<p><b>Aims</b></p><p>The aims of the thesis were to validate investigation instruments for stroke patients with dysphagia, and to improve oropharyngeal dysphagia therapies.</p><p><b>Methods/Results</b></p><p>A Lip Force Meter, LF 100, affirmed excellent intra- and inter-reliability, sensitivity and specificity. Controls had significantly stronger lip force (LF) and swallowing capacity (SC) than stroke patients. A normal lower limit of LF was set to 15 Newton. Dysphagia symptoms improved in 7 stroke patients after a 5-week sensorimotor stimulation therapy comprising manual body and facial regulation in combination with palatal plate application. Impaired LF and impaired SC were parallel phenomena in 22 acute stroke patients and did not differ regardless of presence or absence of facial palsy. LF and SC improved and were parallel phenomena in 30 stroke patients and did not differ regardless of presence or absence of facial palsy, time lag between stroke attack and start of treatment, or age. SC was normalized in 19 of 30 dysphagia patients after a 5-8-week daily lip muscle self-training with an oral screen. </p><p><b>Conclusions</b></p><p>LF100 is an appropriate and reliable instrument for measuring lip force. Dysphagia improvement, by body and facial sensorimotor stimulation in combination with palatal plate application, or by training with an oral screen is excellent examples of brain plasticity and cortical reorganisation. . Swallowing capacity and lip force in stroke patients are parallel phenomena. A sub clinical facial paresis seems to be present in most stroke patients. Training with an oral screen can improve LF and SC in stroke patients with oropharyngeal dysphagia. </p>

<b>Aims</b> The aims of the thesis were to validate investigation instruments for stroke patients with dysphagia, and to improve oropharyngeal dysphagia therapies. <b>Methods/Results</b> A Lip Force Meter, LF 100, affirmed excellent intra- and inter-reliability, sensitivity and specificity. Controls had significantly stronger lip force (LF) and swallowing capacity (SC) than stroke patients. A normal lower limit of LF was set to 15 Newton. Dysphagia symptoms improved in 7 stroke patients after a 5-week sensorimotor stimulation therapy comprising manual body and facial regulation in combination with palatal plate application. Impaired LF and impaired SC were parallel phenomena in 22 acute stroke patients and did not differ regardless of presence or absence of facial palsy. LF and SC improved and were parallel phenomena in 30 stroke patients and did not differ regardless of presence or absence of facial palsy, time lag between stroke attack and start of treatment, or age. SC was normalized in 19 of 30 dysphagia patients after a 5-8-week daily lip muscle self-training with an oral screen. <b>Conclusions</b> LF100 is an appropriate and reliable instrument for measuring lip force. Dysphagia improvement, by body and facial sensorimotor stimulation in combination with palatal plate application, or by training with an oral screen is excellent examples of brain plasticity and cortical reorganisation. . Swallowing capacity and lip force in stroke patients are parallel phenomena. A sub clinical facial paresis seems to be present in most stroke patients. Training with an oral screen can improve LF and SC in stroke patients with oropharyngeal dysphagia.

Sväljkapacitet kan skilja sig åt mellan olika åldrar och kön. Detta kan inverka på prestationen på så kallade vattensväljtest. Ingen uttömmande studie har gjorts angående effekt av ålder, kön och vattenmängd på sväljförmåga hos friska vuxna i Sverige. Syftet med föreliggande studie var att presentera normdata för tre olika mått på sväljförmåga: sväljtid, sväljkapacitet och antal klunkar vid 1 respektive 2 dl vatten hos friska vuxna, samt att undersöka effekter av vattenmängd och ålder respektive kön på sväljförmågan. 239 vuxna deltagare stratifierades utifrån ålder och kön. Under testförfarandet noterades sväljtid, antal klunkar samt övriga observanda. Resultatet visade signifikant längre sväljtid, lägre sväljkapacitet och fler klunkar såväl hos individer över 70 år som hos kvinnor. Tydligare skillnader kunde ses med den större vattenmängden. Dessutom framkom att 1 dl vatten inte mäter sekventiell sväljning hos samtliga individer. / Swallowing may differ between different age groups and genders. This may affect performance on water swallow tests. So far there have been no comprehensive studies on the effect of age, gender and water volume on the swallowing performance of healthy adults in Sweden. The aim of this study was to present normative data for three different measures of swallowing: swallowing time, swallowing capacity and number of swallows at 100 ml and 200 ml of water in healthy adults, and to examine possible effects on swallowing of age and gender. The 239 adult participants were stratified according to age and gender. During testing, time, number of swallows and a number of deviations were noted. Results showed significantly longer swallowing times, lower swallowing capacity and more swallows both in individuals older than 70 and in women. These differences were greater when using the larger volume of water. Furthermore, results showed that 100 ml of water was insufficient for measuring sequential swallowing in some individuals.

