Aging Voice

The term "aging voice" is often used to refer to the changes that occur in the human voice as a person gets older. Another term used to describe this phenomenon is "presbyphonia" or "physiological aging voice." These changes can include a decrease in vocal range, vocal strength, and vocal endurance, as well as a loss of flexibility and control in the voice. 

Approximately 20% of individuals over the age of 60 experience an aging voice disorder (presbyphonia) (25% of those over 65 years old, Bradley 2014). Presbyphonia affects the singing voice more frequently, earlier, and more noticeably than the speaking voice. It not only impairs the quality and endurance of the singing and speaking voice but also weakens the respiratory drive due to restricted lung function. As the larynx lowers, the resonance characteristics in the vocal tract change in seniors, increasing the risk of aspiration (Angerstein 2016). The vocal cord muscles atrophy due to physiological aging processes, typically resulting in an oval-shaped vocal cord gap during phonation. As a result, more effort is required to produce a clear and resonant voice.

The Aging Voice (Presbyphonia)

Presbyphonia affects the singing voice (greater strain on the phonation apparatus) more frequently, earlier, and more noticeably than the speaking voice (lower strain on the phonation apparatus). Higher singing voice ranges (soprano, tenor) are often affected earlier and more frequently due to increased muscular tension, compared to lower voice ranges (alto, bass) with less muscular tension.

Medical Examination

Naturally, for age-related vocal changes, a medical examination by a phoniatrician or otolaryngologist is strongly recommended. This examination includes an assessment of the larynx, vocal production, and hearing capabilities, aiming to:

• Rule out any organ-related diseases of the larynx (benign or malignant tumors, inflammation, paralysis, edema)

• Determine whether medical voice training is warranted to improve vocal performance and quality

• Consider the prescription of hearing aids to improve audio-phonatory feedback for one's own voice and others' voices

Characteristics of the Aging Voice

The aging voice exhibits the following characteristics: weakened, less powerful, less resilient, quick to fatigue, softer, dull, less capable of projection, hoarse, breathy, limited modulation, unstable, and tremulous. The so-called "vocal tremor" of the larynx, characterized by voice tremors, is caused by both a lack of continuity in the airflow and disrupted central nervous system control and coordination of the larynx. Additionally, due to presbycusis, the voice may also contain rough and strained elements.

Changes in the Vocal Cords

The vocal cords themselves undergo characteristic morphological changes with age. In the vocalis muscle, there is degeneration and atrophy of elastic fibers, which are replaced by connective tissue fibers. The number of myofibrils decreases. This results in vocal fold insufficiency/interneuronal weakness with vocal cord atrophy and a spindle-shaped or oval-shaped glottic gap during phonation, known as "vocal fold bowing" in the Anglo-American literature. Muscular hypotonia of the vocal cords, often accompanied by fatty degeneration of elastic fibers, leads to irregular vibrations of the vocal cords, similar to laryngitis sicca. To compensate for the air loss caused by glottic closure insufficiency during phonation, supraglottic hyperfunctional press mechanisms such as false vocal fold use or posterior-anterior contractions with pathological approximation between the arytenoid cartilages and epiglottis often develop.

Therapy:

Therapeutic approaches for the aging voice include vocal training, and in some cases, surgical volume augmentation of the vocal cords, also known as the "voice-lift procedure." Therapeutic interventions may include exercises to tone the vocal cords, reduction of supraglottic press mechanisms, and, if necessary, phonosurgical paraglottic injections to improve phonatory glottic closure.

Appointment Scheduling

To schedule an appointment, you can reach us by phone at 01752920000, contact us via WhatsApp, or send us an email at contact@thevoiceclinic.de.

Alternatively, you can also visit us directly (please make an appointment in advance):

TheVoice Clinic

Medical Center for Voice Disorders, Swallowing Difficulties, Respiratory Diseases, and Laser Therapy

Dr. med. A. Nasr

Bahnhofstraße 22

71034 Böblingen

We look forward to assisting you!