The Aging Voice

Abstract

Age-related dysphonia in the elderly is more common than appreciated because it is an under-reported symptom. Perceptually, the presbyphonic voice is characterized negatively as sounding weak, breathy, tremulous, and unstable. The frequent association with hearing impairment in this group may lead to social isolation and depression, with a significant impact on quality of life. Although several anatomical and physiological alterations are known to contribute to presbyphonia, singing prevents, in large part, many of the perceptual changes. Vocal exercises, with vocal fold augmentation or thyroplasty when indicated, provide significant improvement. Many older individuals with recognized clinical signs of presbylarynx, such as vocal atrophy, report a normal voice. This suggests that the mere presence of presbylarynx does not necessarily result in presbyphonia. Recognition of presbyphonia is important because of its significant impact on quality of life. Appropriate diagnosis is essential in order to provide effective therapy.