The Aging Voice
What is Happening to My Voice?
DO YOU GROWL, not TALK?? When we age, not only do our aches and pains worsen, our teeth fall out, and our hair disappears, but our voices show signs of age as well. It is invariable and predictable, so it is good to understand why we can expect our voices to change, something about how it happens, and a couple of ways to minimize the change that comes with growing older. While looking up information, I noticed that what happens to our larynx is not often described. It was very hard to get specific information. I still have a request in to NIH and the University of North Carolina and will share the information when I get it. In the meantime, here is some information I was able to find through internet searches and email responses from medical sites. (this was found online, so it's not me contacting NIH! I'm just relaying info, as does a poster.)
Picture of Vocal Cords
Iím sure youíve noticed that you can talk with someone on the phone and tell about what age group they are: The voice is a sure way to tell someone is younger or older. Aging will cause changes in the larynx which will lead to the creaky or gravely voice often heard in the elderly. The larynx is also referred to as the voice box. The aging effects on the Ďvoice boxí is called presbyphonia.
Iíve heard the change in all the old folks I know and love, so I wanted to know what is actually going on with our larynx as we age: What actually happens to make us sound older? I did find some information about how our voice is made and the part our vocal cords play.
Robert J. Sinard wrote in "Geriatrics 1998", The Aging Voice: How to differentiate disease from normal changes (Can be read at www.findarticles.com): "Although there is no single unifying characteristic to defying the aging voice, a consideration of the pathophysiologic changes of aging on the organs responsible for voice production will help one to understand the potential efforts.
The "true vocal folds" are also called inferior vocal folds or inner folds. The inner folds are made up of elastic fibers that help make sounds when air is forced between the cords of the larnyx. When we want to talk, the folds vibrate from the air we exhale. The inside muscles of the larynx attach to the cartilages and vocal folds and contract to change the position of the vocal cords and vibrate to make the sound waves. The thyroid cartilage is what protects the vocal cords.
Our vocal cords are moved by muscles which can make the vocal cords tight or loose. The tighter the cord is, the higher the voice is. The cords get less elastic, and are unable to perform as they do in a younger person. The voice changes. That is normal, but rare is Spasmotic Dysphonia which is why Bobby Kennedy Jr has. See:
I googled that and found one man's story of a quasi cure using Voice Doctor the stars..DR Morton Cooper's writings may still be online. Google him + voice.
The John Hopkins Center reports that changes to the brain and spinal cord can affect neurological control of the laryngeal muscles. According to Andrew Gout of the John Hopkins Center for Laryngeal and Voice Disorders, as we get older, the framework cartilages of the larynx ossify (turn to bone) and the cartilages responsible for vocal fold movement become less mobile.
Vocal cords become slowly more thin and weakened with age. Sometimes this results in a higher sounding pitch, but when thickened mucosa increases the vibratory mass, it results in a lower pitched voice. This increased edema is thought to be related to the loss of hormonal influence on the mucosa of the vocal cords comments.
In The Aging Voice Robert Sinard also commented that "A gradual decrease in pulmonary function in the older person may result in a loss of breath support for the voice.
Some other diseases that can affect the seniorís voice are Parkinsonís disease and diabetes. And Spasmotic Dysphonia. (RFK Jr. has that and obviously has not found a cure and he's super rich.) So google all of these.
If you think it's JUST HOARSNESS, SEE: http://www.health911.com/hoarseness
If you notice regurgitation of stomach acid, there's reason to think that the cause is Heartburn (reflux acid) which also may cause a number of problems related to voice production, including common harshness, sore throat, cough during sleep, phlegm, and a sensation of a lump in the throat. Gregory Grillone, M.D., otolaryngologist and director of the Voice Center at Boston Medical Center says that as we get older, the vocal cords get a bit weaker and a little spread apart. Hoarseness, raspiness and breathiness are some ways which most people might describe an aged voice.
There are certain things you can do to help your voice stay younger sounding for a longer time. Lots of water helps keep the larynx moist. Smoking will increase the sounds of hoarseness so no tobacco. Milk and flour create mucus so eliminate them entirely. Switch to soy milk, bible bread.
