(A709) Comparative Management of Dysphagia in Parkinson’s Disease and Non-Neurological Cases

Introduction: Dysphagia is a common and challenging complication, associated with risks of aspiration, malnutrition, and reduced quality of life. While dysphagia in Parkinson's disease (PD) is well studied, comparative data on management approaches in PD versus non-neurological dysphagia is limited. This study examines the incidence of evaluations and management strategies in these two groups.

Methods: Using ICD-9 and ICD-10 codes within the NIH All of Us database, we identified 2,112 PD patients, of whom 699 had comorbid dysphagia. For comparison, 24,743 patients with non-neurological dysphagia were identified. We compared rates of swallow evaluations, swallow therapy utilization, pneumonia, and gastrostomy tube placements between the groups. Statistical significance was set at p < 0.05.

Results: Swallow evaluations occurred in 49.6% of PD patients with dysphagia, compared to 34.4% in non-neurological cases (p < 0.001). Among evaluated patients, 26.5% of PD patients with dysphagia received swallow therapy, compared to 16.3% in the non-neurological dysphagia group (p < 0.001). Gastrostomy tube placement rates were similar between groups, at 3.9% for PD patients with dysphagia and 3.5% for non-neurological dysphagia patients (p = 0.59). Among PD patients with dysphagia, gastrostomy rates were significantly lower for those receiving swallow therapy (4.3%) compared to those who did not (12.4%) (p = 0.02). Pneumonia rates showed no significant difference with or without swallow therapy in PD patients (52.2% vs. 48.2%; p = 0.46).

Conclusions: Dysphagia management in PD patients reflects a more proactive approach, with higher rates of evaluations and therapy utilization. PD patients with dysphagia who received swallow therapy had significantly lower gastrostomy rates than those who did not, suggesting that early therapeutic intervention may help reduce the risk of severe complications.