Pharmacological Management of Dysphagia in Patients with Alzheimer's Disease: A Narrative Review

Chien-Hsun Li; Sun-Wung Hsieh; Poyin Huang; Hsiu-Yueh Liu; Chun-Hung Chen; Chih-Hsing Hung

doi:10.2174/1567205020666221130091507

Pharmacological Management of Dysphagia in Patients with Alzheimer's Disease: A Narrative Review

Curr Alzheimer Res. 2022 Nov 30. doi: 10.2174/1567205020666221130091507. Online ahead of print.

Authors

Chien-Hsun Li^{1

2

3

4

5}, Sun-Wung Hsieh^{1

2

3

4

6}, Poyin Huang^{1

2

4

6}, Hsiu-Yueh Liu⁷, Chun-Hung Chen^{1

2

3

4}, Chih-Hsing Hung^{3

8

9

10

11

12}

Affiliations

¹ Department of Neurology, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, Kaohsiung 812, Taiwan.
² Department of Neurology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807, Taiwan.
³ Dysphagia Functional Reconstructive Center, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, Kaohsiung 812, Taiwan.
⁴ Neuroscience Research Center, Kaohsiung Medical University, Kaohsiung 807, Taiwan.
⁵ Integrated Center of Healthy and Long-term Care, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, Kaohsiung 812, Taiwan.
⁶ Department of Neurology, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan.
⁷ Department of Oral Hygiene, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan.
⁸ Department of Pediatrics, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, Kaohsiung 812, Taiwan.
⁹ Center of Teaching and Research, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, Kaohsiung 812, Taiwan.
¹⁰ Department of Pediatrics, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807, Taiwan.
¹¹ Research Center for Environmental Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan.
¹² Department of Pediatrics, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan.

PMID: 36453507
DOI: 10.2174/1567205020666221130091507

Abstract

Alzheimer's disease (AD) and dysphagia are important health and socioeconomic problems in the aging population. Currently, the medical treatment of dysphagia in AD patients remains insufficient, and there are significant gaps in the management and clinical needs to postpone tube feeding. Literatures published over the last 30 years were searched in the PubMed and Embase databases. All relevant and promising pharmacological management studies were included. Because of the heterogeneity in design and methodology, only narrative reports were mentioned. Nine studies were included with two case reports, two case series, and two observational and three randomized controlled trials. The key approaches and clinical problems related to dysphagia include onset pattern, dementia stage, review of offending drugs and polypharmacy, and comorbidities (cerebrovascular disease, hypertension, parkinsonism, depression, and anorexia). The corresponding strategies of pharmacological treatments are further proposed and discussed comprehensively, with transient receptor potential channel modulators as promising treatment. With the integration of adequate and potential pharmacomanagement, AD patients with dysphagia can achieve a good prognosis and postpone tube feeding to maintain a better quality of life. More rigorous studies are needed to verify the effectiveness of innovative strategies and develop targets for neurostimulation.

Keywords: Alzheimer’s disease; Dementia; Dysphagia; Medication; Pharmacological management; Swallowing disorders.