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.

背景：吞咽困难是多发性硬化症（MS）患者的一种危及生命的表现，因为吞咽障碍会导致吸入性肺炎的发生。吞咽困难可以通过使用患者报告的结果测量方法来检测，以预防并发症。目标：旨在确定吞咽困难的患病率、严重程度和生活质量（QoL），并分析两种经过验证的吞咽困难问卷之间的相关性。方法：收集了64名MS患者的吞咽困难多发性硬化症（DYMUS）和吞咽质量生活质量（SWALQoL）问卷。结果：SWALQoL的总平均得分是70.2（±11.7），DYMUS的平均得分是2.02（±1.3）。SWALQoL子领域得分最高的是沟通，最低的是疲劳量表。年龄与DYMUS和SWALQoL得分之间存在显著的相关性（r：0.539和r：-0.610，P < .001）。此外，疾病病程与DYMUS和SWALQoL得分之间存在显著的中度相关性，这些得分也与疾病病程相关（r：0.693和r：-0.697，P < .001）。DYMUS和SWALQoL得分在男性和女性之间没有差异（P > .05）。在继发性进行性MS患者中，DYMUS和SWALQoL得分较高（吞咽困难更严重），而在原发性进行性或复发型MS中则较低。DYMUS和SWALQoL得分之间存在非常强、负性和统计学意义上的相关性（Pearson’s r：-0.903，P < .001）。生理症状量表与DYMUS得分之间存在非常强的相关性（r：-0.901，P < .001）。DYMUS与疲劳和社会功能子领域之间的相关性较弱（r：-0.430，r：-0.492，P < .001）。其他子领域之间存在中度相关性：（r：-0.628至-0.668）。结论：MS导致吞咽困难和降低生活质量。年龄、疾病病程和MS类型是影响SWALQoL的主要因素。DYMUS和SWALQoL相关性良好。DYMUS是一种易于回答的工具，可能建议用于MS患者的吞咽困难筛查。