Title: Unmasking the Risk: Aspiration Pneumonia in Parkinson’s Disease (P3-16.013)
Authors: Marina Santos De Sousa, Jamir Pitton Rissardo, Omar Elmandouh, Ana Leticia Fornari Caprara, and Ian M. Walker
Conference: 2026 AAN, Chicago, IL
Objective
To assess the risk of aspiration pneumonia among individuals with Parkinson’s disease (PD) compared to controls.
Background
Aspiration pneumonia is a leading cause of morbidity and mortality in PD, accounting for up to 70% of PD-related deaths. The risk is driven by oropharyngeal dysphagia, impaired cough reflex, and reduced airway protection. Despite its clinical impact, the magnitude of risk across observational studies remains uncertain, warranting meta-analytic synthesis.
Design/Methods
PubMed and Google Scholar were searched for studies comparing aspiration pneumonia risk in PD versus non-PD populations. Five observational studies (two cohort, three case-control) met inclusion criteria. Pooled risk ratios (RR) and 95% confidence intervals (CI) were calculated using a random-effects model (DerSimonian-Laird). Heterogeneity was assessed with Cochran’s Q, I², and τ². Publication bias was evaluated using trim-and-fill and fail-safe N methods.
Results
The random-effects pooled RR was 4.80 (95% CI: 2.49–9.27; p < 0.001), indicating a higher risk of aspiration pneumonia in PD, though the prediction interval was wide (0.36 to 63.55). Fixed-effect analysis yielded RR = 3.83 (95% CI: 3.81–3.85). Heterogeneity was significant (Q = 377.84, p < 0.001; τ² = 0.987), and I² was high (99%). Subgroup analysis showed a stronger association in cohort studies (RR = 8.45) than in case-control studies (RR = 4.80). No evidence of publication bias was detected (trim-and-fill: 0 missing studies). Fail-safe N was high (Rosenthal = 763; Rosenberg = 1152), suggesting robust findings.
Conclusions
PD is associated with a significantly increased risk of aspiration pneumonia, particularly in cohort studies, highlighting a critical and preventable complication. These findings emphasize the importance of early dysphagia screening, proactive airway protection strategies, and multidisciplinary interventions to reduce aspiration-related morbidity and mortality in PD. Future large-scale prospective studies are needed to refine risk estimates and guide evidence-based preventive care.
Citation
De Sousa MS, Rissardo JP, Elmandouh O, Caprara AL, Walker IM. Unmasking the Risk: Aspiration Pneumonia in Parkinson’s Disease (P3-16.013). Neurology 2026;106(11_suppl):870. doi: 10.1212/WNL.0000000000213163.
Figure 1. Forest plot shows Parkinson’s disease significantly increases aspiration pneumonia risk versus controls, with substantial heterogeneity and wide prediction interval.
Figure 2. Forest plot confirms increased aspiration pneumonia risk in Parkinson’s disease with narrower confidence intervals, despite persistent high heterogeneity across studies.