Try not to yell. I guess the more you use it the weaker it gets too. Did you know that rheumatoid arthritis can limit the motion of the cricoarylenoid joint, leading to hoarseness because the vocal cord cannot move well.
As long as you are aware of your larynx and try not to shout or yell and use your voice obsessively then your voice can stay younger sounding longer.
If you have an already deep or harsh type voice and canít seem to get it sounding better, then learn to accept the natural and unique voice that you have been blessed with.
WHAT TO DO? Well, you can GET PLASTIC SURGERY ON EPIGLOTTIS.
OR, SING OUT LOUISE! How to sing your way to a sweet voice
Simple Tips that'll keep your voice young
By TANITH CAREY
As we get older, most of us worry about grey hair, wrinkles and maintaining a youthful physique. But many
ignore one of the biggest signs of age - our voice. People often don't realise the voice, like other muscles,
needs looking after - as a result, a third of people over 65 suffer from voice problems, including hoarseness
and weakness. Many are left sounding much older than they are.
The voice is made by many parts of the upper body. To form a sound, the muscles of the abdominal wall and
rib cage squeeze the lungs, making them exhale the breath.
As the airflow comes up the windpipe, it passes through the vocal cords. These are not cords, but are two
complex flaps of tissue stretched across the windpipe which open and close as the air passes through.
This causes them to vibrate, turning the air into a buzzing noise. At the same time, the larynx - or voice box -
adjusts the length and tension of the cords, producing pitch.
The upper part of the throat and cavities in the lower skull refine the noise and make it louder, while the
tongue, teeth and lips shape it into words. With age, the vocal cords and muscles in the larynx wear out.
'The tissue gets tired so you can't keep the same tension,' says Andrew McCombe, an ear, nose and throat
surgeon at Frimley Park Hospital, Surrey.
Lung capacity also declines - by the age of 80 it may be half the volume it was at age 20.
Messages from the brain to the voice box may not be as efficient and nerve endings to the area die. There is
less blood supply and the number of lubricating glands decline, drying out the vocal cords.
Finally, the tongue, lips and teeth change, making it harder to form words. As a result, from middle age the
voice starts to become thinner and wavering.
In the U.S. people are undergoing surgical voice lifts - injecting the vocal cords with fat or collagen from other
body parts. This brings the flaps closer together so they vibrate better, producing a stronger voice.
The technique is available in the UK, but is mainly used to treat inaudible voices, rather than for cosmetic
'There are other things you can do to keep your voice youthful,' says Dr Ruth Epstein of the Royal National
Ear, Nose and Throat Hospital in London. 'Exercising will ensure lung capacity is high, helping to produce a
strong sound. We should also treat the vocal cords - by singing and continuing to use the voice into old age.'
Here, with the help of the UK's leading voice experts, we reveal how to keep your voice young.
DRINK MORE FLUID
'Moisture for the larynx is like grease for a ball-bearing. You need it for the vocal folds to vibrate well,' says
John Rubin, an ENT surgeon and president elect of the British Voice Association.
No liquids touch the vocal cords, but they are lubricated by a salivalike fluid made by nearby glands.
The body must be kept hydrated enough to make this lubrication. Sipping 1.5 litres of water a day at intervals
of 15 minutes is vital, says speech therapist Dr Epstein.
AVOID SPICY FOOD
We may not feel or taste it, but a common cause of damage to the voice is acid reflux.
It irritates and dries out the throat, says Mr Rubin. The vagus nerve in the neck also reacts to the acid by
making the lubricating saliva more sticky, meaning it is harder for the vocal cords to vibrate.
Signs of silent reflux are throat clearing, a croaky lower voice in the morning and the feeling of having a lump
in the throat.
Mr Rubin advises avoiding foods with an irritating effect on the stomach, such as onions, chilli, fizzy drinks
and chocolate: 'Avoid eating two hours before bed to allow time for digestion.'
Simply staying sociable and using your voice is vital. 'As older people get less mobile, they stop going out,' says Dr Epstein. 'They can become socially isolated and speak less. 'The elderly need to interact more by joining social clubs or pursuing interests. By using the vocal cords, they delay ageing.'