Diss. (sammanfattning) Stockholm : Karolinska institutet, 2006. / Härtill 4 uppsatser.

The importance of breastfeeding has been emphasized because of its benefits in relation to children s development, and also related to the great influence to the development of the stomatognathic system. So, this study has the purpose to verify the relationship between breastfeeding and sucking habits, socioeconomic aspects and the stomatognathic system. As a procedure, parents of 195 children (male and female) answered a questionnaire. The children were aged between 5:0 and 8:11 and attended public and private schools. The collected data were related to type and duration of breastfeeding, respiratory aspects of children, family s socioeconomic, family s monthly income, and mothers education status. Besides, it was investigated the presence and duration of sucking habits. Of the questionnaires, 76 children were randomly assigned to be clinically evaluated. The evaluation was based on the Protocol of Orofacial Myofunctional Evaluation with Scores Expanded Adapted and analyzed the functions of chewing, swallowing and breathing. The speech function was evaluated through the articulatory examination, based on the protocol created at the Speech Therapy Service of Federal University of Santa Maria. The data were analyzed in a descriptive and statistical way, this by means of Chi-Square Test with a level of significance of 5%. The results of the questionnaires showed a predominance of mixed type, but may be noted that exclusive breastfeeding was higher than the exclusive use of the artificial, which is used in addition to two. There was relationship between type of breastfeeding and pacifier habit (p=0,000) and its duration (p=0,000); duration of breastfeeding and pacifier habit (p=0,000) and its duration (p=0,000); artificial breastfeeding, pacifier habit (p=0,000) and its duration (p=0,000). In respect to the socioeconomic aspects, there was relationship between type of breastfeeding and family income (p=0,002). It was possible to conclude that the type and duration of breastfeeding were fundamental to the acquisition of the pacifier habit and social levels and lower income can be considered predictors of inclusion of other forms of feeding, which is not natural. The results of evaluations of the stomatognathic system, it was possible to observe that there was no relationship between type and duration of breastfeeding and the studied functions, except between duration of breastfeeding and interdentalization (p=0,033). So, the type and duration of breastfeeding were not determining to the emergence of alterations in chewing, swallowing, and breathing functions, what suggests that these alterations have multifactorial causes. / A importância do aleitamento materno vem sendo enfatizada em função dos benefícios que o mesmo exerce no desenvolvimento infantil, além da grande influência no desenvolvimento do sistema estomatognático. Desta forma, este estudo teve como objetivo verificar a relação entre o aleitamento e hábitos de sucção, aspectos socioeconômicos e o sistema estomatognático. Como procedimento inicial foi aplicado questionário aos pais ou responsáveis de 195 crianças de ambos os sexos, entre cinco anos a oito anos e 11 meses de idade, de escolas públicas e particulares. Foram coletados dados referentes ao tipo e tempo de aleitamento, aspectos respiratórios das crianças e socioeconômicos dos familiares, como renda familiar mensal e escolaridade das mães; além disso, investigou-se a presença e a duração dos hábitos de sucção. Dos questionários, foram escolhidas aleatoriamente 76 crianças para avaliação clínica. Esta avaliação baseou-se no Protocolo de Avaliação Miofuncional Orofacial com Escores Expandido - Adaptado e deste foram analisadas as funções de mastigação, deglutição e respiração. A função de fala foi avaliada através do Exame Articulatório, baseado no protocolo do Serviço de Atendimento Fonoaudiológico da Universidade Federal de Santa Maria. Os dados foram analisados de forma descritiva e estatística, essa última por meio do teste Qui-Quadrado, considerando nível de significância de 5%. Os resultados referentes aos questionários mostraram predomínio do tipo misto, porém pode-se notar que o uso exclusivo do aleitamento materno foi maior do que o uso exclusivo do artificial, sendo esse utilizado além de dois anos. Houve relação entre tipo de aleitamento e o hábito de chupeta (p=0,000) e com tempo da mesma (p=0,000); tempo de aleitamento materno e o hábito de chupeta (p=0,000), bem como, com o tempo de permanência (p=0,000); e entre o aleitamento artificial e o hábito de chupeta (p=0,000) e tempo do mesmo (p=0,000). Quanto aos aspectos socioeconômicos, houve significância entre tipo de aleitamento e renda familiar (p=0,002). Pôde-se concluir que o tipo e o tempo de aleitamento foram determinantes para a aquisição do hábito de chupeta e que níveis sociais de renda mais baixos podem ser considerados preditores da inserção de outras formas de aleitamento, que não o natural. Quanto os resultados das avaliações do sistema estomatongático, pode-se observar que não houve relação entre o tipo e tempo de aleitamento com as funções estudadas, exceto entre o tempo de aleitamento materno e a interdentalização (p=0,033). Desse modo, o tipo e o tempo de aleitamento não foram determinantes no aparecimento de alterações nas funções de mastigação, deglutição e respiração, sugerindo que essas tenham causas multifatoriais.

