Like death and taxes, most people have considered aging changes in the voice inevitable. Indeed, as we get older, there are certainly fundamental changes in the body that often modify the sound of the speaking and singing voice. Typically, we are not surprised to hear breathiness, loss of range, change in the characteristic of vibrato, development of tremolo, loss of breath control, vocal fatigue, pitch inaccuracies, and other undesirable features in older singers. Numerous studies have shown that listeners can generally differentiate between young and old speakers. This subject was recently reviewed and studied again, confirming that aging affects vocal pitch, loudness, and quality, although the effects are highly variable across the aging population.
Although some age-related alterations cannot be avoided in specific individuals, not all of them are manifestations of irreversible deterioration. In fact, as our understanding of the aging process improves, it is becoming more and more apparent that many of these changes can be forestalled or even corrected. Woo, et al., reached similar conclusions, recognizing that “presbylarynges is not a common disorder and should be a diagnosis of exclusion made only after careful medical and speech evaluacion. As physicians and teachers, we need to look closer before concluding, “I can’t help your voice; you’re just getting older.”
The aging process is being researched extensively because of the importance of aging on the heart, brain, and all other body organs. No natural process has greater impact on our lives. Much of the pioneering work on vocal aging is being performed by scientists who have dedicated their lives to this subject, such as Drs. Robert L. Ringel and Wojtek Chodzko-Zaijko of Purdue University, who discussed aging in 1986 at the Voice Foundation’s Fifteenth Symposium: Care of the Professional Voice. The author also presented on this subject in 1995 at the Voice Foundation’s Twenty-fourth Symposium: Care of the Professional Voice.31 We are beginning to learn much more about the aging voice by combining general knowledge about the aging process with specific knowledge about laryngeal aging.32-34 This interdisciplinary approach helps us understand our perceptions of voices over the years and helps explain our recent observations that some “old” voices can be made young again.
Aging is a complex conglomeration of biological events that change the structure and function of various parts of the body. There are many theories of aging that focus on processes of individual cells, molecules responsible for the genetic transmission of our characteristics, and changes in various organ systems. The details of specific theories are beyond the scope of this article. However, their principles and solutions show great promise for clinical application in the physician’s office and in the voice studio.
All theories and approaches to study of the aging process recognize well-established, predictable changes throughout the body. Although various mechanisms are involved in causing these changes, the effects are remarkably similar among various organ systems. As body structure changes, so does performance. Aging is associated with deteriorating bodily functions.
Among them are accuracy, speed, endurance, stability, strength, coordination, breathing capacity, nerve conduction velocity, heart output, and kidney function. Muscle and neural tissues atrophy, and the chemicals responsible for nerve transmission change. Ligaments atrophy and cartilages turn to bone (including those in the larynx). Joints develop irregularities that interfere with smooth motion. The vocal folds themselves thin and deteriorate, losing their elastic and collagenous fibers. This makes them stiffer and thinner and may correlate with voice changes often noted with aging. The vocal fold edge also becomes less smooth.
The not-so-cheery picture is one of inevitable decline for all of us. However, the notion that this decline occurs gradually and progressively is open to challenge. It appears possible that many of these functions can be maintained at a better level than expected until very near the end of life, perhaps allowing a high quality singing or acting career to extend into or beyond the seventh decade.
antonio pavao says