Voice

Voice Changes in Older Adults: Causes, Symptoms, and Treatment

As we age, it’s typical to experience voice changes, also called presbyphonia. You might see changes in your pitch, volume, and clarity. Your voice might sound raspy, weak, or hoarse. While voices changes with age are common, they can be frustrating. Voice therapy is a highly effective treatment for age-related voice disorders, improving both your voice and your overall quality of life.

Key takeaways

  • Voice changes with age are common, such as a weaker, raspier, or hoarser voice.

  • Your voice might change as you get older due to a weaker larynx, changes in lung health, effects of smoking or GERD, or other conditions such as thyroid disease or Parkinson’s disease.

  • Voice therapy is an effective treatment. It’s been shown to strengthen the vocal cords, enhance vocal function, and increase the activity of muscles involved in voice production, leading to a clearer, stronger voice.

  • There are also at-home tips to help keep your voice healthy, such as staying hydrated, using a humidifier, avoiding straining your voice, and doing vocal exercises.

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What causes raspy voice and other voice changes in older adults?

Voice changes with age, such as weakness or raspiness, might include a weaker larynx, changes in lung health, effects of smoking or GERD, or other conditions such as thyroid disease or Parkinson’s disease.

Voice changes have been reported in up to 52% of older adults. There are a variety of reasons our voice changes as we get older. Aging brings changes to the voice box (larynx) and vocal cords, which can lead to a condition called presbylarynx. As we age, the soft tissues in the larynx begin to weaken and shrink. This natural process can cause the vocal cords to lose their tone and elasticity, making the voice sound weaker and reducing the ability to speak loudly or for long periods. People with presbylarynx may sound hoarse or have a limited vocal range. “Aging can also cause changes to our respiratory system,” explains Heather Gross, M.S., CCC-SLP, a speech-language pathologist with Expressable who specializes in voice therapy “Healthy lung function is needed for a strong and effective voice. However, as we age, it’s common to experience shortness of breath, coughing, and increased mucus production. This can lead to older people having a raspy or breathy voice.” Other factors, such as smoking, certain workplace environments, and digestive conditions like gastroesophageal reflux disease (GERD), can also cause wear and tear on the vocal cords, resulting in a hoarse voice.

Other causes of voice changes with age

It’s important to note that voice changes in older adults are not only due to aging. Various health conditions can impact the voice, including:

In fact, research has shown that more than half of older adults with presbylarynx also have underlying diseases, such as diabetes or pulmonary disease.

Voice changes in the elderly are often accompanied by other voice disorders. Conditions like laryngopharyngeal reflux (where stomach acid affects the throat), muscle tension dysphonia, vocal cord paralysis, and even benign or malignant vocal masses can occur with presbylarynx. For example, studies have found that nearly all older adults with presbylarynx also have laryngopharyngeal reflux, which can further impact and change the voice.

What are the signs of age-related voice changes?

Common symptoms of voice changes include:

  • A weaker voice with reduced volume and projection

  • Vocal fatigue

  • A tremor or a shaky voice

  • Changes in pitch (men may notice a higher pitch, while women may have a lower one)

  • Rough, raspy, or breathy voice

  • Frequent hoarseness

  • Speaking requires more effort than before

Some people may also experience swallowing difficulties.

If you or a loved one notice these changes, talk with your healthcare provider. And be sure to contact your doctor if you experience sudden changes. While some voice changes may be a natural part of aging, sudden voice changes in the elderly can signal health issues that may need treatment.

How voice therapy helps people regain their voice

Many older adults don’t seek help for voice problems, assuming it’s just a normal part of aging. However, voice changes can greatly affect your communication and social interactions, leading to isolation, anxiety, and even depression. This is where voice therapy can make a big difference.

“Voice therapy is like physical therapy for your vocal cords,” explains Gross. “It can improve your voice’s health, function, quality, and stamina.”

Voice therapy is a highly effective treatment for age-related voice disorders. It’s often the first treatment recommended by laryngologists, and it’s been shown to improve voice quality and overall quality of life. Studies have shown that voice therapy can strengthen the vocal cords, enhance vocal function, and increase the activity of muscles involved in voice production. This means that people who receive voice therapy often experience clearer, stronger voices and can communicate more easily.

Voice therapy is like physical therapy for your vocal cords. It can improve your voice’s health, function, quality, and stamina. 

One of the great things about voice therapy is that it can be tailored to each person’s needs. Both in-person sessions and teletherapy have been proven to be effective. Online voice therapy has the added benefit of convenience, since it can be done from the comfort of home.

Voice therapy provides targeted exercises to improve vocal health, helping prevent the negative social and emotional effects of presbyphonia. So, if you or someone you know is experiencing age-related voice changes, talk with a speech therapist who specializes in voice therapy. It’s a crucial step in maintaining not just your voice, but your overall well-being.

Voice therapy is often covered by insurance, so check with your health insurance plan.

6 tips for keeping your voice healthy and strong as you age

While research on preventing presbyphonia is still limited, Gross recommends these practical tips to help keep your voice healthy and strong:

1 Stay hydrated

Proper hydration is crucial for vocal cord health. Drinking six to eight glasses of water daily keeps your vocal cords lubricated, making it easier to produce a clear, strong voice. Hydrated vocal cords are also less prone to irritation and injury.

2 Do regular vocal exercises

Just like your body needs regular exercise to stay fit, so do your vocal cords. Do vocal exercises regularly to keep your voice strong and flexible. “Simple exercises like humming, lip trills, and tongue trills can help keep your voice in shape and build resilience against age-related changes,” Gross says.

3 Avoid straining your voice

Avoid shouting or speaking loudly for long periods, which can damage your vocal cords. Take regular breaks when speaking or singing to give your voice time to rest and recover.

4 Practice good vocal hygiene

How you care for your throat and larynx directly impacts your voice. Keep your larynx moist and flexible by staying hydrated and using a humidifier, especially in dry environments. Limit caffeine and alcohol, as they can dry out your throat. And most importantly, avoid smoking.

5 Keep your body healthy

Your overall health affects your voice. Conditions like asthma, allergies, and COPD can impact breathing, which is vital for voice production. Regular exercise helps you build stamina and improve your posture, which contributes to a healthier voice.

6 Use your voice regularly

“For older adults, particularly those who are retired or living alone, it’s important to keep using your voice,” Gross says. Whether by joining a choir, singing in the shower, or reading aloud, use your voice regularly to help keep it strong.

By following these tips, you can help maintain a strong, healthy voice. Being able to communicate clearly helps you stay connected with the world around you. Don’t hesitate to seek help if you notice changes in your voice—because your voice truly matters.

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