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| ORIGINAL ARTICLE |
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| Year : 2012 | Volume
: 2
| Issue : 2 | Page : 81-84 |
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Acoustic measurements of geriatric voice
Swapna Sebastian, Sonia Babu, Neethu E Oommen, Achamma Ballraj
Department of ENT, Christian Medical College, Vellore, Tamil Nadu, India
| Date of Web Publication | 5-Feb-2013 |
Correspondence Address:
Swapna Sebastian
Department of ENT, Christian Medical College, Vellore, Tamilnadu
India
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/2230-9748.106984
 Abstract | | |
Background: Aging larynx can cause changes in the voice. Knowledge about the normal changes in voice parameters is important in differentiating it from pathological voices. This study is a preliminary investigation on the age related changes in the parameters of voice in geriatric normal subjects, which has been scarcely reported in the Indian literature. Materials and Methods: Our study focused on the changing acoustic parameters of voice due to aging in normal geriatric subjects. The acoustic parameters of males and females with normal voice between the age groups of 60 to 80 were studied. 20 subjects in each category (male and female) were included in the study. All the subjects were taken after clearance from ENT to rule out any vocal pathology. The parameters taken were fundamental frequency, formants (f1, f2), jitter and shimmer. Results and Discussion: Our study shows that there are not any significant changes in the acoustic parameters either in males or in females across the age of 60 years to 80 years. However when compared to adult norms (18-25 yrs) the acoustic values are showing a difference both in males as well as in females in fundamental frequency. Comparison was also done between males and females between the age group of 60 to 80 years. Males differed from females significantly for the parameters of fundamental frequency and formant frequencies (f1 and f2 ) only and not for the parameters of jitter and shimmer. Keywords: Acoustic parameters, aging larynx in normal population, geriatric voice measurements
How to cite this article:
Sebastian S, Babu S, Oommen NE, Ballraj A. Acoustic measurements of geriatric voice. J Laryngol Voice 2012;2:81-4 |
| Introduction | |  |
As the life span of human beings has increased, the quality of life of the elderly has also become a concern. Like any other part of the body, larynx also undergoes changes due to aging. Due to anatomical and physiological changes; voice can also undergo changes as age increases.
Voice is produced by the interactive function of Respiratory, Laryngeal and Resonatory System. Age related structural changes to these systems will in-turn change the voice parameters. The respiratory system provides the aerodynamic force (i.e., sub glottal pressure) needed to set the vocal folds into vibration and initiate phonation. Due to aging there can be loss of elasticity of the lung tissue, weakening of respiratory muscles and stiffening of the thorax which will alter the lung volumes, [1] this in turn can affect the phonation.
The larynx also undergoes age-related anatomic changes like ossification and calcification of laryngeal cartilages, [2],[3],[4],[5],[6] atrophy and degeneration of intrinsic muscles, deterioration of cricoarytenoid (CA) joint, degeneration of glands in the laryngeal mucosa, degenerative changes in the lamina propria, and degenerative changes in conus elasticus. These may affect vocal fold approximation, or reducing the smoothness of vocal fold adjustments during phonation. Glandular changes, [7] may cause drying of epithelium, which may increase stiffness of VC cover. Increased cover stiffness could increase instability of vocal fold vibration and raise fundamental frequency (F0) in elderly men. [1]
Aging can affect the head and neck muscles, including the extrinsic laryngeal muscles which control the vertical positioning of the larynx like the sternocleidomastoid and trapezius muscles. This can results in a permanent descent of the larynx. [8]
Hormonal Changes can also cause changes in the voice. In females after menopause there is cessation of progesterone, a reduction in estrogens, and the appearance of androgen. [9] These hormonal changes alter the physical characteristics of the vocal folds and consequently affect phonation. [9],[10],[11] Reduced estrogens and increased androgens are responsible for an increase in vocal fold mass (i.e., they become oedematous), and the lowering of vocal pitch, [6] acoustic and physiological measurement of the voice yield information regarding subtle changes in the voicing mechanism. This study provided preliminary normative acoustic data of voice for the elderly, which has been scarcely reported in the Indian literature.
| Materials and Methods | | |
The objectives of this study were to find out the age related changes in the parameters of voice in geriatric normal subjects.
Participants
Twenty elderly men (between the age ranges of 60-80 years) and twenty elderly women (between the age ranges of 60-80 years) participated in the study. They were divided into 4 age groups (60-64 years, 65-69 years, 70-74 years, and 75-79 years) with 5 subjects in each group. All the subjects were taken after clearance from ENT to rule out any vocal pathology and were free of perceived speech or voice disorders. All participants were in good health, were free of neurological diseases, and were nonsmokers. Voice samples were elicited by asking each participant to produce sustained phonations of the /a/ sound at his or her habitual levels of pitch and loudness lasting longer than 3 seconds. All acoustic analyses were conducted using PRAAT software (version 5.1.04).
The acoustic parameters that were taken up for the study were as follows:
- Fundamental frequency (F0)-is the rate of vibration of the vocal folds.
- Jitter-is an acoustic measurement of how much a given period differs from the period that immediately follows it.
- Shimmer- is the cycle to cycle variation in amplitude.
- Formants are the spectral peaks of the sound spectrum or an acoustic resonance of the human vocal tract. The formant with the lowest frequency is called f1, the second f2.
