P4‐251: Dysphagia in individuals with Alzheimer's disease: A systematic review of the evidence

Background: Dementia is a syndrome that can be caused by a number of neurodegenerative disorders that affect memory, thinking, behavior, and the ability to perform activities of daily living. Alzheimer’s disease is the most common type of dementia and currently affects approximately 250,000 Canadians. Individuals with dementia of the Alzheimer’s type may experience swallowing impairment, or dysphagia, during the progression of the disease. Swallowing function is controlled in part by the parasympathetic branch of the autonomic nervous system. The primary objective of this study was to review studies of dysphagia in individuals with Alzheimer’s disease. Secondary objectives included identification and review of the literature concerning autonomic dysfunction in individuals with Alzheimer’s disease. Methods: Systematic searches of the PubMed, EBSCOhost, PsychINFO, Cochrane, EMBASE, and Scopus databases were completed. Search terms included dementia, Alzheimer’s disease, swallowing, deglutition disorders, autonomic nervous system, and parasympathetic nervous system. Published studies and grey literature describing dysphagia or autonomic dysfunction in the context of Alzheimer’s diseasewere identified. Studies were reviewed and organized into categories according to type. These categories included clinical reports, physiologic studies, and brain imaging studies.Results:The literature contains evidence that dementia of the Alzheimer’s type results in distinct dysphagia or dysautonomia profiles, even in the early stages of the disease process. Conclusions: Although the prevalence and incidence of dysphagia or dysautonomia in the Alzheimer’s population is unknown, there is preliminary evidence to suggest that dysphagia or autonomic dysfunction can occur in dementia of the Alzheimer’s type.