How Parkinson's Disease Can Impact Speech and Swallowing

Updated: Dec 23, 2019

When my brother and I left for college, my mom made the decision to build an addition to her home. Instead of embracing an empty nest and contemplating a downsize, she slapped on an entirely new suite to the back of her house. As unorthodox as that may seem for a single person household, there was good reason for it.

Her own mother was living alone across the country, and she was slowly becoming weaker. Her walk was growing unsteady. My grandmother had Parkinson's disease, and it was time she moved in with one of her children. With my mom's background in adult protective services, it only seemed natural that she built a new nest for her aging parent.

Before I even completed my studies in speech-language pathology, I was acutely aware of my grandmother's quiet voice. Sometimes her words seemed rushed, as if they were quietly spilling from her mouth. I couldn't always hear or understand her. I didn't learn why this was happening until I studied speech-language pathology.

Parkinson's disease is a progressive disorder of the central nervous system that impacts movement, muscle control,and balance. One area of the brain it affects is called the substantia nigra. This is where dopamine is produced.

Dopamine is a chemical in the brain that acts as the messenger delivering information to and from neurons (nerve cells.) We rely on dopamine to pass along the message to other parts of our brain when we want to walk, run, speak, eat, and make any other body movement without having to think hard about it! Isn't it nice that when we want to walk, we don't have to actively think, right foot forward, right foot down, left foot forward, left foot down...? Thank you, dopamine!

Unfortunately, Parkinson's disease causes the substantia nigra to produce less and less dopamine. Less dopamine = less communication to certain parts of the brain. As the amount of dopamine becomes smaller, our movements become smaller. It is believed that Parkinson's disease itself doesn't cause weakness, rather it's the smaller movements that cause muscle weakening over time. Essentially, it follows the "if you don't use it, you lose it" rule.

This is when you might begin to notice smaller steps, or shuffling feet. The acts of speaking and eating require many detailed muscle movements with precise coordination, and often times these are movements we never think about. Since our throat muscles will not receive all of the information from the brain once dopamine is disappearing, we might have a harder time with chewing and swallowing. It becomes difficult to take in a deep breath and speak loudly, and our lips and tongue won't move as much. All of these automatic movements aren't so automatic anymore.

If you have a loved one that is diagnosed with Parkinson's disease and you notice the following symptoms, speech therapy might be able to help:

-Coughing during meals or while drinking

-Fear of choking

-Frequently asking your loved one to repeat him/herself

-Asking your loved one to "speak up"

-Increased isolation because it is too difficult to hold conversations

Prior to seeing a speech therapist, it is recommended that you call a physician for any formal work ups and recommendations.

Some simple tips in the meantime include eliminating all distractions during conversation (e.g. turn off the TV, shut doors, go somewhere quiet), go to restaurants outside of peak hours, and provide foods that are easier to manage, like lasagna instead of spaghetti.

Whether your loved one is in assisted living or now in your nest, speech therapy can help.

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