O peristaltismo constritor é um dos principais componentes da fase faríngea da deglutição. Foram estudados os efeitos das consistências e volumes de alimento ofertado sobre a duração do fechamento faríngeo (white-out) por meio da videoendoscopia da deglutição em 61 indivíduos com deglutição normal. Os resultados foram correlacionados com gênero (24 masculinos e 37 femininos) e idade (20 a 77 anos). Foram ofertadas amostras alimentares de 5 e 10mL, nas consistências liquido, liquido espessado, pastoso e sólido a todos os indivíduos, obtendo-se 394 vídeos do período de fechamento faríngeo nas diversas consistências e volumes. As imagens foram digitalizadas e analisadas quadro-a-quadro no programa Adobe® Premiere® 6.5. Não houve diferença estatisticamente significante no tempo de fechamento faríngeo comparando-se entre as diferentes consistências e volumes. Não houve diferença quando comparados com gênero ou idade dos indivíduos. Conclui-se que o tempo de fechamento faríngeo não sofre impacto das diferentes consistências e volumes, assim como o gênero e idade em indivíduos com deglutição normal / Peristaltic constriction is one of the main components of the pharyngeal phase of swallowing. This study assessed the effects of various food consistencies and volumes on pharyngeal contraction time (as measured by duration of white-out during fiberoptic endoscopy) in 61 subjects with no swallowing problems. Results were correlated with gender (24 male, 37 female) and age (range, 2077 years). Food was provided in 5 and 10mL samples in various consistencies (fluid, thickened fluid, pureed, and solid) to all participants; a total of 394 video recordings of pharyngeal contraction during the passage of these various food consistencies and volumes were obtained. Footage was digitized and frame-by-frame analysis was carried out in the Adobe® Premiere® 6.5 software package. There were no statistically significant differences in pharyngeal contraction time during swallowing of the various food consistencies and volumes provided. Furthermore, there were no statistically significant differences between male and female patients or across different age. We conclude that sample consistency, bolus volume, gender and age have no impact on pharyngeal contraction time among individuals with no pathological changes in swallowing

No description available.

