Presbyphonia: Why the Voice Changes with Age and How to Treat It
As a speech therapist specializing in voice, I treat presbyphonia in older adults both in Malaga and online.
Presbyphonia is the term used to describe the vocal changes associated with the natural aging of the larynx. It is not a disease, but rather a physiological consequence of the passage of time on the structures that produce the voice.
What is presbyphonia?
Presbyphonia refers to vocal changes caused by anatomical and physiological alterations in the larynx that occur with aging. It affects approximately 10–20% of older adults and can negatively impact their quality of life. Its diagnosis is typically one of exclusion: it is confirmed in the absence of other laryngeal conditions, along with a clinical presentation characteristic of an aged voice.
Why is it more common than it seems?
The prevalence of voice disorders among people over the age of 65 is four times higher than in the general population, and presbyphonia is the most common cause of dysphonia in this age group.
How is the voice perceived in cases of presbyphonia?
Perceptually, a presbyphonic voice is characterized by sounding weak, breathy, tremulous, and unstable. Its frequent association with hearing loss in this group can contribute to social isolation.
Presbyphonia Treatment: What Does the Evidence Say?
The treatment of choice for presbyphonia is voice therapy with a speech therapist.
A systematic review with a meta-analysis confirmed a significant improvement in patient-reported outcomes following treatment, with a large effect size. The maximum phonation time increased by an average of 5.37 seconds following therapy, with better results when the approach focused on the function of the organ itself (the larynx) than when it focused solely on skills and habits.
The most commonly used techniques include vocal function exercises, semi-occluded vocal tract exercises, and resonant voice training.
It is important to be honest about the limitations of the evidence: although the results are encouraging, the overall quality of the available studies remains poor, so no definitive statements can be made about their effectiveness in all cases.
Presbyphonia: Voice Therapist in Malaga and Online
If you notice that your voice has changed with age (it has become weaker or shakier, or you get tired when you speak), a speech therapy assessment can help you regain your vocal quality and confidence when communicating.
I offer speech therapy sessions in Spanish, French and English, both in person at my office in Mijas (Malaga) and online for patients from all over Spain and abroad.
Would you like to learn more about voice disorders? Be sure to read my article on voice therapy and dysphonia as well.
- The Aging Voice: A Systematic Review of Presbyphonia. (2021). https://pubmed.ncbi.nlm.nih.gov/34654233/
- Saccente-Kennedy, B., Gillies, F., Desjardins, M., Van Stan, J., & Govender, R. (2024). A systematic review of speech-language pathology interventions for presbyphonia using the Rehabilitation Treatment Specification System. Journal of Voice. https://doi.org/10.1016/j.jvoice.2023.12.010
