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Older Patients May Lose Voice Quality Over Time, Naturally

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WebMD Health News

Nov. 22, 1999 (Atlanta) -- A quiver in the voice, a loss of vocal strength, perhaps a change in pitch. These may all be normal changes in a person's voice as they age. But then again, maybe they're not, and it could be important to know the difference, especially if the change signals an underlying medical condition.

A new study presented at the annual meeting of the American Speech-Language-Hearing Association, held in San Francisco, finds that updated norms may be needed for speech pathologists to effectively test elderly patients in the brave new world of digital technology.

The study's lead author, Steve Xue, PhD, assistant professor of hearing and speech sciences at Ohio University, tells WebMD that current standards for voice testing are based on young and middle-aged people. "This study showed that if you are an elderly patient, especially ... over age 70, your noise level may be quite normal for your age group. But those [current] tests will show that it's abnormal, so the current problem in our field is we use young or middle-aged people as yardsticks to measure those clients of different age groups, including those over 70," Xue says.

The study put 21 men and 23 women between the ages of 70 and 80 through tests that used digital equipment that measured 15 different acoustic parameters, covering frequency, pitch, tone, and other vocal characteristics. None of the group had smoked or had neurological damage or speech disorders in the last five years. The results were then compared with published norms of young and middle-aged adults. The researchers found the elderly participants had significantly poorer vocal quality when compared to younger people.

The elderly participants had a harder time keeping a stable tone, and some voices were harsher or more hoarse. Xue also pointed out that for some women, their voices get deeper as they age, whereas for some men, their voices get higher as they age. Without the proper norms in place, Xue tells WebMD it is likely some speech pathologists could make mistakes or misdiagnoses.

Xue pointed to two reasons for the study. First, there's a large increase in the elderly population in the U.S., leading to more speech-language pathologists with elderly patients. And second: "[New] digital technology will enable us to make very detailed measurements, so if we use thresholds from 30- or 40-year-olds, then apply them to a 70-year-old client, the testing results will be quite different, abnormal here and there, but then you realize maybe aging is the real cause," Xue tells WebMD.

Digital equipment is central to this issue. Richard K. Adler, PhD, CCCSLP, a clinical language speech pathologist, acknowledges that updated norms could help clinicians using the new digital equipment. But that equipment is expensive, and he says generally just used by hospitals and research labs at this point. Using more traditional methods, Adler says he doesn't necessarily compare his patients to a set of norms.

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