Stepwise Training Program Improves Dysphagia in Patients With Alzheimer’s Disease

Photo Credit: Kazuma Seki

Intervention with swallowing exercises for dysphagia can be easily implemented in clinical practice and can potentially improve the quality of life for patients with Alzheimer’s Disease.

Dysphagia, or difficulty swallowing, is a common issue in patients with Alzheimer’s disease (AD) that impacts their nutrition, daily activities, and overall quality of life. Current rehabilitation strategies primarily focus on nutrition management and posture adjustment. However, there is a need for a more targeted and effective approach to address this challenge.

“Although swallowing exercises are a fundamental treatment for dysphagia, few studies have evaluated the effectiveness of swallowing training in patients with AD,” wrote the authors of a study in the International Journal of Nursing Studies.

For the study, researchers recruited 93 patients with AD from three hospitals for a randomized controlled trial that evaluated the efficacy of a stepwise swallowing training program. The intervention group (n=48) received systematic stepwise swallowing training for four weeks, while the control group (n=45) received routine dysphagia care, including diet and posture management, and health education about swallowing dysfunction.

The study team assessed swallowing function using the Water Swallowing Test and Standard Swallowing Assessment. Secondary outcomes included the incidence of aberrant eating behavior, nutritional status, and daily activities. The researchers performed statistical analyses with SPSS software.

Results showed that the intervention group had significantly greater improvements in swallowing function, aberrant eating behaviors, daily function, and nutritional status when compared with the control group. The researchers determined the stepwise swallowing training program was safe and effective for managing dysphagia and related symptoms in patients with AD.

“[Patients in] the intervention group exhibited greater improvements in swallowing function (Water Swallowing Test: β=−3.133; 95 % CI: −4.113-−2.154; P<0.001; Standard Swallowing Assessment: β=−5.813; 95 % CI: −7.782-−3.844; P<0.001), abnormal eating behaviors (abnormal eating behavior questionnaire: β=−13.324; 95 % CI: −21.643-−5.005; P=0.002), daily function (Barthel index: β=11.280; 95 % CI: 4.021-18.540; P=0.002), and nutritional status (Mini-Nutritional Assessment Short Form: β = 2.402; 95 % CI: 1.313-3.490; P<0.001) over time than the routine-care group in the fourth week,” the authors wrote.

Overall, this study adds to the existing knowledge by demonstrating the efficacy of a stepwise swallowing training program in improving swallowing function and reducing aberrant eating behaviors in patients with AD.

The authors contend that this intervention can be easily implemented in clinical practice and improve these patients’ quality of life. “Stepwise swallowing training is a safe and effective intervention for managing dysphagia and other related symptoms in patients with AD,” they concluded.