Les maladies altérant le processus de la déglutition sont multiples, affectant la qualité de vie du patient et sa capacité de fonctionner en société. La nature exacte et la gravité des changements post/pré-traitement dépendent de la localisation de l’anomalie. Une réadaptation efficace de la déglutition, cliniquement parlant, dépend généralement de l’inclusion d’une évaluation vidéo-fluoroscopique de la déglutition du patient dans l’évaluation post-traitement des patients en risque de fausse route. La restriction de cette utilisation est due au fait qu’elle est très invasive, comme d’autres moyens disponibles, tels que la fibre optique endoscopique. Ces méthodes permettent d’observer le déroulement de la déglutition et d’identifier les lieux de dysfonctionnement, durant ce processus, avec une précision élevée. "Mieux vaut prévenir que guérir" est le principe de base de la médecine en général. C’est dans ce contexte que se situe ce travail de thèse pour la télésurveillance des malades et plus spécifiquement pour suivre l’évolution fonctionnelle du processus de la déglutition chez des personnes à risques dysphagiques, que ce soit à domicile ou bien en institution, en utilisant le minimum de capteurs non-invasifs. C’est pourquoi le principal signal traité dans ce travail est le son. La principale problématique du traitement du signal sonore est la détection automatique du signal utile du son, étape cruciale pour la classification automatique de sons durant la prise alimentaire, en vue de la surveillance automatique. L’étape de la détection du signal utile permet de réduire la complexité du système d’analyse sonore. Les algorithmes issus de l’état de l’art traitant la détection du son de la déglutition dans le bruit environnemental n’ont pas montré une bonne performance. D’où l’idée d’utiliser un seuil adaptatif sur le signal, résultant de la décomposition en ondelettes. Les problématiques liées à la classification des sons en général et des sons de la déglutition en particulier sont abordées dans ce travail avec une analyse hiérarchique, qui vise à identifier dans un premier temps les segments de sons de la déglutition, puis à le décomposer en trois sons caractéristiques, ce qui correspond parfaitement à la physiologie du processus. Le couplage est également abordé dans ce travail. L’implémentation en temps réel de l’algorithme de détection a été réalisée. Cependant, celle de l’algorithme de classification reste en perspective. Son utilisation en clinique est prévue. / The diseases affecting and altering the swallowing process are multi-faceted, affecting the patient’s quality of life and ability to perform well in society. The exact nature and severity of the pre/post-treatment changes depend on the location of the anomaly. Effective swallowing rehabilitation, clinically depends on the inclusion of a video-fluoroscopic evaluation of the patient’s swallowing in the post-treatment evaluation. There are other available means such as endoscopic optical fibre. The drawback of these evaluation approaches is that they are very invasive. However, these methods make it possible to observe the swallowing process and identify areas of dysfunction during the process with high accuracy. "Prevention is better than cure" is the fundamental principle of medicine in general. In this context, this thesis focuses on remote monitoring of patients and more specifically monitoring the functional evolution of the swallowing process of people at risk of dysphagia, whether at home or in medical institutions, using the minimum number of non-invasive sensors. This has motivated the monitoring of the swallowing process based on the capturing only the acoustic signature of the process and modeling the process as a sequence of acoustic events occuring within a specific time frame. The main problem of such acoustic signal processing is the automatic detection of the relevent sound signals, a crucial step in the automatic classification of sounds during food intake for automatic monitoring. The detection of relevant signal reduces the complexity of the subsequent analysis and characterisation of a particular swallowing process. The-state-of-the-art algorithms processing the detection of the swallowing sounds as distinguished from environmental noise were not sufficiently accurate. Hence, the idea occured of using an adaptive threshold on the signal resulting from wavelet decomposition. The issues related to the classification of sounds in general and swallowing sounds in particular are addressed in this work with a hierarchical analysis that aims to first identify the swallowing sound segments and then to decompose them into three characteristic sounds, consistent with the physiology of the process. The coupling between detection and classification is also addressed in this work. The real-time implementation of the detection algorithm has been carried out. However, clinical use of the classification is discussed with a plan for its staged deployment subject to normal processes of clinical approval.

