Phonation Research Articles

Acoustic Analysis for Predicting Voice Recovery Following Injection Laryngoplasty in Patients With Unilateral Vocal Fold Paralysis.

This study aimed to evaluate the efficacy of injection laryngoplasty (IL) in improving voice quality in patients with unilateral vocal fold paralysis (UVFP), as measured by acoustic parameters. A cohort of 177 patients with UVFP underwent preIL and postIL assessment using maximum phonation time (MPT), Acoustic Voice Quality Index (AVQI), and Acoustic Breathiness Index (ABI), in conjunction with auditory-perceptual (A-P) ratings and the Voice Handicap Index-10 (VHI-10). Significant improvements were observed across all acoustic and perceptual measures following IL. MPT, AVQI, and ABI, as analyzed using Praat, provided comprehensive quantification of voice recovery. All three measures showed high diagnostic accuracy, with area under the curve values of ≥ 0.73. Receiver-operating characteristic analysis identified effective cutoff values for MPT, AVQI, and ABI, confirming their predictive value for voice recovery. The findings of this study support the integration of MPT, AVQI, and ABI in clinical practice for a more precise assessment of IL outcomes in patients with UVFP. Future research should involve larger sample sizes to investigate cause-specific recovery rates and the role of postIL voice therapy.

The effect of mild-stage Alzheimer’s disease on the acoustic parameters of voice

Abstract Objective Our study aimed to reveal the differences by comparing the objective and subjective voice features of individuals diagnosed with mild-stage Alzheimer’s disease (AD) with those with normal cognitive abilities. Methods The study comprised 51 participants, who were divided into two groups: those with AD (study group, n = 28) and those with normal cognitive abilities (control group, n = 23). In the objective voice assessments of the participants, s/z ratio, maximum phonation time (MPT), F0, F1, F2, F3, jitter, shimmer, and NHR values were examined. The Voice Handicap Index-10 (VHI-10) and Voice-Related Quality of Life Scale (V-RQOL) were employed for the subjective assessments. Results In both males and females, the jitter and shimmer values in the study group were considerably higher than those in the control group (p < 0.000). The MPT of male participants in the study group was significantly lower than that of male participants in the control group (p < 0.036). Regarding VHI-10 and V-RQOL, the groups showed no statistically significant variation (p > 0.005). Conclusion Differences in shimmer, jitter, and MPT values based on gender among individuals with mild-stage AD indicate an impact on voice quality. It is suggested that clinicians should consider voice parameters during the assessment and intervention processes for mild-stage AD.

Ecological Validity of Self-Perceived Voice Quality and Acoustic Measures During Voice Assessments: An Observational Study on Faculty Teachers.

This study investigated the ecological validity of conventional voice assessments by comparing the self-perceived voice quality and acoustic characteristics of voice production during these assessments to those in a simulated environment with varying distracting conditions and noise levels. Forty-two university professors (26 women) participated in the study, where they were asked to produce loud connected speech by reading a 100-word text under four different conditions: a conventional assessment and three virtual classroom simulations created with 360° videos, each with different noise levels, played through a virtual reality headset and headphones. The first video depicted students paying attention in class (40 dB classroom noise); the second showed some students talking, generating moderate conversational noise (60 dB); and the third depicted students talking loudly and not paying attention (70 dB). The entire experiment was conducted in a sound-treated room, and the voice of each participant was recorded for acoustic analysis. In each condition, self-perception of voice quality (vocal effort and vocal ease), SPL, fundamental frequency, long-term average spectrum (L1-L0 ratio, alpha ratio, and the 1/5-5/8 ratio), and smooth cepstral peak prominence were measured. Visual distraction and noise level significantly impacted both subjective and acoustic measures of voice production, as shown by numerous statistically significant differences across almost all conditions and variables examined. Specifically, all measures increased with higher levels of distraction and noise, except for the 1/5-5/8 ratio, which showed a decreasing trend. These findings indicate that visual distraction and noise level significantly influence self-perceived and acoustic vocal characteristics and suggest that conventional assessments, typically conducted in silence and without visual distractors, may not accurately represent real-world performance, thus limiting their ecological validity.

Measuring Talker Age Estimates Through Crowdsourced Listeners' Ratings: A Pilot Study for Voice Research.

