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Understanding Voice Disorders in Seniors

By Chris Iliades, MD

Some changes in a person’s voice are a normal part of aging. As we get older our voices loose strength, range and some quality, but did you know that voice disorders in seniors are quite common and can significantly impact a senior’s quality of life?

A recent study published in the medical journal Laryngoscope, found that 47 percent of seniors had experienced a voice disorder at some time in the past and that 29 percent reported a current voice disorder. The study looked at 117 men and women between the ages of 65 and 94 and found that 60 percent of those experiencing a current voice disorder had been affected for over four weeks.

"Voice-related effort and discomfort, combined with increased anxiety and frustration and the need to repeat oneself, were specific areas that adversely affected quality of life." - The Laryngoscope

Symptoms of Voice Disorders in Seniors

Most voice disorders in seniors are not life-threatening and can be managed or treated, but some voice changes may be a warning sign of a more serious medical condition. Here are some voice disorder symptoms you should pay attention to:

     
  • Hoarseness lasting more than several days
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  • Constant need to clear the throat
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  • Throat or neck pain while speaking
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  • A breathy voice
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  • A jerky, quivery voice
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  • Having trouble speaking and breathing at the same time

Common Causes of Voice Disorders

In order to produce a normal voice you need to be able to move your vocal cords back and forth. It is the vibration of the vocal cords touching each other that creates sound. Anything that keeps the cords from moving normally, or distorts their smooth surface, changes the quality of that sound.

     
  • Laryngitis. This voice disorder is the most common cause of hoarseness and occurs when irritation or infection causes the vocal cords to swell. The most common type of infection is a virus. Laryngitis can also be caused by irritants like tobacco smoke or inhalers that many seniors use for asthma.
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  • Gastric reflux. A common cause of voice disorders in seniors is esophageal reflux. This is caused by stomach acid backing up into the throat and spilling over to irritate the vocal cords. Although gastric reflux usually causes symptoms like heartburn, choking or difficulty swallowing, in some cases hoarseness is the only symptom.
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  • Vocal cord paralysis. If the nerve supply to the vocal cords is interrupted, one or both vocal cords may be unable to move properly which will result in a speech disorder. Vocal cord paralysis is more common in the elderly, especially those with a history of stroke or Parkinson’s disease.
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  • Spastic dysphonia.  This is a long-term voice disorder that causes the voice to fluctuate, seize up or sound quivery and strained. The voice changes are caused by uncoordinated movement of the muscles that control the vocal cords, but the exact cause of spastic dysphonia is not completely understood.
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  • Benign growths on the vocal cords. Non-cancerous growths that can form on the vocal cords include nodules, cysts and polyps. Because they grow on the surface of the cords where they touch, they can make the voice hoarse or weak. Seniors may then have to strain to make themselves heard, which can actually make these growths worse.
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  • Cancer. Hoarseness is the most frequent warning symptom of throat cancer that starts on the vocal cords. Seniors, especially men, and those with a history of smoking and drinking alcohol are at a higher risk for cancer of the throat and larynx.

Voice disorders can have a significant impact on a senior’s quality of life. Treatment for a voice disorders can involve simple voice rest, speech therapy, medications or surgery. The most important thing to remember is that any persistent voice change needs to be investigated by your doctor.
 

Warning Signs for Caregivers

When Does a Senior Need Immediate Medical Consultation?
Some voice disorder symptoms require immediate attention. Start with your primary care doctor, but remember it may take a consultation with a throat specialist to visualize the vocal cords and get the right diagnosis. Symptoms that can’t be ignored include:

     
  • Hoarseness that lasts longer than one to two weeks
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  • Any voice change accompanied by a swelling in the neck
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  • Any voice change accompanied by noisy high-pitched breathing
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  • Any voice change accompanied by choking or difficulty swallowing
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  • Any voice change accompanied by unexplained weight loss