Introdução: A deglutição e suas características principais ainda são desconhecidas na demência frontotemporal. Objetivos: Caracterizar a deglutição e o comportamento alimentar de pacientes com diagnóstico de demência frontotemporal que apresentam a variante comportamental (DFTvc) e a afasia progressiva primária (APP). Caracterizar os pacientes com DFT e seus cuidadores. Descrever aspectos cognitivos e comportamentais, funcionalidade global, comunicação funcional, e a funcionalidade da deglutição na DFT. Descrever os problemas de deglutição e do comportamento alimentar na DFTvc e APP. Correlacionar os aspectos cognitivos e comportamentais, funcionalidade global e a comunicação com as características da deglutição. Identificar fatores preditivos da piora da funcionalidade da deglutição e do comportamento alimentar na DFT. Avaliar o comportamento dos instrumentos empregados. Desenvolver a versão reduzida do Questionário de Habilidades de Alimentação e Deglutição nas Demências e do Questionário de Comunicação Funcional na Afasia. Método: Este estudo incluiu 46 indivíduos com DFT nas fases leve, moderada e grave, e seus 46 cuidadores. O Mini exame do estado mental (MEEM) e o Mini exame do estado mental grave (MEEM-g) foram usados para avaliar os aspectos cognitivos. A Escala de estadiamento da demência (CDR-DLFT) foi usada para confirmar a fase da doença. O Inventário Neuropsiquiátrico (INP) foi aplicado para investigar os problemas comportamentais. A Bateria de Avaliação Frontal (BAF) investigou as funções executivas. O Índice das Atividades de Vida Diária (Katz), Questionário para Avaliação da Comunicação Funcional na Afasia (QACFA) e a Escala de funcionalidade da deglutição (EFD) avaliaram as habilidades funcionais. O Questionário de Habilidades de Alimentação e Deglutição nas Demências (QHADD) avaliou as dificuldades na deglutição e alimentação. Resultados: Os grupos DFTvc e APP não mostraram diferença estatisticamente significante no MEEM, CDR e BAF. Os cuidadores dos pacientes com DFTvc apresentaram mais horas de cuidado por dia em comparação aos pacientes com APP (p<0,05). Os grupos diferiram na EFD (p < 0,05). As características comportamentais que foram significantes na comparação entre os grupos DFTvc e APP foram: delírio, desinibição, comportamento motor aberrante e distúrbios do sono(p < 0,05) e alucinação (p=0,01). Os pacientes com DFTvc tiveram mais problemas de deglutição do que os pacientes com APP, tais como: tosse e engasgos, dificuldade com alguma consistência alimentar e dificuldade com alimento específico. Os problemas de deglutição na DFTvc se correlacionaram com a funcionalidade, aspectos cognitivos (p < 0,05), com a função executiva e com o comportamento (p < 0,01). Na APP, o subtipo semântico apresentou mais problemas de deglutição, tais como: escape de saliva e comida da boca, múltiplas deglutições, atraso na iniciação da deglutição e engasgos, estas características se correlacionaram com a ansiedade (p < 0,01), apatia e comportamento motor aberrante (p=0,01). Os problemas do comportamento alimentar foram mais frequentes no subtipo logopênico e se correlacionaram com dificuldades de comunicação. Os principais fatores preditivos da piora da funcionalidade da deglutição foram: declínio funcional, alterações comportamentais e o comprometimento da comunicação. Os problemas de deglutição foram observados em todas as fases da demência. A BAF foi o único instrumento que não apresentou uma boa confiabilidade interna. Conclusão: Problemas na deglutição foram observados nas duas variantes desde os estágios iniciais da demência. As alterações comportamentais, cognitivas e funcionais, e dificuldades na comunicação comprometeram as fases antecipatória e preparatória oral da deglutição. Por causa destas alterações, os cuidadores tiveram dificuldade no gerenciamento da situação de alimentação. Nosso estudo desenvolveu questionários resumidos para avaliar a deglutição e a comunicação funcional / Introduction: Swallowing and its main characteristics are still unknown in frontotemporal dementia. Objectives: To characterize swallowing and feeding behavior of patients with frontotemporal dementia who have behavioral variant (bvFTD) and primary progressive aphasia (PPA). To characterize patients with FTD and their caregivers.To describe cognitive and behavioral aspects, functionalstatus, functional communication, and swallowing function in FTD.To describe swallowing problems and feeding behavior in bvFTD and PPA. To correlate cognitive and behavioral aspects, functional status, and communication with swallowing. To identify predictive factors associated with worsening of functionality of swallowing and feeding behavior in FTD. To evaluate the instruments used. To develop reduced versions of: \"Assessment of Feeding and Swallowing Difficulties in Dementia\" and \"Functional Outcome Questionnaire Aphasia\". Method: This study included 46 individuals with FTD in mild, moderate and severe phases, and their 46 caregivers. The Mini mental state examination (MMSE) and the