current evidence indicates that swallowing impairment, as well as ANS dysfunction, may occur in AD. Potential relationships between dysphagia and ANS dysfunction in AD have not been examined. Future research should explore the possibility that swallowing and ANS dysfunction in AD are related.

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