Independent samples Kruskal-Wallis test was done to find the difference in the different acoustic parameters between the different age groups and also between males and females.
| Results | | |
[Table 1] Shows that there is no significant difference in the voice parameters of fundamental frequency, jitter, shimmer and the first and second formants across the age groups of male subjects (significance level is 0.05). Similar findings were found across the age groups of female subjects also as shown in [Table 2] (significance level is 0.05). The acoustic values obtained for the geriatric subjects in the present study were compared with existing adult norms for females between the age range of 18-25 yrs for female subjects in [Table 3] and for male subjects in [Table 4]. There is a difference both in geriatric males as well as in females compared to adult subjects in fundamental frequency. Comparison was also done between males and females between the age group of 60 to 80 years [Table 5]. Males differed from females significantly for the parameters of fundamental frequency and formant frequencies (f1 and f2) only and not for the parameters of jitter and shimmer. | Table 1: Showing the results of Independent samples Kruskal-Wallis test to find the difference in distribution across the age groups of male subjects for the different acoustic parameters of voice (significance level is 0.05)
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 | Table 2: Showing the results of Independent samples Kruskal-Wallis test to find the difference in distribution across the age groups of female subjects for the different acoustic parameters of voice (significance level is 0.05)
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 | Table 3: Comparing the acoustic values obtained for the geriatric subjects in the present study with existing adult norms for females between the age range of 18-25 yrs
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 | Table 4: Comparing the acoustic values obtained for the geriatric subjects in the present study with existing adult norms for males between the age range of 18-25 yrs
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 | Table 5: Showing the results of Independent samples Kruskal-Wallis test to find the difference in distribution between male and female subjects of 60 to 80 years of age for the different acoustic parameters of voice (significance level is 0.05)
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| Discussion | | |
In the present study we tried to find out the changes in the voice parameters across the age of 60 years to 80 years. The subjects were grouped into four age groups with 5 years of time interval i.e. (60-64,65-69,70-74,75-79) Examination of the fundamental frequency (F0) data did not reveal any significant changes either in males [Table 1] or in females [Table 2] after the age of 60 years till the age of 80 years (at 0.5 level of significance). However when compared to norms for adults between the age range of 18-25 years for Indian population, [12] the values of these geriatric subjects is found to be higher for the male subjects and lower for the female subjects. [Table 3] and [Table 4]. These results are in support of previous research in which F0 was found to decrease in women and increase in males with increase in age. [13],[14],[15],[16],[17] The decrease in F0 for females may be a consequence of the increase in vocal fold mass due to hormonal changes that occur during menopause, [9] for males, the opposite effect occurs, showing reduced vocal fold mass from aging-induced atrophy of the internal thyroarytenoid, [17] and results in thinner vocal folds and a higher F0. However the study needs to be extended to younger age groups to find out the age at which the transition in the parameters take place.
Formant frequencies are the frequency loci of clusters of spectral energy representing the resonant frequencies of the vocal tract. The first two formants (F1 and F2) are related to tongue location, including the height and frontness of the tongue while producing a vowel. The frequency of F1 is inversely related to tongue height. For example, the high vowel /i/ is associated with a lower F1 than the low vowel /a/. The frequency of F2 is related to the "frontness" of the tongue position i.e. the further front (anterior) the tongue bulge, the higher the F2 frequency. The frequency of F2 is further affected by the degree of lip rounding. Lip rounding extends the length of the vocal tract and thus lowers the frequencies of F2. A change in vocal tract length as the larynx is raised or lowered, changes the dimensions of the resonating chamber and effectively changes its resonating frequencies. When the larynx is raised or lowered, it shortens or lengthens the vocal tract and results in raising or lowering of the formants respectively, [18] western literature shows that the formants tend to lower in the elderly, [17],[18],[19],[20],[21],[22] in the current study we found that there were no significant changes in the formant frequencies after the age of 60 years [Table 1] and [Table 2]. Further investigation extending the study to lower age groups need to be done to substantiate the changes in formants in the Indian population.
We could not find any significant changes in the jitter values across the age of 60 to 80 in both males and females [Table 1] and [Table 2]. There are differing opinions regarding the effectiveness of % jitter as a reliable indicator of age. In some studies, no significant age-induced differences were found, [23] while other studies reported significant differences for % jitter between younger and older participants, [24],[25] these conflicting results raise the question of the usefulness of % jitter as a reliable indicator of aging-induced changes to the voice.
Comparison was also done between males and females between the age group of 60 to 80 years. Males differed from females significantly for the parameters of fundamental frequency and formant frequencies (f1 and f2) only and not for the parameters of jitter and shimmer [Table 5]. This investigation can contribute to forensic medicine to create an awareness regarding the possible changes in the voice with age since there is probably a long delay between 'crime' and 'suspect' recordings.
| Conclusion | | |
Our study shows that there are not any significant changes in the acoustic parameters either in males or in females across the age of 60 years to 80 years. (at 0.5 level of significance). However when compared to adult norms (between the age of 18 to 25 years) the acoustic values are showing a difference both in males as well as in females in terms of fundamental frequency. This suggests that the aging effect on voice starts even before the age of 60 years. At what age these acoustic parameters of voice starts changing is a subject of further research by extending the study to with subjects of lower age ranges or preferably a longitudinal study
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[Table 1], [Table 2], [Table 3], [Table 4], [Table 5]
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