Severe Mini mental state examination (SMMSE) were used to assess the cognitive aspects. The FTLD-modified Clinical Dementia Rating scale (FTLD-CDR) was used to confirm the stage of the disease. The Neuropsychiatric Inventory (NPI) was applied to investigate the behavioral problems. The Frontal Assessment Battery (FAB) investigated executive functions. The Index of Activities of Daily Living (Katz), Functional Outcome Questionnaire- Aphasia and Swallowing rating scale (SRE) evaluated the functional abilities. The Assessment of Feeding and Swallowing Difficulties in Dementia (QHADD) evaluated the difficulties in swallowing and feeding. Results: bvFTD and PPA groups showed no statistically significant difference in MMSE, CDR and FAB. Caregivers of patients with bvFTD had more hours of care per day compared to patients with PPA (p < 0.05). The groups differed in SRE (p < 0.05). The behavioral characteristics that were significant in the comparison between bvFTD and PPA groups were delirium, disinhibition, aberrant motor behavior and sleep disturbances (p < 0.05), and hallucinations (p = 0.01). Patients with bvFTD had more swallowing problems than patients with PPA, such as coughing and choking, difficulty with some food consistency and difficulty with specific food. Swallowing problems in bvFTD correlated with functionality, with the cognitive aspects (p < 0.05), with executive function and behavior (p < 0.01). In PPA, the semantic subtype showed more swallowing problems such as escape of saliva and food in mouth, multiple swallows, delay in initiation of swallowing and choking, these characteristics correlated with anxiety (p < 0.01), apathy and aberrant motor behavior (p = 0.01). The problems of feeding behavior were more frequent in logopenic subtype and correlated with communication difficulties. The major predictors of worsening of swallowing function were: functional decline, behavioral changes and impaired communication. Swallowing problems were observed at all stages of dementia. The BAF was the only instrument that had bad internal reliability. Conclusion: Swallowing problems were observed in the two variants from the early stages of dementia. Behavioral, cognitive and functional changes, and difficulties in communication compromised the anticipatory and oral preparatory phase of swallowing. Because of these changes, caregivers had difficulty in managing the feeding situation. Our study developed reduced versions of questionnaires to assess swallowing and functional communication

Introdução: A deglutição e suas características principais ainda são desconhecidas na demência frontotemporal. Objetivos: Caracterizar a deglutição e o comportamento alimentar de pacientes com diagnóstico de demência frontotemporal que apresentam a variante comportamental (DFTvc) e a afasia progressiva primária (APP). Caracterizar os pacientes com DFT e seus cuidadores. Descrever aspectos cognitivos e comportamentais, funcionalidade global, comunicação funcional, e a funcionalidade da deglutição na DFT. Descrever os problemas de deglutição e do comportamento alimentar na DFTvc e APP. Correlacionar os aspectos cognitivos e comportamentais, funcionalidade global e a comunicação com as características da deglutição. Identificar fatores preditivos da piora da funcionalidade da deglutição e do comportamento alimentar na DFT. Avaliar o comportamento dos instrumentos empregados. Desenvolver a versão reduzida do Questionário de Habilidades de Alimentação e Deglutição nas Demências e do Questionário de Comunicação Funcional na Afasia. Método: Este estudo incluiu 46 indivíduos com DFT nas fases leve, moderada e grave, e seus 46 cuidadores. O Mini exame do estado mental (MEEM) e o Mini exame do estado mental grave (MEEM-g) foram usados para avaliar os aspectos cognitivos. A Escala de estadiamento da demência (CDR-DLFT) foi usada para confirmar a fase da doença. O Inventário Neuropsiquiátrico (INP) foi aplicado para investigar os problemas comportamentais. A Bateria de Avaliação Frontal (BAF) investigou as funções executivas. O Índice das Atividades de Vida Diária (Katz), Questionário para Avaliação da Comunicação Funcional na Afasia (QACFA) e a Escala de funcionalidade da deglutição (EFD) avaliaram as habilidades funcionais. O Questionário de Habilidades de Alimentação e Deglutição nas Demências (QHADD) avaliou as dificuldades na deglutição e alimentação. Resultados: Os grupos DFTvc e APP não mostraram diferença estatisticamente significante no MEEM, CDR e BAF. Os cuidadores dos pacientes com DFTvc apresentaram mais horas de cuidado por dia em comparação aos pacientes com APP (p<0,05). Os grupos diferiram na EFD (p < 0,05). As características comportamentais que foram significantes na comparação entre os grupos DFTvc e APP foram: delírio, desinibição, comportamento motor aberrante e distúrbios do sono(p < 0,05) e alucinação (p=0,01). Os pacientes com DFTvc tiveram mais problemas de deglutição do que os pacientes com APP, tais como: tosse e engasgos, dificuldade com alguma consistência alimentar