Most auditory-perceptual voice research utilizes the judgments of trained listeners rather than everyday listeners with no previous training in speech pathology. Online crowdsourcing of behavioral data from untrained participants is rapidly increasing in popularity but has yet to be a common procedure for auditory-perceptual studies of the voice. The objective of this pilot study was to assess the functionality of this model for judgments of voice by using an online experiment platform to replicate a lab-based, voice-specific age estimation study. Fifty crowdsourced untrained listeners estimated the age of a single talker based on audio samples taken from 20 speeches over a 48-year span. The primary outcome was overall age estimation accuracy. The crowdsourced age estimations closely matched those of a previous highly controlled in-person laboratory study using the same auditory samples. Listeners generally overestimated the talker's age when the talker was younger and underestimated his age when he was older. The age at which the estimated age equaled the talker's chronological age was 54 years. Online crowdsourcing may be a feasible modality for auditory-perceptual voice ratings with the potential to add low-cost, high-number options to validate and enhance clinical and laboratory-based studies by (a) including a wider diversity of participants and (b) providing the means for rapidly recruiting more participants. Further research investigating crowdsourced ratings of the complex parameters of voice quality using more listeners is needed to continue supporting this methodology as a tool for perceptual voice research.

Vocal and Facial Behavior During Affect Production in Autism Spectrum Disorder.

We investigate the extent to which automated audiovisual metrics extracted during an affect production task show statistically significant differences between a cohort of children diagnosed with autism spectrum disorder (ASD) and typically developing controls. Forty children with ASD and 21 neurotypical controls interacted with a multimodal conversational platform with a virtual agent, Tina, who guided them through tasks prompting facial and vocal communication of four emotions-happy, angry, sad, and afraid-under conditions of high and low verbal and social cognitive task demands. Individuals with ASD exhibited greater standard deviation of the fundamental frequency of the voice with the minima and maxima of the pitch contour occurring at an earlier time point as compared to controls. The intensity and voice quality of emotional speech were also different between the two cohorts in certain conditions. Additionally, facial metrics capturing the acceleration of the lower lip, lip width, eye opening, and vertical displacement of the eyebrows were also important markers to distinguish between children with ASD and neurotypical controls. Both facial and speech metrics performed well above chance in group classification accuracy. Speech acoustic and facial metrics associated with affect production were effective in distinguishing between children with ASD and neurotypical controls. https://doi.org/10.23641/asha.28027796.

In-Office Hyaluronic Acid Injection of Vocal Folds in Patients with Presbyphonia

Objective: to evaluate the advantages and disadvantages of injection laryngoplasty with hyaluronic acid in patients older than 65 years with presbyphonia. Study Design: a retrospective observational study. Setting: an academic secondary medical center. Methods: This study was performed using a group of patients diagnosed with presbyphonia who were treated using injection laryngoplasty with hyaluronic acid and underwent a minimum follow-up of 12 months. Subjective parameters such as the Voice Handicap Index–10 (VHI-10) and the GRBAS scale (grade, roughness, breathiness, asthenia, strain) were measured, as well as objective parameters such as the closure defect area. The medical records of patients undergoing this procedure during the 2020–2023 period were reviewed. An analysis of the demographic and clinical variables of the group was performed, as well as the values of the VHI-10, GRBAS, difference, and improvement of the area of closure defect before and after the procedure, along with the treatment duration and sensation of improvement. Results: The mean pre- and postoperative VHI-10 decreased from 26.8 to 19.6, showing significant differences (p = 0.007). The postoperative GRBAS mean score was 5.6 and normality can be assumed when it is below 9. Out of the 16 patients, 11 of them reported subjective improvement in their symptoms. More than half of them showed an improvement in the closure defect greater than 80%, with a significant reduction in the area (p < 0.001). Conclusions: hyaluronic acid injection in patients with presbyphonia produced a clear subjective improvement in voice quality and a decrease in the closure defect area.

Severity Cut-Off Ranges for Auditory-Perceptual Evaluation Using Visual Analog Scales.