SING IN THE SHOWER
This is one of the best ways to preserve your voice, as it keeps the larynx muscles strong while the steam
lubricates the voice box. 'Singing is gymnastics for the voice,' says Andrew McCombe. 'The control and neuro-muscular co-ordination you need means the voice is being used in a good way.' Joining a choir is one of the best ways to preserve a youthful tone, says Dr Epstein. 'Professional singers' voices take longer to age as they keep the muscles strong.'
Shouting can inflame the vocal cords, making them harder to close properly. If they repeatedly 'bang' together, it can lead to callous- like growths called nodules. These make the larynx work harder, causing muscle tiredness and discomfort. Teachers, City traders and telephone workers are prime candidates for damaging their voices. 'It's estimated the vocal cords of female primary school teachers can go through one million cycles of vibrations a day - a huge number,' says Mr Rubin. Keep calm: Shouting can damage the vocal cordsPeople who work in noisy pubs, restaurants and factories or shout at football games are at risk. Mr Rubin recommends anyone who shouts a lot at work rest their voice for five minutes every hour. People shouldn't strain their voice when out socialising, adds Mr Rubin. 'Don't talk to someone more than an arm's length away.' Although unusual, one loud shout can be enough to cause a vocal haemorrhage, which can permanently damage the voice.
KEEP YOUR TEETH
When you lose teeth, the jaw bone starts to waste away, the shape of the face begins to collapse inwards and, as a result, the muscles do not work as well to formulate speech. The tongue is adept at moving upwards and forward in the mouth to make the 't' sound.
IMPROVE YOUR POSTURE
Good posture is essential to keeping the voice young - slumping causes the entire vocal tract to change, preventing deep breathing and making the vocal cords work harder to make a sound. This can be quickly fixed by standing properly, says Mr Rubin. To test this, he suggests standing straight, saying 'e' and then moving the head forward, holding the note - 'this will demonstrate the changes bad posture can cause'. Exercise, such as pilates, which strengthens the abdominal muscles, helps you take deeper breaths as it means there is better airflow through the voice box, producing a stronger tone.
CUT BACK ON SMOKING
Smoking is disastrous, drying up the inside of the larynx and stopping the vocal cords working. Nicotine also exacerbates gastric reflux, while the heat from cigarette smoke can scar the vocal cords, causing a rough rasping quality. Alcohol can inflame the mucous membranes that line the throat. 'A single glass of wine with a meal is probably not harmful to the larynx, but anything more is too much,' says Mr Rubin.
REST THE THROAT
The vocal cords can be scarred if you use your voice during a bad cough. If you have a case of laryngitis with
a cold, you should rest your voice for a day or two, Mr Rubin says: 'Scarring on the vocal colds means when
they heal they may not vibrate so well - your voice will sound rough and you may lose your upper register,
possibly permanently.' If your voice is hoarse for longer than two weeks then it's time to seek medical advice, says Mr Rubin. There are more than 100 voice clinics in the UK where people with voice problems can be seen by an ENT
surgeon and a speech and language therapist, who teach exercises to revive the voice.
For more information, visit british-voice-association.com
THE SYNDROME by Sue Ellen Linville:
As the 21st century advances, senior citizens will make up an
increasingly large segment of the population. In recognition of that
demographic shift, researchers are developing a database of voice
features that are characteristic of normal speakers from young adulthood
through old age. Such a database would be invaluable to clinicians
struggling to differentiate normal vocal changes with aging from
pathologic vocal conditions affecting elderly patients. Changes in
Speech Production Mechanism
The respiratory system changes from young adulthood to old age. In lung
tissue, loss of elasticity is considered the most significant change.
Other respiratory system changes include stiffening of the thorax and
weakening of respiratory muscles. These changes alter lung volumes and
respiratory mechanics. While total lung volume remains unchanged in the
elderly, vital capacity decreases and residual volume increases. Maximum
expiratory flow rate is decreased and lung pressure is decreased. Thus,
elderly speakers experience a decline in the amount of air they can move
in and out of the lungs and in the efficiency with which they move air.
The larynx also undergoes age-related anatomic changes during adulthood.
