Now, with due respect to the neurologists, and with admission of my bias, I would rank decline in speech and swallowing as being right up there as one of the ULTIMATE challenges for most people living with Parkinson's and related disorders. And unfortunately, with no mention of this to the audience, this error of omission became a missed opportunity for participants to be educated about the importance of early exercise for the whole body, including the respiratory, speech and swallowing systems.
There is some recent research, in fact, indicating that postural instability and cognitive decline may have a strong correlation with decline in swallowing function. ( Dysphagia. 2011 Mar;26(1):92-6.)
Walker, et al reported that although many people with Parkinson's disease (PD) experience dysphagia (swallowing problems) , the prevalence of dysphagia in people with PD is unknown. Therefore the intent of their research was to examine this further by studying a prevalent population of PD cases. Anyone who answered "yes" to either one of the two questions: Do you have difficulty swallowing food/liquid or tablets? and Do you cough after eating/drinking? was considered to have dysphagia. Question 7 of the Unified Parkinson's Disease Rating Scale (UPDRS) was also used to identify dysphagia. Almost one third of study participants reported dysphagia, and there were significant correlations with cognitive function, anxiety, depression, quality of life, and UPDRS-reported gait disturbance, postural instability and problems with falling. There was no correlation with disease duration, age, or gender.
As I read these study findings, they speak again to that somewhat "sneaky" or insidious nature of Parkinson's I often refer to when speaking to patient groups. A disease which lurks in the background, changing the way muscles are working, even before full blown symptoms are present, and this includes speech and swallowing.
Please don't wait for your neurologist to consider a referral to a speech pathologist. Regardless of how long it has been since your diagnosis of Parkinson', if you have not already had a consult with a speech pathologist, request one. Learn some voice and swallowing exercises that can be incorporated into your general exercise program as one more step to reduce the impact of Parkinson's on your quality of life.