A survey of approximately 460 patients with Parkinson’s disease (PD) or multiple sclerosis (MS) shows that speech and swallowing difficulties are very frequent within these groups. Seventy percent of the PD patients and 44% of the MS patients had experienced impairment of speech and voice after the onset of their disease. Forty-one percent of the PD patients and 33% of the MS patients indicated impairment of chewing and swallowing abilities. The speech disorder was regarded as one of their greatest problems by 29% of the PD patients and by 16% of the MS patients. Only a small number of patients, 3% of the PD and 2% of the MS group, had received any speech therapy.

Oropharyngeal dysphagia (OD) is prevalent in the elderly and persons with complex medical conditions, resulting in considerable medical and psychosocial consequences and reduced quality of life. Many prevalence studies regard OD in relation to age or diagnosis. Knowledge on the prevalence of OD in different healthcare settings is lacking. This systematic review aimed to estimate the prevalence of OD in adults admitted to hospitals, rehabilitation facilities, nursing homes, and palliative care facilities through meta-analyses. A systematic literature search was completed including all dates up to March 30, 2021. The methodology and reporting were based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Forty-four out of 1,956 screened articles were deemed eligible. Considerable heterogeneity in definitions of OD and type and quality of selected outcome measures were observed. Overall within-group pooled prevalence estimates for OD determined by meta-analysis were 36.5% (95% CI 29.9 − 43.6) in the hospital setting, 42.5% (95% CI 35.8 − 49.5) in the rehabilitation setting, and 50.2% (95% CI 33.3–67.2) in nursing homes. No OD prevalence data were identified for palliative care facilities. Results for between-group analyses of OD prevalence estimates in the hospital setting were non-significant for type of assessment method, diagnostic group, and type of hospital ward, but indicated significantly higher prevalence estimates in nursing homes when using screening compared to patient-report. Future research should provide OD prevalence data for palliative care, achieve consensus in OD-related terminology when performing prevalence studies, and use screening and assessments with optimal diagnostic performance and psychometric properties.

The study describes an effort to evaluate the speech difficulties as perceived by individuals with dysarthria. A self-report questionnaire, Living with Neurologically Based Speech Difficulties (Living with Dysarthria), was answered by 55 individuals with varying types and degrees of dysarthria. Results show that both type and degree of subjectively perceived communicative difficulties varied. Degree of communicative difficulties was not related to age, gender, diagnosis, disease duration or employment status in this group. Generally, the overriding problems were related to restrictions in communicative participation, possibilities to actively take part in work and studies and to express one’s personality were particularly affected. Communication was also affected by emotions and by the number and familiarity of people present in communicative encounters. The dominating speech difficulties were related to reduced speech rate and a need for repetition as a consequence of misunderstandings. A statistically nonsignificant difference was found between the higher mean of the group with moderate dysarthria compared to the groups with severe and mild dysarthria, indicating that severity of dysarthria does not necessarily predict extent of perceived communicative difficulties. It is concluded that systematic subjective reports should always be included in the assessment of individuals with acquired dysarthria.

Few attempts have been made to use degree and type of multiple sclerosis (MS) dysarthria in neurological evaluation. In the present study, 77 individuals drawn from an MS population were examined both by a speech pathologist and a neurologist, and data from three sources of information were subsequently combined: (1) a clinical dysarthria test procedure, (2) a perceptual analysis of speech characteristics in continuous speech, and (3) neurological deficit scoring. The speech of 15 age- and gender-matched healthy control subjects was also investigated. It was concluded that: (1) the prevalence of mild to severe dysarthria in this cohort was 51% and occurred in all components of speech production: respiration, phonation, prosody, articulation and nasality. (2) The clinical dysarthria test was sensitive in detecting subclinical speech signs. The prevalence of pathologic speech signs found on the basis of the test was found to be 62%. The prevalence of dysarthria based on the neurological evaluation alone was 20%. (3) The dysarthria of MS was a predominantly mixed dysarthria, with both ataxic and spastic speech signs frequently present in the speech of a given individual. (4) Furthermore, when a predominant type of dysarthria existed, it was not generally associated with a characteristic profile of neurological deficits. Rather, severity of speech deviation was positively correlated to overall severity of neurological involvement, type of disease course, and number of years in progression.

Twenty-six subjects with idiopathic Parkinson's disease (PD) and normal cognitive status (as measured by the Mini-Mental State Examination) were examined with a battery of tests selected to reveal subtle and/or high-level language impairments. The test battery included 'repetition of long sentences', 'recreating sentences', 'making inferences', 'comprehension of logico-grammatical sentences', 'comprehension of ambiguous sentences' and 'comprehension of metaphors', 'word definitions', 'word fluency', 'naming', 'sentence analysis' and 'morphological completion'. Comparisons were made between the PD subjects and 26 control subjects matched for age, gender and level of education. Significant differences in performance between the PD subjects and the control subjects were found in the ability to make inferences and to analyse sentences (state the correct number of words in a read sentence). An additional four subjects with different degrees of cognitive dysfunction were also investigated and were found to have particular problems in making inferences, recreating sentences and comprehending metaphors and ambiguities. The results suggest that processing implied information might be a specific problem in this group and that the task of making inferences could be a particularly sensitive test of high-level language dysfunction.

Background: As an effect of the cognitive, emotional and motor symptoms associated with Huntington's disease, communicative interaction is often dramatically changed. No study has previously included the subjective reports on this subject from individuals with Huntington's disease.Aims: To explore the qualitative aspects of how communication is affected by Huntington's disease from a triangular perspective represented by individuals with Huntington's disease, family members and professional carers.Methods & Procedures: Eleven persons with Huntington's disease, seven family members and ten carers were interviewed in focus groups or individually, using a semi‐structured interview guide. The interviews were transcribed verbatim and analysed using thematic content analysis, resulting in a number of free codes concerning communication. The codes describing related phenomena were merged into categories. Categories were analysed and reanalysed resulting in three major themes, common to the three groups of participants.Outcomes & Results: The themes found were: Communication has changed; Factors that influence communication negatively; and Factors that influence communication positively. Subcategories differed between the three groups. All participants seemed to acknowledge the variability and lack of initiative in communication. The persons without Huntington's disease focused on the changes in terms of speech, language comprehension, the lack of depth in conversation and the need to make adjustments, while the persons with Huntington's disease focused on the effort and concentration demanded to communicate. They described the change they perceived in their communicative ability in terms of loss. All participants thought that an emotional load had a negative impact on communication. Furthermore, individuals with Huntington's disease stressed that other people's speed of communication had a negative impact, while family members and carers stressed that things such as personality changes in persons with Huntington's disease and lack of eye contact with them influenced communication negatively. All participants acknowledged the need for increased participation in social life in order to enhance communication.Conclusions & Implications: In brief, persons with Huntington's disease expressed a need for a richer social life and more (adjusting) conversation partners, family members expressed a need for more support and professional carers wanted more information about Huntington's disease. The triangular perspective utilized in the present study completed the picture of the communicative consequences of Huntington's disease. In particular, it became clear, that the insights of persons with Huntington's disease can and has to be included in communicative assessments and plans for intervention.