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J Voice. 2018 Jul 25. pii: S0892-1997(18)30196-6. doi: 10.1016/j.jvoice.2018.06.001. [Epub ahead of print]

Frailty Syndrome, Cognition, and Dysphonia in the Elderly.

Author information

1
Department of Speech, Language, and Hearing Sciences, University of Arizona, Tucson, Arizona; Department of Otolaryngology Head and Neck Surgery, University of Arizona College of Medicine, Tucson, Arizona. Electronic address: rsamlan@email.arizona.edu.
2
Department of Speech, Language, and Hearing Sciences, University of Arizona, Tucson, Arizona; Department of Otolaryngology Head and Neck Surgery, University of Arizona College of Medicine, Tucson, Arizona.
3
Department of Speech, Language, and Hearing Sciences, University of Arizona, Tucson, Arizona.
4
Arizona Center on Aging, University of Arizona, Tucson, Arizona.

Abstract

PURPOSE:

The purpose of the current study is to determine the relation of frailty syndrome to acoustic measures of voice quality and voice-related handicap.

METHODS:

Seventy-three adults (52 community-dwelling participants and 21 assisted living residents) age 60 and older completed frailty screening, acoustic assessment, cognitive screening, and the Voice Handicap Index-10 (VHI-10). Factor analysis was used to consolidate acoustic measures. Statistical analysis included multiple regression, analysis of variance, and Tukey post-hoc tests with alfa of 0.05.

RESULTS:

Montreal Cognitive Assessment (MoCA) and exhaustion explained 28% of the variance in VHI-10. MoCA and sex explained 27% of the variance in factor 1 (spectral ratio), age and MoCA explained 13% of the variance in factor 2 (cepstral peak prominence for speech), and slowness explained 10% of the variance in factor 3 (cepstral peak prominence for sustained /a/). There were statistically significant differences in two measures across frailty groups: VHI-10 and MoCA. Acoustic factor scores did not differ significantly among frailty groups (P > 0.05).

CONCLUSIONS:

Voice-related handicap and cognitive status differed among robust and frail older adults, yet vocal function measures did not. The components of frailty most related to VHI-10 were exhaustion and weight loss rather than slowness, weakness, or inactivity. Based on these findings, routine screening of physical frailty and cognition are recommended as part of a complete voice evaluation for older adults.

KEYWORDS:

Acoustic; Aging voice; Cognition; Frailty; Patient-reported outcome; Presbyphonia

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