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Is Your Voice Failing You in Old Age ?

Sahasranam Kalpathy is a Senior Cardiologist who has had his degree in Cardiology from India and has been practicing for the past 45 years.

Is your voice failing you in old age ?

What happens to your voice when you age?

Speech needs the Lungs, the nervous system and the voice box or larynx for normal phonation. What happens to our voice as we grow old? There is a definite decline in various aspects of our voice and speech as we age. Our voice tends to become weak and hoarse. This often leads to depression, social withdrawal, and isolation. It is noted that about 10% of elderly individuals develop changes in voice as evidenced by a decrease in loudness, vocal fatigue, changes in the pitch of the voice or a rough or breathy voice.

Normal speech is facilitated by a coordinated effort by the respiratory system, neurological system, and the voice box (larynx). The muscles of the larynx and the vocal cords are important in phonation. These muscles of the larynx weaken as age advances and this leads to the changes in voice. Changes in the voice occurring with age is called Presbyphonia. The voice tends to become hoarse with a breathy quality. There may be some vocal tremor.

The vocal cords or vocal folds become thin with age and the respiratory muscles also become weak thereby affecting the voice. The main changes in the vocal cords are thinning and loss of flexibility. The joints of the voice box also tend to become stiff. The individual’s lungs also become less pliable adding to the problem.

Consequent to these changes, the elderly who have a problem with their voice tend to speak less and may become withdrawn and depressed. The volume of the voice also decreases as they cannot raise their voice.

Parkinson’s disease affects about 2% of the elderly and almost 90% of them will have problems with their voice. They may not be able to articulate properly. The voice may be hoarse, breathy, and monotonous. They also have a lack of facial expression which accompanies normal speech.

What happens when the voice changes?

  • · The changes may be so subtle and gradual that it may not be noticed by the person. Hoarseness of the voice and an increase in the effort of speaking or feeling breathless while speaking are some of the early features which can be recognized.
  • · Diseases like Asthma, allergies, Chronic lung diseases can also affect the voice of the elderly as these diseases interfere with their breathing.
  • · The voice tends to fade away by the end of the day and by evening the person’s voice is weak. This is called ‘Voice fatigue’.
  • · The elderly individuals who have problems with their voice gradually tend to speak less and may succumb to depression or social withdrawal. Their job performance may be adversely affected, and they may feel isolated especially when they communicate with young people.
  • · The pitch of the voice also may change with age. In women the pitch decreases as they age, and the reverse happens in men. In men the pitch may rise with age. This possibly is due to the weakening of the muscles in the vocal cords.

How to prevent voice changes and care for your voice

Vocal hygiene is important. As age advances, one should endeavor to take care of one’s voice and lungs adequately.

The most important is awareness that voice changes can occur in the elderly individuals.

1. Avoid speaking very loudly. Also, it is not good to speak with a high pitch or whisper.

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2. When the voice is hoarse or one is fatigued, it is preferable to give one’s voice adequate rest.

3. The elderly should be well hydrated. At least 6 to 8 glasses of water need to be consumed per day. Those taking alcohol or caffeinated beverages should be careful to drink more water.

4. A humidifier in the room, especially in dry climates is ideal. The room should have a humidity of 30–40 %. Cold or medications taken for allergy (antihistaminics) may dry out the vocal cords and affect voice.

5. Smoking is taboo. Even passive smoking can harm the voice in the elderly. Also avoid the smoke of incense in the house.

6. Overuse of one’s voice should be avoided as one grows older. Shouting and screaming will be harmful. Avoid noisy places as one must raise one’s voice while speaking in such places.

7. Avoid very spicy foods as these may cause reflux heart burn when the acidic content from the stomach regurgitates into the throat leading to hoarseness of voice. If this is very troublesome, medications will be needed to control the symptoms of heartburn.

8. As far as possible, avoid mouthwashes and gargles that contain irritant chemicals or alcohol.

9. Regular physical exercise like walking or swimming and a good lifestyle will go a long way in promoting the health of the respiratory system and the larynx in the elderly.

10. Simple exercises for the vocal cords may be tried in early stages. Humming into a straw is said to be a good exercise for the vocal cords. Reading aloud also will be beneficial. The daily newspaper may be read aloud for 20 or 30 minutes. Singing along with music also is helpful in keeping one’s voice healthy.




This content is for informational purposes only and does not substitute for formal and individualized diagnosis, prognosis, treatment, prescription, and/or dietary advice from a licensed medical professional. Do not stop or alter your current course of treatment. If pregnant or nursing, consult with a qualified provider on an individual basis. Seek immediate help if you are experiencing a medical emergency.

© 2022 Sahasranam Kalpathy

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