Speech therapist intervention in swallowing disorders in adults with Down syndrome and dementia diagnosis

Abstract

Introduction: Adults with Down Syndrome (DS) have gone through an accelerated degeneration process with a dementia rate greater than 90%, there is a greater risk of developing clinical complications that require attention in the swallowing area, especially. This article analyzes the swallowing disorders that come together in DS and Dementia, as if it were effective. Objective: To establish the intervention of the speech therapist in swallowing disorders in adults with Down Syndrome and dementia diagnosis. Material and methods: A systematic literature review study was conducted. The information sources used were printed and digital books, databases, scientific articles from the web, and specialized scientific journals. The bibliographic search was conducted in academic databases such as PubMed, Scielo, and Google Scholar. The bibliographic search focused on studies published between 2017 and 2023, in English and Spanish, that addressed swallowing disorders in people with Down syndrome and dementia. Key terms used included "Down syndrome," "dementia," "dysphagia," "speech therapy," and "intervention strategies." A total of 37 scientific articles were included. Results: The common swallowing disorders of the population from the mild stage converge in: hypotonia in chewing and swallowing muscles, dental disorders, delay in swallowing, nausea and cough reflexes, tongue protrusion, incomplete lip seal, temporo-mandibular joint dysfunction, alteration in chains muscles, dysfunction of the lingual and nasopharyngeal leaflets, respiratory disorders, tongue movement, Sleep Apneas, xerostomia, dryness labial, lingual interposition and alteration of oral sensitivity. The association of swallowing disorders in this population cannot be delimited to a stage of dementia disease. The speech therapist will perform an intervention to mitigate swallowing disorders, seeking quality of life in the patient, but it is not curative. Conclusions: It is almost impossible to link swallowing disorders to a specific stage of dementia in people with DS, since the literature consulted does not manage to classify the clinical manifestations into stages. But rather, it describes them in a general way and in relation to each patient and their comprehensive context. Therefore, in the present investigation, it was not possible to establish the alterations that the speech therapist may find as unique to the moderate stage.  The speech therapist's intervention in the swallowing disorders of adults with DS and a dementia diagnosis must be coordinated with an interdisciplinary group and with a biopsychosocial approach.