Validation of the Dutch Version of the M.D. Anderson Dysphagia Inventory for Neurogenic Patients.

BACKGROUND/AIM: The aim of this study was to validate the Dutch-language version of the M.D. Anderson Dysphagia Inventory (MDADI) for patients with neurogenic oropharyngeal dysphagia (OD). METHODS: One hundred and seventy-eight patients with neurogenic OD and 92 healthy control subjects completed the MDADI and the Dutch version of the Swallowing Quality-of-Life Questionnaire (SWAL-QOL-NL). Exclusion criteria were: suffering from a concurrent head-and-neck oncological disease, scoring below 23 on a Mini Mental State Examination, being older than 85 years, and being illiterate or blind. None of the patients was in a palliative state of disease. Floor and ceiling effects, known-groups validity, internal consistency, construct validity, and criterion validity were assessed. RESULTS: The MDADI total score showed no floor or ceiling effects for the patient group. Known-groups validity was confirmed by group differences in score distributions between patients and healthy control subjects. The internal consistency showed Cronbach's α-values ranging from 0.77 to 0.92. Correlations between the MDADI subscales and SWAL-QOL-NL domains were moderate to strong: 0.71, 0.70, and 0.62 (convergent construct validity). Correlations between the MDADI scores and the SWAL-QOL-NL domains general burden, food selection, eating duration, communication, mental health, social functioning, and frequency of symptoms were moderate to strong, ranging from 0.41 to 0.75. Weak correlations (<0.4) were found between the MDADI scores and the SWAL-QOL-NL domains eating desire, sleep, and fatigue. CONCLUSION: The results of this study show that the Dutch translation of the MDADI is a psychometrically validated and suitable dysphagia-specific quality-of-life questionnaire for patients with neurogenic OD.

Tongue-Strengthening Exercises in Healthy Older Adults: Specificity of Bulb Position and Detraining Effects.

Clinical tongue-strengthening therapy programs are generally based on the principles of exercise and motor learning, including the specificity paradigm. The aim of this study was to investigate the specific effect of anterior and posterior tongue-strengthening exercises (TSE) on tongue strength (TS) in healthy older adults and to measure possible detraining effects. Sixteen healthy elderly completed 8 weeks of TSE by means of the Iowa Oral Performance Instrument (IOPI). They were distributed in two different treatment arms and performed either exclusively anterior or posterior TSE (ATSE, n = 9 or PTSE, n = 7) depending on the treatment arm. Anterior and posterior maximal isometric pressures (MIPA, MIPP) were measured at baseline, halfway, and after completion of the training sessions. Detraining was measured by repeating MIPA and MIPP measures 4 weeks after the last session of TSE. MIPA and MIPP increased significantly in both treatment arms. MIPA was significantly higher in the ATSE group compared to the PTSE group across all measures in time. No significant differences were observed in MIPP between the ATSE and PTSE groups. Regardless of treatment arm, there was no significant detraining effect measured 4 weeks after the last TSE session. This study suggests that TSE show partial specificity concerning bulb position. We conclude that especially anterior training results in higher anterior TS in comparison with posterior exercises. Furthermore, we found no detraining effects, independent of bulb location.

Dysphagia management in Parkinson's disease: Comparison of the effect of thickening agents on taste, aroma, and texture.

Dysphagia is a frequent symptom in Parkinson's disease (PD). Thickening liquids facilitates safe swallowing, however, low treatment compliance is a major issue, due to patients' dislike of thickened liquids. Some studies suggest a negative impact of gum-based thickeners, currently most used in clinical practice, on sensory properties compared to starch-based thickeners. This has not yet been investigated in PD. This study's aim was to compare taste, texture, and aroma of gum-based and starch-based thickened soups in participants with PD. Gum-based resource thicken up clear (RTUC) and starch-based kitchen products potato starch (PS) and quinoa flour (QF) were evaluated in broccoli soup. Texture, aroma, and taste were characterized by rheology, volatile, and sensory profiling. Thickened soups were evaluated in participants with PD and controls through a paired comparison test. Reduced release of 61.4%, 46.2%, and 38.5% of volatiles was observed after thickening with RTUC, PS, and QF, respectively. Overall taste intensity was reduced in RTUC- and PS-thickened soup, respectively. Taste and aroma of PS-thickened soup were considered more intense by 70.3% and 63.8% of all participants, respectively (n = 36 PD, n = 41 controls), 56.3% preferred the PS-thickened soup's texture . Taste and aroma of QF-thickened soup were considered more intense by 68.1% and 65.6% of all participants, respectively (n = 47 PD, n = 31 controls), 58.0% preferred the QF-thickened soup's texture. Starch-based thickeners demonstrated higher taste and aroma intensity. However, volatile and sensory profiling demonstrated reduced taste and aroma in all thickeners. Combining kitchen products with flavor enhancers may increase palatability of thickened beverages.