Swallowing Dysfunction and Autonomic Nervous System Dysfunction in Alzheimer's Disease: A Scoping Review of the Evidence
Bibliographic record
Abstract
OBJECTIVES: To describe, synthesize, and interpret literature on swallowing impairment (dysphagia) and autonomic nervous system (ANS) dysfunction in Alzheimer's disease (AD) and to identify gaps in the existing literature. DESIGN: Scoping review of literature covering several study designs. SETTING: Literature review. PARTICIPANTS: Individuals with AD. MEASUREMENTS: Systematic searches of the PubMed, EBSCOhost, PsychINFO, Cochrane, EMBASE, and Scopus databases were conducted. Literature was identified and organized into categories. Studies were then evaluated using the Oxford Centre for Evidence-Based Medicine Levels of Evidence criteria. After evaluation, the literature was synthesized to form conclusions and identify knowledge gaps. RESULTS: Ninety-five articles met the study criteria and were included in the review. Thirty-one studies examining dysphagia in AD provide preliminary evidence on the prevalence, nature, and treatment of dysphagia in AD; knowledge gaps were identified with respect to demographic characteristics, nature of dysphagia, functional significance, assessment, treatment, and underlying mechanisms of dysphagia in AD. Sixty-four studies of ANS dysfunction in AD were reviewed, of which 49 identified at least one variable reflecting ANS dysfunction in AD. Knowledge gaps were identified related to demographics, functional significance, and underlying neural mechanisms. No studies were found that examined both dysphagia and ANS dysfunction in AD. CONCLUSION: Current evidence indicates that swallowing impairment, as well as ANS dysfunction, may occur in AD. Potential relationships between dysphagia and ANS dysfunction in AD have not been examined. Future research should explore the possibility that swallowing and ANS dysfunction in AD are related.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.015 | 0.054 |
| Meta-epidemiology (narrow) | 0.002 | 0.002 |
| Meta-epidemiology (broad) | 0.006 | 0.005 |
| Bibliometrics | 0.029 | 0.022 |
| Science and technology studies | 0.002 | 0.001 |
| Scholarly communication | 0.005 | 0.005 |
| Open science | 0.002 | 0.002 |
| Research integrity | 0.004 | 0.002 |
| Insufficient payload (model declined to judge) | 0.003 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".