Matthew R. Hoffman
The purpose of this study is to determine if presbyphonia, or voice disorder caused by age-related change in the larynx, is associated with change in social interaction. This proposal investigates the impact of voice impairment in older adults on social interaction, loneliness, social disconnectedness, and depression. A series of questionnaires, voice assessments, and interviews will be performed to improve our understanding of how voice disorders affect older adults and how treatment of voice impairment with voice therapy may improve quality of life.
During the study visit, all subjects (including the control group) will be given ten questionnaires asking them to rate their loneliness and quality of life in relation to the changes in their voice. All participants will undergo audiometry to assess hearing (with hearing aids if used at home). If they do not pass the hearing test, they will be screened out of the study. Participants will then provide a required voice sample using sustained vowels for 3-5 seconds 5 times each, repeating six standard sentences, and 20 seconds of natural conversational speech. Using this voice recording, the fo…
Inclusion Criteria: * Diagnosis of presbyphonia with findings of presbylaryngis on videostroboscopy, with findings of bilateral true vocal fold atrophy and normal vocal fold motion bilaterally * Able to complete all questionnaires and voice assessment tasks * Normal to mild hearing loss in aided condition (with hearing aids) Exclusion Criteria: * Liquid dysphagia or pneumonia in the last year * Vocal fold lesion/scar/motion impairment * Neurologic disorder affecting the voice * Montreal cognitive assessment score \<26 or \<25 if 12 or fewer years of formal education
Speech therapy program guided by a speech language pathologist. This program includes in person or virtual visits and at home exercises.
A questionnaire measuring levels of loneliness.
A questionnaire that asks about social network size and the frequency of social activities attended.
A questionnaire measuring levels of depression.
A questionnaire of patient-reported voice outcome measures designed to capture the quality of life impact of dysphonia in older adults.
A questionnaire that measures frailty levels.
A picture based questionnaire scale that asks the subject to rate their perceived effort when using their voice.
A screening tool used to test for cognitive impairment.
A questionnaire used to measure quality of life impact of dysphonia.
A 4 question survey that captures impact of voice on four domains - work/daily activities, social life, home, and overall quality of life.
A 10 question survey asking to rate severity of cough.
Nose is anesthetized and a flexible endoscope is passed to visualize the larynx at rest and during sustained vowel production (/i/) for 3-5 seconds. This will be used to measure bowing index and normalized glottal gap of the vocal folds.
Participants will complete voice recording tasks including sustained vowel production, six standard sentences, and 20 seconds of natural conversational speech. This will be used to measure CAPE-V rating, Cepstral peak prominence, fundamental frequency, signal-to-noise ratio, voice type components, mean flow rate, subglottal pressure, and vocal efficiency.
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