This retrospective, observational analytic, cross-sectional research study aimed to establish cut-off scores for categorizing the severity of voice qualities on a 100-unit visual analog scale (VAS). The study investigated the VAS cut-off ranges corresponding to auditory-perceptual ratings of normal, mild, moderate, and severe severities from the GRBAS scale for overall severity, breathiness, roughness, and strain. The study utilized voice samples and ratings from thePerceptual Voice Qualities Database(PVQD). The database contains 296 audio samples, including sustained vowels and sentences, rated by 19 experienced voice clinicians. The raters used a 100-point VAS and the GRBAS scale to evaluate voice qualities. Receiver operator curves (ROC) were calculated to determine cut-off scores for each severity category, balancing a 90% sensitivity with a 10% allowable false-positive categorization. Cut-off ranges were established for overall severity, breathiness, and roughness, demonstrating similar values across severities. The ranges were: Overall severity: normal (0-15), mild (16-39), moderate (40-69), severe (70-100). Breathiness: normal (0-14), mild (15-34), moderate (35-68), severe (69-100). Roughness: normal (0-13), mild (14-37), moderate (38-65), severe (66-100). For strain, only the normal range (0-15) could be determined with statistical significance. This study provided clinically relevant cut-off values for severity categories on a VAS, enhancing communication with patients and facilitating the use of both sensitive and specific categorical measures in voice evaluation. The findings contribute to a more standardized and objective assessment of voice quality.

Management of <i>Swarabheda</i> (Hoariness of Voice) Through <i>Ayurveda</i>: A Case Report

Swarabheda, or hoarseness of voice, is one condition that afflicts one-third of the population. The vocal quality was described as weak, breathy, or strained. This condition often results from inflammation or infection of the vocal cords, imposing several social, emotional, and occupational limitations. Ayurvedic literature refers to Swarabheda as an independent pathology related to doshas in stages of alterations that affect the Shabda Vaha Srotas (voice channels), with conventional intervention focused on voice rehabilitation. To evaluate the efficacy of Ayurvedic treatment modality in the form of Shodhana Chikitsa (purification therapy) and Shamana Chikitsa (pacification therapy) in the treatment of Swarabheda (hoarseness of voice). A single case study was undertaken of a 30-year-old female patient diagnosed with Vataja Swarabheda. The treatment plan included Bala Ghrita, Gandusha, and a combination of herbal drugs like Khadiradi Vati, Lavangadi Vati, Kalyana Avaleha and Marsha Nasya. Treatment was for one month, and the patient was monitored at 15-day intervals with the G.R.B.A.S. Scale and vocal cord imaging. Good voice quality was resumed, hoarseness was alleviated, and other symptoms of nasopharyngeal carcinoma, like discomfort in the throat, dry cough, and fever, subsided during treatment. Scores on the G.R.B.A.S. Scale were enhanced, and endoscopic studies established a reduction in inflammation and cystic size on the affected vocal cords. This case report indicates that a confluence of Ayurvedic treatment is compelling for treating Swarabheda and a much less invasive nonsurgical solution with fewer side effects than conventional surgical treatments. Further studies are recommended to confirm these findings and validate Ayurvedic interventions as an effective treatment for voice alterations.Major Findings: The Ayurvedic treatment combined with Shodhana and Shamana therapies relieved hoarseness in the patient diagnosed with Vataja Swarabheda and significantly improved voice quality. The inflammation was also shown to be less by endoscopy.

The aging human larynx, presbyphonia, and voice quality: The evolutionary and social effects on listeners.

The human voice is a major signal transmission modality for our species. Accordingly, perception of its quality serves as an intraspecific window into the status of an individual's health, robusticity, and even stature in the group. Diminished quality-as may occur in aging or certain diseases-is a major feature in the lessening of an individual's communication modality. Here, we review the underlying anatomy and function that comprise the voice producing elements-the vocal tract sensu lato-from the lungs through the larynx and supralaryngeal modifying elements. Aspects of the aging larynx and constituent elements such as the vocal folds ("true vocal cords") and intrinsic laryngeal joints, are discussed within the context of how their aging or disease degradation may affect an individual's speech and concomitant perception and interpretation by listeners. The aging voice is considered within the context of the overall effects of aging sensory systems in both humans and other mammals.

Self-Perception of Voice at Different Moments and Hospitalization for COVID-19: The Influence of Sociodemographic and Clinical Variables.

