Objective: To assess feasibility, safety, adherence, and acceptability of an early integrated dysphagia–nutrition pathway for parkinsonism.

Background: Dysphagia in parkinsonism may occur early and remain under-recognized, contributing to weight loss, dehydration, and respiratory morbidity. Pragmatic pathways that translate swallowing diagnostics into timely nutritional action and structured monitoring are not routinely implemented.

Method: Adults with parkinsonism and dysphagia risk (Eating Assessment Tool-10), clinician concern, or unintentional weight loss will receive standardized bedside assessment (GUSS) and/or (MASA) and FOIS grading. FEES and/or VFSS will be performed after bedside triage for: recurrent aspiration pneumonia in the medical history; clinical suspicion of silent aspiration at bedside; and/or clinically significant, rapid unintentional weight loss (≥5% within 1 month or ≥10% within 6 months), indicative of inadequate oral intake potentially attributable to swallowing impairment. Instrumental findings will be quantified with scales (PAS, MSS, YPRSRS). Nutrition evaluation will include body mass index, weight-change %, and Nutrition Risk Screening (NRS-2002) or Mini Nutritional Assessment (MNA) to set individualized energy/protein targets. Dysphagia diet planning (food texture and fluid consistency modification) will follow the International Dysphagia Diet Standardisation Initiative (IDDSI). A diary will track intake, hydration, and weekly weight; swallowing findings will guide texture/fluid recommendations and nutrition-support actions. We plan to enroll 50 patients with Parkinson’s Disease.

Results: Primary outcomes will be feasibility/implementation metrics (recruitment, retention, completion rates, time-to-completion, diary adherence, acceptability). Secondary outcomes will describe within-participant change in nutritional status, oral intake (FOIS), instrumental safety/efficiency (PAS/MSS/YPRSRS), and dysphagia-related complications during follow-up. Preliminary data will be presented at the congress.

Conclusion: This diagnose-to-nutrition pathway integrates bedside triage with FEES/VFSS as needed and operationalizes early nutritional support in parkinsonism. Feasibility results will guide pathway refinement and a subsequent effectiveness study.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/early-integrated-dysphagia-and-nutritional-management-in-parkinsonism-a-prospective-feasibility-study-to-prevent-malnutrition-and-complications/