Parkinson's Disease and Swallowing Difficulties

Swallowing difficulties affect the majority of people with Parkinson's disease at some point, yet they often go unrecognised - either because they develop gradually, or because other aspects of the condition take precedence. Early recognition and support can make a significant difference to nutrition, quality of life and safety.

Why does Parkinson's affect swallowing?

Parkinson's disease affects the dopaminergic system in the brain, which is responsible for coordinating smooth, controlled movement. Because swallowing relies on the precise coordination of over 30 muscles, Parkinson's can disrupt the process at multiple stages.

Changes in swallowing in Parkinson's may include reduced tongue movement, slower triggering of the swallow reflex, reduced strength and coordination of the throat muscles, and reduced sensation - meaning that food or liquid entering the airway may not always trigger a cough response.

Signs to watch for

• Coughing or choking during meals
• A wet or gurgly voice after eating or drinking
• Food sticking in the throat
• Taking much longer to finish meals
• Recurrent chest infections
• Weight loss or reduced appetite
• Drooling or difficulty managing saliva

Silent aspiration - where food or liquid enters the airway without a cough reflex - is particularly common in Parkinson's and carries a risk of aspiration pneumonia, which is a leading cause of hospitalisation in people with the condition.

How speech and language therapy can help

SLT input for swallowing in Parkinson's typically includes assessment of all stages of the swallow, advice on food and liquid textures, exercises to maintain and strengthen swallowing function, and strategies for safer mealtimes.

Importantly, therapy is most effective when it begins early - before swallowing difficulties become severe. If you or someone you care for has Parkinson's and is noticing any of the signs above, it is worth seeking assessment sooner rather than later.

You can read more about what dysphagia is and what causes it, or find out what to expect from an adult dysphagia assessment.