Summary
Purpose
Only a full understanding of how different diseases affect the same or different anatomical/functional
entities, may provide a clue on how comorbidity should be taken into consideration.
The aim of this study was to evaluate the chronic medical illnesses of an elderly
population, in order to analyze potential correlation of specific comorbidities with
presbylarynx.
Methods
This case-control, prospective, observational, and cross-sectional study was carried
out on consecutive subjects observed by otorhinolaryngology, in a tertiary center,
from January to September 2020. The inclusion criteria were ability to report an accurate
medical history and ≥65 years of age. The exclusion criteria were neurologic diagnoses,
autoimmune disease, history of thoracic or head and neck surgery, cancer, radiotherapy,
thyroid pathology, vocal fold mass lesions, acute laryngitis, or vocal fold paralysis.
Based on videostroboscopy of the larynx, the patients were subdivided into two main
groups: presbylarynx versus no presbylarynx. Health status was assessed by evaluation of chronic medical illnesses
(individual diagnoses of chronic conditions plus Charlson comorbidity index [CCI]),
functional status (Katz index of independence in activities of daily living and functional
Ambulation ambulation classification), and emotional status (Geriatric Depression
Scale).
Results
A total of 174 subjects (60 males; 114 females) were included (mean age = 73.99 years;
range 65-95 years). Presbylarynx was identified in 71 patients (41%). A statistically
significant difference was found concerning diabetes mellitus type 2 (T2DM); P< 0.001), asthma or chronic obstructive pulmonary disease (COPD; P< 0.001), and psychiatric disorder (P< 0.001). The mean score of CCI between “presbylarynx” and “no presbylarynx” groups
was statistically different (P= 0.021). Results showed an association between some functional dependence (P< 0.001), and mild or severe depression (P< 0.001) and the presence of presbylarynx.
Conclusions
Presbylarynx may be considered a sign of the health status of the elderly. Based on
CCI, It was found that patients with higher probability of 10-year mortality exhibit
more endoscopic signs of presbylarynx. It was also found that patients with better
scores in functionality scales exhibited less endoscopic findings compatible with
presbylarynx. Among chronic medical illnesses, T2DM, asthma, or COPD may be considered
risk factors for noticeable endoscopic signs of presbylarynx.
Key Words
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Article info
Publication history
Published online: January 16, 2021
Accepted:
December 21,
2020
Identification
Copyright
© 2021 The Voice Foundation. Published by Elsevier Inc. All rights reserved.
