Dysphagia in Multiple Sclerosis for Screening Dysphagia and its Correlation with Swallowing Quality of Life in Patients with Multiple Sclerosis
Background: Dysphagia is a life-threating symptom in patients with multiple sclerosis (MS) because aspiration pneumonia develops as a consequence of swallowing disorders. Dysphagia can be detected by using patient-reported outcome measures in order to prevent complications. Objective: To identify the dysphagia prevalence, severity, and quality of life (QoL), and to analyze the correlation between two validated dysphagia questionnaires. Method: Dysphagia in Multiple Sclerosis (DYMUS) and Swallowing Quality of Life (SWALQoL) questionnaires were collected from 64 patients with MS. Results: The mean total SWALQoL score was 70.2 (±11.7) and the mean DYMUS score was 2.02 (±1.3). The highest mean SWALQoL subdomain score belonged to communication, and the lowest score belonged to the fatigue scale. There was a significant correlation between age and DYMUS and SWALQoL scores (r: 0.539 and r: -0.610 respectively, P < .001). Additionally, there was a significant moderate correlation between disease duration and DYMUS and SWALQoL scores, which were also correlated to disease duration (r: 0.693 and r: -0.697 respectively, P < .001). DYMUS and SWALQoL scores did not vary between males and females (P > .05). Patients with secondary progressive MS had higher DYMUS and lower SWALQoL scores (more dysphagia) in primary progressive or relapsing-type MS. There was a very strong, negative and statistically significant correlation between DYMUS and total SWALQoL scores (Pearson’s r: -0.903, P < .001). The physical symptom scale had a very strong correlation with DYMUS score (r: -0.901, P < .001). The correlation between the DYMUS and the fatigue and social functioning subdomains was weak (r: -0.430, r: -0.492 respectively, P < .001). Other subdomains had moderate correlation: (r: -0.628 to -0.668). Conclusion: MS causes dysphagia and reduces QoL. Age, disease duration, and MS type are major factors that influence SWALQoL. DYMUS and SWALQoL are well correlated. DYMUS is an easy to answer tool that may advised for screening dysphagia in patients with MS.