This study aimed to compare the self-perception of voice at different times and the influence of age, number of infections, underlying diseases, and occupational voice use among individuals with Coronavirus Disease 2019 (COVID-19), with or without a history of hospitalization. Data were collected from adults and older adults with COVID-19, treated at a Brazilian Military Hospital between April 2020 and May 2023. The questionnaire was sent by email and a messaging application. The data were analyzed by comparing self-perception of voice at different times and the study variables in the hospitalized and nonhospitalized groups. The sample comprised 101 individuals. Self-perception of voice quality worsened during COVID-19 in all three age groups, regardless of hospitalization history. Individuals with more than one infection had worse vocal self-perception during COVID-19, regardless of hospitalization. The worsening was greater among individuals with allergies and hearing loss. Arterial hypertension was associated with worsening after COVID-19 in the nonhospitalized group and with better self-perception before COVID-19 in hospitalized patients. Reflux was associated with hospitalized patients and worse self-perception of vocal quality at all times. Hospitalized occupational voice users had greater vocal quality improvement after COVID-19. Regardless of hospitalization and age group, participants self-perceived voice worsening during COVID-19, with a greater decline among hospitalized patients, and a slower recovery among hospitalized older people. More than one infection negatively impacted voice self-perception during COVID-19, and having one infection and no hospitalization was more promising for the voice. Allergies, hearing loss, hypertension, and reflux had an impact on voice self-perception during and/or after COVID-19. Hospitalized occupational voice users had greater vocal quality improvement, whereas nonhospitalized occupational voice users improved more slowly.

Age Prediction from Korean Speech Data Using Neural Networks with Diverse Voice Features

A person’s voice serves as an indicator of age, as it changes with anatomical and physiological influences throughout their life. Although age prediction is a subject of interest across various disciplines, age-prediction studies using Korean voices are limited. The few studies that have been conducted have limitations, such as the absence of specific age groups or detailed age categories. Therefore, this study proposes an optimal combination of speech features and deep-learning models to recognize detailed age groups using a large Korean-speech dataset. From the speech dataset, recorded by individuals ranging from their teens to their 50s, four speech features were extracted: the Mel spectrogram, log-Mel spectrogram, Mel-frequency cepstral coefficients (MFCCs), and ΔMFCCs. Using these speech features, four deep-learning models were trained: ResNet-50, 1D-CNN, 2D-CNN, and a vision transformer. A performance comparison of speech feature-extraction methods and models indicated that MFCCs + ΔMFCCs was the best for both sexes when trained on the 1D-CNN model; it achieved an accuracy of 88.16% for males and 81.95% for females. The results of this study are expected to contribute to the future development of Korean speaker-recognition systems.

From practice to protocol: The CAPE-VFQ by and for Quebec French SLPs

ABSTRACT This article presents the Quebec French adaptation of the Consensus Auditory-Perceptual Evaluation of Voice (CAPE-VFQ), a standardised protocol for evaluating voice quality. Developed through collaboration within the Quebec Voice Speech-Language Pathologist (SLP) Community of Practice, the adapted tool addresses linguistic and cultural nuances specific to Quebec French. This adaptation ensures standardised assessments and harmonises clinical and research practices across the province. The article outlines the iterative development process, including clinician feedback, and describes ongoing efforts to validate and support the use of the Quebec French CAPE-V in clinical settings. The adapted protocol serves as both a clinical tool and a reference point for future research, promoting reliable and culturally relevant voice assessments.

Investigating the moments of "aha" and "hmm" through acoustic analysis of voice and speech in pre-service physics teacher education-A novel method for identifying significant learning moments.

The aim of the study was to find whether certain meaningful moments in the learning process are noticeable through features of voice and how acoustic voice analyses can be utilized in learning research. The material consisted of recordings of nine university students as they were completing tasks concerning direct electric circuits as part of their course of teacher education in physics. Prosodic features of voice-fundamental frequency (F0), sound pressure level (SPL), acoustic voice quality measured by LTAS, and pausing-were investigated. The results showed that instances of confusion and understanding were manifested in acoustic parameters. F0 was significant in characterizing the both kind of learning instances. Confusion had lower SPL and alpha ratio, indicating that voice quality was softer than in understanding. Degree of voice pauses was lower in understanding, suggesting less hesitation or need for clarification for understanding compared to confusion. Voice research adds to the research of learning as speaker´s voice is affected by the different instances in the process of learning. This research approach can be used for identification of important instances of learning and directing these instances to closer analysis of content or interaction to further understand the learning processes. Therefore, this study is a novel contribution to the study of learning as it adds acoustic voice and speech analyses to the discipline.

Relating production and perception in two Raglai dialects at different stages of registrogenesis.

