Canadian Guideline for Parkinson Disease
CMAJ: Canadian Medical Association Journal
Grimes, D., Fitzpatrick, M., et al. (2019).
CMAJ: Canadian Medical Association Journal, 191(36), E989-E1004.
This is an update to a 2012 guideline that provides recommendations for the diagnosis and treatment of individuals with Parkinson's disease. The intended audience includes all health care professionals, with some of the recommendations specifically pertaining to speech and language therapy. The guideline developers used the ADAPTE process to identify recently published scientific evidence to update specific recommendations identified by a panel of experts.
Parkinson Canada
This article is updated from:<ul><li>Canada, P. S. (2012). Canadian Guidelines on Parkinson's Disease. <em>The Canadian Journal of Neurological Sciences, 39</em>(4), S1-S30. doi:10.1017/S031716710001516X</li></ul>
<div>As Parkinson disease progresses and communication needs change, consider alternative and augmentative communication (Good Practice Point).</div>
<div>Diagnosis of dementia associated with Parkinson disease and diagnosis of mild cognitive impairment in Parkinson disease can be made using the MDS Clinical Diagnostic Criteria. "These require reports of subjective cognitive decline and difficulties on psychometric testing" (Good Practice Point; p.31).</div>
<div>"Because people with Parkinson disease may develop impaired cognitive ability, a communication deficit, or depression, they should be provided with both verbal and written communication throughout the course of the disease — which should be individually tailored and reinforced as necessary — and consistent communication from the professionals involved" (Grade D evidence, Good Practice Point; p. 13).</div>
<div>Individuals with Parkinson disease who are experiencing problems with communication, swallowing, or saliva should be offered SLP treatment including strategies to improve swallowing, speech, and communication. These may include, but are not limited to, such as attention to effort therapies and treatments to improve swallowing efficiency and risk of aspiration, such as expiratory muscle strength training (Grade A evidence).</div>
