The Voice and Aging
As we age, it is inevitable for our bodies to experience changes. We’ve come to expect the physical appearance to change, and it is common for one’s mobility to be affected. One area that usually isn’t considered when assessing the changes that the body experiences as it ages is the effects of aging on voice. Just as young children who enter puberty experience voice changes, as we leave from middle age and become part of the elderly population, we once again experience changes in our voice. As in puberty, the changes that are experienced can often vary dependent upon the gender of the individual. It is important to note that the age of onset when the voice begins to display “aged” qualities differs from person to person. Some people will begin to experience these changes while in their 50’s, while others will not see any changes until they are well into their 80’s. While there is much information that has been discovered on this topic, physicians in this field are still conducting heavy research to fully understand the phenomenon of the aging voice. |
Presbyphonia
Presbyphonia is age-related dysphonia. It is a term that is generally used to describe the aging voice. It is a result of the changes that the vocal production mechanisms encounter. It is diagnosed by excluding other possible factors for a change in quality of the voice. Severity of symptoms will vary from person to person. For some people, presbyphonia will highly effect intelligibility. Symptoms of presbyphonia include:
• Occasional or frequent breaks in their voice
• A breathy vocal quality
• Laryngeal tension
• Sudden interruptions in the normal flow of speech – stoppages in phonation
• Reduced Pitch and loudness
• Occasional or frequent breaks in their voice
• A breathy vocal quality
• Laryngeal tension
• Sudden interruptions in the normal flow of speech – stoppages in phonation
• Reduced Pitch and loudness
Physical/Structural Changes
As a person ages, the speech mechanism endures many changes that are a direct cause for the perceived vocal changes. The changes can take place in one or all of the mechanisms used in voice production.
Due to thinning, the pictured vocal folds are unable to completely close during voicing, leading a spindle shaped gap.
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Because of the thinned vocal folds, normal projections of cartilage appear to be abnormal masses.
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Vocal folds appear to be scalloped or concave due to the thinning of the vocal folds.
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Respiration
• The lung tissue loses elasticity
• Stiffening of thorax • Weakening of respiratory muscles • Vital capacity decreases • Residual volume increases • Lung pressure and maximum expiratory flow rate is decreased. Supralaryngeal System
• Craniofacial skeleton undergoes 3-5% symmetrical enlargement
• Atrophy of facial, mastication and pharyngeal muscles • Thinning of elasticity of oral mucosa • Declining salivary function • Loss of tongue strength • Loss of teeth • Degeneration of temporomandibular joint |
Larynx
• The laryngeal cartilages undergo ossification and calcification
• Atrophy and degeneration of intrinsic muscles • Deterioration of cricoarytenoid joint • Degenerateion of laryngeal mucosa glands and conus elasticus, and lamina propria. • The cricoarytenoid joint may lessen vocal fold approximation or reduce smoothness of VF adjustments. • Glandular changes cause drying of the epithelium • Increased instability of vocal fold vibration • Lowering of the larynx in neck |
Perceptual/Functional Changes
The following are commonly reported perceived
changes that we experience as we age: • Higher pitch voice in men • Lower pitch voice in women • Reduced volume and projection of the voice (or “thin” voice) • Reduced vocal endurance • Difficulty being heard in noisy situations • Tremor or shakiness in the voice |
· Speaking fundamental frequency raises in men and lowers in women.
· Maximum phonational frequency range is reduced in men and women · Speaking fundamental frequency is less stable in men and women · Amplitude is less stable in men and women · Standard deviations of SFF and amplitude increase in men and women · Maximum intensity of vowel production is reduced in men and women · Perturbation increases (jitter, shimmer, spectral noise) in men and woman · Formant frequencies are lowered in men -Taken from Table 8.2 (Boone, et al., 2013). |
The greatest change experienced is the pitch level. Women’s pitch can drop as much as 10-15 Hz. The pitch level in men as they reach advanced old age can increase up to 35 Hz, causing it to be the highest level in adulthood.
The aging population may experience increased tremor and hoarseness in their voice, as well. These changes may possibly contributed to amplitude instability, which also decreases as one ages. Increased breathiness is also noted in the aging voice. As people age, there becomes a higher incident of glottal gap. Women tend to present this gap anteriorly.
The aging population may experience increased tremor and hoarseness in their voice, as well. These changes may possibly contributed to amplitude instability, which also decreases as one ages. Increased breathiness is also noted in the aging voice. As people age, there becomes a higher incident of glottal gap. Women tend to present this gap anteriorly.