We listen and act



Dysphagia

Dysphagia is a swallowing disorder involving the oral cavity, pharynx, esophagus, or gastroesophageal junction. Consequences of dysphagia include malnutrition and dehydration, aspiration pneumonia, compromised general health, chronic lung disease, choking, and even death. Adults with dysphagia may also experience disinterest, reduced enjoyment, embarrassment, and/or isolation related to eating or drinking. Dysphagia may increase caregiver costs and burden and may require significant lifestyle alterations for the patient and the patient’s family. Speech-language pathologists (SLPs) are the preferred providers of dysphagia services and are integral members of an interprofessional team to diagnose and manage oral and pharyngeal dysphagia. SLPs also recognize causes and signs/symptoms of esophageal dysphagia and make appropriate referrals for its diagnosis and management. Dysphagia intervention may concentrate on swallowing exercises, compensatory swallowing strategies (including posture considerations), bolus consistency modification, and caregiver/patient education.

Adult Dysphagia (asha.org)

Dementia

Dementia is a syndrome resulting from acquired brain disease. It is characterized by a progressive decline in memory and other cognitive domains that, when severe enough, interferes with daily living and independent functioning.

Mild Cognitive Impairment

MCI is described as an “intermediate stage of cognitive impairment that is often, but not always, a transitional phase from cognitive changes in normal ageing to those typically found in dementia” (Petersen et al., 2014, p. 214). Early identification of MCI might enable the use of cognitive interventions to slow the progression of decline (Qualls, 2005). See section in this Portal page on modifiable risk factors.

Unlike dementia, the cognitive decline associated with MCI does not interfere with independence in everyday activities (see, e.g., McKhann et al., 2011). This definition of MCI is consistent with the diagnostic category, mild neurocognitive disorder (mild NCD), as defined in the DSM-5 (APA, 2013).

Dementia (asha.org)

Traumatic Brain Injury

Traumatic brain injury (TBI) is a form of nondegenerative acquired brain injury, resulting from an external physical force to the head (e.g., fall) or other mechanisms of displacement of the brain within the skull (e.g., blast injuries). TBI is associated with one or more of the following characteristics:

• Changes in levels of consciousness
• Memory disturbances
• Confusion associated with deficits in orientation
• Neurological signs, such as brain injury observable on neuroimaging, new onset or worsening of seizure disorder, visual field deficits, and hemiparesis

TBI can cause brain damage that is focal (e.g., gunshot wound) or widespread (e.g., diffuse axonal injury sustained in a motor vehicle accident). Damage can result from a primary injury or a secondary injury.

TBI Severity

Severity of TBI is based on the extent and nature of the injury, duration of loss of consciousness, posttraumatic amnesia (PTA; loss of memory for events immediately following injury), and extent of confusion at initial assessment during the acute phase of the injury (APA, 2013; Centers for Disease Control and Prevention [CDC], 2015).

The Department of Defense (DOD) defines the following levels of severity (Defense Health Agency, 2019):

• Concussion/Mild TBI
• Moderate TBI
• Severe TBI
• Penetrating TBI

Traumatic Brain Injury in Adults (asha.org)