What swallowing changes are typical in Parkinson's disease, and what therapy is commonly recommended?

• A. Delayed swallow initiation, reduced pharyngeal constriction, and sometimes reduced laryngeal closure; recommended therapies include effortful swallow, Mendelsohn maneuver, postural adjustments, sensory enhancement, and careful texture modification.
• B. Faster swallow initiation; no therapy recommended.
• C. Only esophageal symptoms.
• D. No dysphagia in Parkinson's disease.

Answer: (A)

Swallowing in Parkinson’s disease often shows a slower, more fragile swallow with delayed initiation and weaker pharyngeal constriction, and sometimes reduced protection from the larynx. This combination raises the risk of residue and airway invasion, so the recommended therapy targets both timing and strength of the swallow. An effortful swallow helps increase pharyngeal constriction and bolus clearance. The Mendelsohn maneuver prolongs the peak of laryngeal elevation, supporting safer airway protection and better opening of the upper esophageal sphincter. Postural adjustments alter the path of the bolus to reduce penetration risk and improve flow. Sensory enhancement, such as sour or carbonated stimuli, can trigger the swallow more robustly and quickly. Texture modification tailors the bolus consistency to the patient’s swallow, reducing residue and aspiration risk. This combination directly addresses the typical PD pattern of delayed initiation and reduced pharyngeal strength, making it the best fit. The other statements don’t align with the common PD presentation—faster initiation, only esophageal symptoms, or no dysphagia are not typical or accurate.