Objective: To evaluate evidence linking respiratory dysfunction with dysphagia and aspiration risk in Parkinson’s disease (PD) and examine the potential role of digital respiratory biomarkers in identifying early swallowing impairment.

Background: Aspiration pneumonia is a major cause of morbidity and mortality in PD. Dysphagia results from brainstem involvement, impaired cough reflex, and progressive axial motor dysfunction. Early respiratory abnormalities may precede clinically apparent swallowing dysfunction but are often underrecognized in routine neurological evaluation.

Method: A systematic search of PubMed, Embase, and the Cochrane Library was conducted through January 2026 following PRISMA guidelines. Studies evaluating respiratory function in adults with PD and reporting associations with dysphagia, aspiration, or pneumonia were included. Data were extracted on study characteristics, respiratory measures, and swallowing outcomes.

Results: Several studies demonstrate that impaired cough effectiveness and reduced respiratory muscle strength are associated with greater dysphagia severity and increased aspiration risk in PD. Emerging digital approaches, including wearable respiratory monitoring and automated respiratory pattern analysis, may detect early respiratory abnormalities preceding aspiration complications.

Conclusion: Respiratory dysfunction is closely linked to dysphagia and aspiration risk in PD. Objective respiratory assessments and emerging digital biomarkers may help identify high-risk patients earlier and support preventive strategies to reduce pneumonia-related morbidity.

Characteristics of Studies

Respiratory Biomarkers

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MDS Abstracts - https://www.mdsabstracts.org/abstract/digital-respiratory-biomarkers-as-early-indicators-of-dysphagia-and-aspiration-risk-in-parkinsons-disease-a-systematic-review/