Comparison of 2 Interventions for Liquid Aspiration on Pneumonia Incidence

Study answer

What this study found

3-month pneumonia incidence: chin-down 9.8% vs thickened liquids 11.6%; HR 0.84 (95% CI 0.49–1.45); P=0.53—no significant difference. Nectar-thick vs honey-thick: 8.4% vs 15.0%; HR 0.50 (95% CI 0.23–1.09); P=0.083—not statistically significant. Pneumonia or death: 18.0% vs 18.3% (HR 0.98; P=0.94); 16.3% vs 20.5% (HR 0.76; P=0.36). Adverse events occurred in 23% overall; dehydration/UTI/fever more frequent with thickened liquids (P=0.055). Median hospital stay for pneumonia: honey-thick 18 days vs nectar-thick 4 days and chin-down 6 days. No clear superiority of a single intervention for…

Study & population

Randomized, controlled, parallel-design trial; 515 participants aged 50–95 years with dementia or Parkinson disease and dysphagia; aspirators identified by videofluoroscopic swallowing study; not blinded to assignment.

Intervention

Chin-down posture during swallowing thin liquids (15 centipoise); nectar-thick liquids (300 centipoise) swallowed in head-neutral position; honey-thick liquids (3000 centipoise) swallowed in head-neutral position; duration 3 months.

Key limitation

Early termination with enrollment below target; no no-treatment control; adherence to interventions varied; partial meal-monitoring; lack of blinding for care providers; short 3-month follow-up; limited generalizability beyond frail older adults with dementia or Parkinson disease.

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Original abstract