This paper explores the perception of two diachronically related and mutually intelligible phonological oppositions, the onset voicing contrast of Northern Raglai and the register contrast of Southern Raglai. It is the continuation of a previous acoustic study that revealed that Northern Raglai onset stops maintain a voicing distinction accompanied by weak formant and voice quality modulations on following vowels, while Southern Raglai has transphonologized this voicing contrast into a register contrast marked by vowel and voice quality distinctions. Our findings indicate that the two dialects partially differ in their use of identification cues, Northern Raglai listeners using both voicing and F1 as major cues while Southern Raglai listeners largely focus on F1. Production and perception are thus not perfectly aligned in Northern Raglai, because F1 plays a stronger role in perception than production in this dialect. We conclude that mutual intelligibility between dialects is possible because they both use F1 for identification.

What do the voice-related parameters tell us? The multiparametric index scores, cepstral-based methods, patient-reported outcomes, and durational measurements.

This study aimed to identify how the acoustic parameters, patient-reported outcomes (PROs), and durational measurements differ based on perceptually rated dysphonia severity and to investigate their relationship with dysphonia severity. One hundred seventy-nine subjects (males-78, females-101; mean ± SD age of 47.79 ± 14.05 years) with various etiology of dysphonia were included in this prospective cohort study. The G parameter of GRBAS was used to rate dysphonia severity. The Acoustic Voice Quality Index (AVQI v. 03.01), Acoustic Breathiness Index (ABI), and cepstral peak prominence-smoothed (CPPS) values for sustained vowel (CPPSsv) and connected speech (CPPScs) samples were obtained using the Praat software. The Voice Handicap Index-10 (VHI-10) and Voice-Related Quality of Life (V-RQOL) were used for PROs, and the maximum phonation time (MPT) and s/z ratio were measured as durational parameters. The acoustic parameters, including AVQI and ABI scores, and CPPSsv and CPPScs values significantly differed based on dysphonia severity, particularly in those with moderate (G2) or severe dysphonia (G3) compared to those with normal (G0) and/or slightly deviated (G1) voice. Among the PROs, VHI-10 scores significantly differed only between the groups G1 and G2 (p < 0.005) and the groups G1 and G3 (p < 0.005), whilst there were not any significant differences between the V-RQOL scores of all the compared groups. Significant differences were observed within the groups for MPT, but the s/z ratio significantly differed only between the groups G1 and G3. Correlation analysis revealed significant relationships between the G parameter of GRBAS and all measured variables (p < 0.001). Particular attention should be paid to the AVQI and ABI scores, CPPsv and CPPcs values, VHI-10 scores, and MPT values since they provide valuable information for overall dysphonia severity.

Redundant voicing and register in Mnong Râlâm.

Mnong Râlâm is a South Bahnaric language (Austroasiatic) that is traditionally described as preserving a voicing contrast in onset obstruents, contrary to other languages of the Mnong/Phnong continuum. Acoustic results yield evidence that this voicing distinction is less robust than previously suggested and is redundant with a register contrast realized on following vowels through modulations of F1 at vowel onset (and more limited variations of F2 and voice quality). A perception experiment also shows that F1 weighs heavier than closure voicing in identification. The existence of a language in which voicing and register are redundant allows us to revisit previous models of registrogenesis. It suggests that the acoustic properties of register may develop and become distinctive while voicing is still present rather than as a direct consequence of devoicing. The unexpected discovery of register in Mnong Râlâm also challenges previous reconstructions of Proto-South-Bahnaric, in which only voicing is postulated, based on hitherto limited available descriptive materials.

Voice Meets Swallowing: A Scoping Review of Therapeutic Connections.

This scoping review aimed to explore the use of volitional voice tasks in assessing swallowing-related outcomes and to evaluate their therapeutic impact on swallowing disorders, including their effects on swallowing biomechanics. This scoping review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews guidelines. A literature search was performed across multiple databases (PubMed, Web of Science, and Scopus), and additional records were identified through manual searches. After screening and eligibility assessment, 36 studies were included for data extraction and analysis. The Effective Public Health Practice Project Quality Assessment Tool for Quantitative Studies was employed to evaluate the quality of the included studies. The review identified various volitional voice tasks, such as maximum phonation time and pitch glides, as potential assessment tools for predicting swallowing-related outcomes. Additionally, voice tasks targeting pitch modulation, increased vocal loudness, and squeezed voice quality showed promising therapeutic benefits for swallowing disorders across different populations, especially individuals with neurological conditions and head and neck cancer. While methodological limitations were found in current literature, volitional voice tasks demonstrate potential as complementary tools for assessing and treating swallowing disorders, leveraging their interconnected neurological and biomechanical mechanisms underlying functions. Further research with more robust methodologies is needed to establish the efficacy of these integrated interventions, facilitate their translation into clinical practice, and test new possibilities.