Many of the changes are more extensive in males, including ossification
and calcification of laryngeal cartilages, atrophy and degeneration of
intrinsic muscles, deterioration of cricoarytenoid (CA) joint,
degeneration of glands in the laryngeal mucosa, degenerative changes in
the lamina propria, and degenerative changes in conus elasticus. In
elderly males, changes in the CA joint may affect function by lessening
vocal fold approximation, or reducing the smoothness of vocal fold
adjustments during phonation. Glandular changes may cause drying of
epithelium, which may increase stiffness of VC cover. Increased cover
stiffness could increase instability of vocal fold vibration and raise
fundamental frequency (F0) in elderly men. Some investigators report
progressive thickening of the epithelium with aging in both sexes. In
males, thickening reportedly is progressive up to age 70, with declines
thereafter. In females, thickening is described as progressive,
particularly after age 70. Thickening of the laryngeal epithelium may
contribute to lowering of F0 or to increased harshness of voice. The
supralaryngeal system also changes. The craniofacial skeleton reportedly
undergoes a process of "symmetrical enlargement" (3%-5%) from young
adulthood to old age. Atrophy of facial, mastication, and pharyngeal
muscles is reported in the elderly, along with lowering of the larynx in
the neck. Degenerative changes in the temporomandibular joint are
described, along with thinning/loss of elasticity of oral mucosa,
declining salivary function, loss of tongue strength, and tooth loss.
Age-Related Voice Changes
Perhaps the voice change that has been investigated most is pitch level.
Speaking changes from young adulthood to old age, but the pattern
differs according to gender. In women, F0 remains fairly constant until
menopause, when a drop occurs (approximately 10 Hz -15 Hz). This drop
presumably results from hormonal changes that cause thickening and edema
of the laryngeal mucosa. In men, F0 lowers approximately 10 Hz from
young adulthood to middle age. The reason for this drop is unclear.
After middle age, F0 in men rises substantially (approximately 35 Hz)
into advanced old age, reaching the highest level of adulthood. Tremor
and increased hoarseness have been associated with the aged voice. These
voice characteristics may result from F0 or amplitude instability.
Stability of F0 reportedly declines from young adulthood to old age in
both men and women. In men, levels of fundamental frequency standard
deviation (F0 SD) more than double between young adulthood and old age.
In women, levels jump 71% over a similar period. F0 SD ranges for young
and elderly speakers demonstrate little overlap, regardless of gender.
In contrast, measures of jitter-the cycle-to-cycle fluctuations in the
fundamental period of vocal fold vibration-overlap extensively in young
and elderly speakers, especially women. Amplitude stability also
declines with aging, at least in men. Indeed, shimmer, which reflects
cycle-to-cycle variation in waveform amplitude, may be a better measure
than jitter of chronological aging in men's voices because shimmer
levels increase independently of health and fitness variables.
Age-related jitter differences disappear if health and fitness are
considered. Another voice quality linked with the aged voice is
increased breathiness. While elderly men demonstrate a higher incidence
of glottal gap than young men, spectral noise levels do not differ in
the two groups. However, spectral noise levels increase in men in poor
physiological condition, regardless of age. In contrast to men, both
young and elderly women demonstrate a high incidence of glottal gap.
However, young women tend to demonstrate posterior chink, while elderly
women demonstrate gaps anteriorly in the glottis. There is acoustic
evidence of age-related changes in vocal resonance patterns in both men
and women. Lowering of formant frequencies (more pronounced in women)
suggests lengthening of the vocal tract. Altered vowel formant frequency
patterns (more pronounced in men) suggests centralization of tongue
position during vowel production. Altered resonance patterns in elderly
speakers may result from growth of the craniofacial skeleton, lowering
of the larynx in the neck and/or degenerative changes in oral structures
that reduce articulatory precision. In summary, structural and
functional changes occur in the respiratory, phonatory, and
supralaryngeal systems with aging. Those changes alter the voice
produced by the aged mechanism. Gender differences exist both in the
nature and extent of age-related changes.
ARTICLES ON THE "CURE"
Singing as a cure http://www.ns.umich.edu/htdocs/releases/story.php?id=2984
* * * * * *
Sue Ellen Linville is associate professor of speech pathology at Marquette University and the author of Vocal Aging (San Diego: Singular Publishing, 2001). She is an affiliate of Special Interest Division 3, Voice and Voice Disorders. She can be reached at sueellen.linville @ marquette.edu.
* * * * * * * * * * * * * * * * * * * * * * * * *
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