Gap Education
A Tale of Two Studies*
Tim Stockdale, SLPD, CCC-SLP
Managing dysphagia requires evidence-based strategies, and these two studies provide valuable insights: Logemann et al., 2008 and Robbins et al., 2008.
(Legend has it that the cohorts were overlapping 😉)
Here’s some of what you need to know:
Who Were the Participants?
• Logemann et al.: 711 patients, ages ≥50, with dementia and/or Parkinson’s disease.
• Robbins et al.: 515 patients, ages ≥50, with dementia and/or Parkinson’s disease.
What Were the Interventions for Both?
• Honey-thick liquids
• Nectar-thick liquids
• Chin-down posture
📊 Key Outcomes
Immediate Prevention of Aspiration (Logemann et al.):
• Honey-thick: Most effective.
• Nectar-thick: Second most effective.
• Chin-down: Least effective (especially in severe dementia).
Pneumonia Incidence (Robbins et al.):
• 15%: Honey-thick liquids.
• 8.4%: Nectar-thick liquids.
• 9.8%: Chin-down posture.
💡 Other Observations
• Logemann et al.: Patient preference favored chin-down > thickened liquids.
• Robbins et al.: Higher rates of dehydration, UTIs, and fever with thickened liquids.
📝 Some Key Takeaways:
Thickened liquids may reduce immediate aspiration, but this does not necessarily translate to pneumonia prevention.
Patient preferences and long-term risks (like dehydration) must guide decisions.
📣 Want to Learn More?
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References:
Logemann, J. A., Gensler, G., Robbins, J., Lindblad, A. S., Brandt, D., Hind, J. A., Kosek, S., Dikeman, K., Kazandjian, M., Gramigna, G. D., Lundy, D., McGarvey-Toler, S., & Miller Gardner, P. J. (2008). A randomized study of three interventions for aspiration of thin liquids in patients with dementia or Parkinson's disease. Journal of Speech, Language, and Hearing Research, 51(1), 173–183. https://doi.org/10.1044/1092-4388(2008/013)
Robbins, J., Gensler, G., Hind, J., Logemann, J. A., Lindblad, A. S., Brandt, D., Baum, H., Lilienfeld, D., Kosek, S., Lundy, D., Dikeman, K., Kazandjian, M., Gramigna, G. D., McGarvey-Toler, S., & Miller Gardner, P. J. (2008). Comparison of 2 interventions for liquid aspiration on pneumonia incidence: a randomized trial. Annals of Internal Medicine, 148(7), 509–518. https://doi.org/10.7326/0003-4819-148-7-200804010-00007