Short-Term Effects of Semi-Occluded Vocal Tract Therapy on the Phonation of Children With Vocal Fold Nodules: A Randomized Controlled Trial.

The aim was to determine and compare the short-term effects of two intensive semi-occluded vocal tract (SOVT) programs, "straw phonation" (SP) and "resonant voice therapy" (RVT), on the phonation of children with vocal fold nodules. A pretest-posttest randomized controlled study design was used. Thirty children aged 6-12 years were randomly assigned to the SP group (n = 11), RVT group (n = 11), or control group receiving indirect treatment (n = 8) for their voice problems. All participants received 11 hr of group voice therapy over four consecutive days. A multidimensional voice assessment consisting of both objective (dysphonia severity index and acoustic voice quality index) and subjective (pediatric voice handicap index and perceptual rating of overall severity) measures was performed pre- and posttherapy. Voice therapy effectiveness was evaluated using group-level analyses (linear mixed models) and individual-level analyses to investigate what proportion of participants changed to a clinically relevant degree. Group-level analyses found no significant Time × Group interactions, indicating that the evolution over time did not differ among the three groups. Within-group effects of time showed a significant and equal improvement in dysphonia severity index in the SP and RVT groups and a significant improvement in perceptual rating of overall severity in the SP group. For dysphonia severity index, individual-level analyses showed that 36% and 45% of participants improved to a clinically relevant degree in the SP and RVT groups, respectively. For acoustic voice quality index, 38% improved to a clinically relevant degree in the SP group. Results suggest that short-term intensive SOVT programs may have a positive effect on voice quality and vocal capacities of children with vocal fold nodules. Participants seem to benefit more from a SP program than a RVT program.

Preparatory Switches of Auditory Spatial and Non-Spatial Attention Among Simultaneous Voices.

Can one shift attention among voices at a cocktail party during a silent pause? Researchers have required participants to attend to one of two simultaneous voices - cued by its gender or location. Switching the target gender or location has resulted in a performance 'switch cost' - which was recently shown to reduce with preparation when a gender cue was presented in advance. The current study asks if preparation for a switch is also effective when a voice is selected by location. We displayed a word or image 50/800/1400 ms before the onset of two simultaneous dichotic (male and female) voices to indicate whether participants should classify as odd/even the number spoken by the voice on the left or on the right; in another condition, we used gender cues. Preparation reduced the switch cost in both spatial-and gender-cueing conditions. Performance was better when each voice was heard on the same side as on the preceding trial, suggesting 'binding' of non-spatial and spatial voice features - but this did not materially influence the reduction in switch cost with preparation, indicating that preparatory attentional shifts can be effective within a single (task-relevant) dimension. We also asked whether words or pictures are more effective for cueing a voice. Picture cues resulted in better performance than word cues, especially when the interval between the cue and the stimulus was short, suggesting that (presumably phonological) processes involved in the recognition of the word cue interfered with the (near) concurrent encoding of the target voice's speech.

Analysis of the Auditory-Perceptual Voice Quality in Older and Younger Adults Without Self-Reported Voice Complaints.

The objectives of this study were to compare the auditory perceptual voice quality in young and older adults who had no self-reported voice complaints and to investigate the relationship of voice quality with age and gender in older adults. This is a retrospective study. This study included 114 participants. The study group comprised 57 older adults (24 men, 33 women) with a mean age of 72.6±0.76 years, while the control group included 57 young adults matched by gender. All participants reported no voice complaints and scored less than 19 points on the Voice Handicap Index. Clinicians applied the GRBAS (Grade, Roughness, Breathiness, Asthenia, and Strain) auditory perceptual assessment protocol to evaluate the voice quality of the participants of the study and control groups. More than half of the study group (50.9%) were rated as having mild voice abnormality (G1) based on the GRBAS auditory perceptual assessment protocol, while 21.1% exhibited moderate (G2). In contrast, only 19.3% of the control group participants had mild voice abnormality. The study group demonstrated statistically worse voice quality compared to the control group. Furthermore, participants over 75 years of age had statistically higher G ratings compared to those under 75. No significant difference was found between the G category and gender in older adults. The present study's findings indicate that compared to younger adults, older adults perceive voice quality deviation less than clinicians do. Furthermore, it is found that the deviation in voice quality among older adults was influenced by age but not by gender. This study highlights the need for screening and early identification/prevention of voice disorders in older adults.