e dificuldade com alimento específico. Os problemas de deglutição na DFTvc se correlacionaram com a funcionalidade, aspectos cognitivos (p < 0,05), com a função executiva e com o comportamento (p < 0,01). Na APP, o subtipo semântico apresentou mais problemas de deglutição, tais como: escape de saliva e comida da boca, múltiplas deglutições, atraso na iniciação da deglutição e engasgos, estas características se correlacionaram com a ansiedade (p < 0,01), apatia e comportamento motor aberrante (p=0,01). Os problemas do comportamento alimentar foram mais frequentes no subtipo logopênico e se correlacionaram com dificuldades de comunicação. Os principais fatores preditivos da piora da funcionalidade da deglutição foram: declínio funcional, alterações comportamentais e o comprometimento da comunicação. Os problemas de deglutição foram observados em todas as fases da demência. A BAF foi o único instrumento que não apresentou uma boa confiabilidade interna. Conclusão: Problemas na deglutição foram observados nas duas variantes desde os estágios iniciais da demência. As alterações comportamentais, cognitivas e funcionais, e dificuldades na comunicação comprometeram as fases antecipatória e preparatória oral da deglutição. Por causa destas alterações, os cuidadores tiveram dificuldade no gerenciamento da situação de alimentação. Nosso estudo desenvolveu questionários resumidos para avaliar a deglutição e a comunicação funcional / Introduction: Swallowing and its main characteristics are still unknown in frontotemporal dementia. Objectives: To characterize swallowing and feeding behavior of patients with frontotemporal dementia who have behavioral variant (bvFTD) and primary progressive aphasia (PPA). To characterize patients with FTD and their caregivers.To describe cognitive and behavioral aspects, functionalstatus, functional communication, and swallowing function in FTD.To describe swallowing problems and feeding behavior in bvFTD and PPA. To correlate cognitive and behavioral aspects, functional status, and communication with swallowing. To identify predictive factors associated with worsening of functionality of swallowing and feeding behavior in FTD. To evaluate the instruments used. To develop reduced versions of: \"Assessment of Feeding and Swallowing Difficulties in Dementia\" and \"Functional Outcome Questionnaire Aphasia\". Method: This study included 46 individuals with FTD in mild, moderate and severe phases, and their 46 caregivers. The Mini mental state examination (MMSE) and the Severe Mini mental state examination (SMMSE) were used to assess the cognitive aspects. The FTLD-modified Clinical Dementia Rating scale (FTLD-CDR) was used to confirm the stage of the disease. The Neuropsychiatric Inventory (NPI) was applied to investigate the behavioral problems. The Frontal Assessment Battery (FAB) investigated executive functions. The Index of Activities of Daily Living (Katz), Functional Outcome Questionnaire- Aphasia and Swallowing rating scale (SRE) evaluated the functional abilities. The Assessment of Feeding and Swallowing Difficulties in Dementia (QHADD) evaluated the difficulties in swallowing and feeding. Results: bvFTD and PPA groups showed no statistically significant difference in MMSE, CDR and FAB. Caregivers of patients with bvFTD had more hours of care per day compared to patients with PPA (p < 0.05). The groups differed in SRE (p < 0.05). The behavioral characteristics that were significant in the comparison between bvFTD and PPA groups were delirium, disinhibition, aberrant motor behavior and sleep disturbances (p < 0.05), and hallucinations (p = 0.01). Patients with bvFTD had more swallowing problems than patients with PPA, such as coughing and choking, difficulty with some food consistency and difficulty with specific food. Swallowing problems in bvFTD correlated with functionality, with the cognitive aspects (p < 0.05), with executive function and behavior (p < 0.01). In PPA, the semantic subtype showed more swallowing problems such as escape of saliva and food in mouth, multiple swallows, delay in initiation of swallowing and choking, these characteristics correlated with anxiety (p < 0.01), apathy and aberrant motor behavior (p = 0.01). The problems of feeding behavior were more frequent in logopenic subtype and correlated with communication difficulties. The major predictors of worsening of swallowing function were: functional decline, behavioral changes and impaired communication. Swallowing problems were observed at all stages of dementia. The BAF was the only instrument that had bad internal reliability. Conclusion: Swallowing problems were observed in the two variants from the early stages of dementia. Behavioral, cognitive and functional changes, and difficulties in communication compromised the anticipatory and oral preparatory phase of swallowing. Because of these changes, caregivers had difficulty in managing the feeding situation. Our study developed reduced versions of questionnaires to assess swallowing and functional communication