Objective: The project aimed to determine the frequency and severity of drooling in the Parkinson’s Disease (PD) population in Cardiff & the Vale Health-board through a questionnaire handed out in both outpatient and inpatient settings. An assessment through a separate questionnaire was performed to determine the impact of drooling on the quality of life of patient’s with Parkinson’s disease.

Background: The symptoms of PD are subdivided into motor (dopaminergic) and non-motor features (non-dopaminergic).[1] Drooling is defined throughout the projects as the “uncontrolled loss of saliva from the mouth”, it is an autonomic, non-motor symptom seen in PD patients, recognised as being a debilitating physical and psychological manifestation of PD.[2,3] Our hypothesis is that drooling is an overlooked symptom in PD which impacts on the QOL of those it affects.

Method: Literature Review Five studies were selected for literature review using a systematic technique using Ovid MEDLINE® and the terms ‘drooling’ (or ‘sialorrhoea’) and ‘Parkinson’s Disease’ with a specified year range from 2007 to 2018.[4] 86 articles were identified, however, many were excluded due to their inaccessibility and not containing an assessment of quality of life. Drooling Research The PDQ-8 assessment of QOL and an in-depth questionnaire of drooling were distributed to 41 patients for comparison with established research.[5] The patient’s Levodopa Equivalent Dose (LED), Hoehn and Yahr stage (H&Y) and PD type were acquired from their medical records and noted as possible aetiological factors of drooling.[6] Three patients were excluded from the study due to discounting the drooling component of the questionnaire.

Results: Drooling and sialorrhoea have an incidence of 78.9% in the population sampled. A statistically significant negative impact on QOL of severe drooling was detected in patients either treated clinically or required help for drooling (p=0.001).

Conclusion: As our hypothesis suggested, drooling does have significant impact on the QOL of the people that it effects (p=0.001). Although, statistical significance was not determined by many of the aetiological factors screened for in the study, the observational trends seen in factors assessed by our study and in the literature provide support for the continued research and development of clearly defined screening and management tools.

References: [1] DeMaagd, G. and Philip, A. 2015. Parkinson’s Disease and Its Management: Part 1: Disease Entity, Risk Factors, Pathophysiology, Clinical Presentation, and Diagnosis.P & T. 24. pp. 504-532. [2] Oxford English Dictionary. 2018. Online Edition. Oxford University Press. Available a thttps://en.oxforddictionaries.com/definition/drool [Accessed 24 April 2018] [3] Kalf, J. et al. 2007. Impact of drooling in Parkinson’s disease. Journal of Neurology. 254: 1227. doi: https://doi.org/10.1007/s00415-007-0508-9 [4] Wolter Kluwer. 2018. Ovid: Search Form. Available at: http://ovidsp.uk.ovid.com/sp-3.28.0a/ovidweb.cgi?QS2=434f4e1a73d37e8c6d5cc3ea7a7100e0c91ef741466d1c6a0b61f97d968e7de93b4cbdd1930c963a17b659c645e1282892f48e6acba357134cdd6e91a50f66f26c9e4f48173fb3b2238cdf7ff55647b47300aa72bd9c8b607a23a95fed4a0b7846d90e7f08f65dbf8b4b830476f7a026740f9ece46d70065af13cc773df50dcf8d444ab84c8a1118285df06340cfe084ff55045674469dd541db4e7f59a876528c37fe2b6b411ad73c288688aba9e2bfee18a0bbbd68f1d697c32bbc5be9cd4c29515d2d463e111a [Accessed 24 April 2018] [5] Jenkinson, C. Fitzpatrick, R. and Peto, V. 1998. Parkinson’s Quality of Life Questionnaire-8. Isis Innovation Limited (Oxford Universty Innovation). Available at: https://innovation.ox.ac.uk/wp-content/uploads/2014/07/Final_PDQ-8_English_UK_SAMPLE.pdf [Date Accessed 24 April 2018] [6] 3- Author Unkown. Date Unknown. Levadopa Equivalent Dose Calculator. Parkinsons Measurement. Available at: http://www.parkinsonsmeasurement.org/toolBox/levodopaEquivalentDose.htm [Date Accessed 24 April 2018].

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MDS Abstracts - https://www.mdsabstracts.org/abstract/incidence-of-drooling-in-parkinsons-disease-and-impact-on-quality-of-life/