Coughing and Swallowing

Karl38

My wife is in Stage 4 ALZ but seems healthy except for serious memory issues. She developed a chronic cough last Winter which persists today. Lately she occasionally has trouble swallowing food. Also her appetite is diminished. I'm suspecting this is ALZ related. Have others out there seen these symptoms?

M1

Hi Karl. A chronic cough can be a sign of asthma, or of chronic gastric reflux. I'd talk to her docs, it's pretty easy to do a trial of a proton pump inhibitor like Prilosec or Nexium to see if she improves. But—she could also need a swallowing evaluation. A gastroenterologist may need to see her. I'd be reluctant to put her through an endoscopy, but she might be able to do a swallowing study (done with a thin barium liquid and a fluoroscope). If she has a good primary care doc, I'd discuss with them first.

Anyone with a chronic cough also ought to have a chest xray. This is also pretty easy to do.

Iris L.

Do not feed her steak or any meat or food that requires a lot of chewing before swallowing. It's just too easy to choke on steak.

Iris

Quilting brings calm

Does she take a blood pressure medication? Lisinopril is in a list of blood pressure meds that can cause chronic cough. For some reason, primary care physicians don’t catch it. My spouse saw a pulmonologist who diagnosed it immediately.

Iris L.

I took lisinopril years ago and I developed a terrible cough. The internist was unaware of this known side effect of lisinopril.

Iris

MN Chickadee

Seconding the idea to check meds - the elderly people in my life have had wicked coughs from certain heart/blood pressure meds. Also try meds for acid reflux. A chest xray may be helpful if she can sit still long enough to see if there are any nodules etc.
A person at one of my support groups had a similar situation - their PWD had a chronic cough and despite a massive amount of tests and tinkering they never could figure it out. Between the person not being able to communicate well plus possibly not tolerating the same tests that a cognitively normal person would it can be constraining. At minimum a swallow study may be in order to help you figure out what to feed her.

Bob in LW

My LO has diminished appetite and is also in Stage 4. That is common for Alzheimers, and she is also sleeping 16-18 hours a day.