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.
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).
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.
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.
To read this article in full you will need to make a payment
Purchase one-time access:Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
One-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:Subscribe to Journal of Voice
Already a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
- Clinical assessment of glottal insufficiency in age-related dysphonia.J Voice. 2017; 128: 1-5
- Vocal fold atrophy in a Japanese Tertiary Medical Institute: status quo of the most aged country.J Voice. 2014; 28: 231-236
- Voice rehabilitation after partial laryngeal surgery.Otolaryngol Clin North Am. 2004; 37: 637-653
- The prevalence of major psychiatric pathologies in patients with voice disorders.Ear Nose Throat J. 2003; 82: 808-814
- Clinical analysis of presbylarynx-vocal fold atrophy in the elderly individuals.Auris Nasus Larynx. 2010; 37: 461-467
- Dysphonia in the aging: physiology versus disease.Laryngoscope. 1992; 102: 139-144
- Cause of hoarseness in elderly patients.Otolaryngol Head Neck Surg. 1998; 118: 481-485
- Epidemiology of voice disorders in the elderly: preliminary findings.Laryngoscope. 2007; 117: 628-633
- Presbyphonia: a review.Curr Opin Otolaryngol Head Neck Surg. 2007; 15: 137-140
- Vocal characteristics of elderly women engaged in aerobics in private institutions of Salvador, Bahia.J Voice. 2016; 30: 9-19
- Presbylaryngis: a state-of-the-art review.Curr Opin Otolaryngol Head Neck Surg. 2019; 27: 168-177
- Aging voice and the laryngeal muscle atrophy.Laryngoscope. 2015; 125: 2518-2521
- Voice and ageing: clinical, endoscopic and acoustic investigation.Clin Otolaryngol. 2017; 42: 330-335
- Glottic characteristics and voice complaint in the elderly.J Voice. 2005; 19: 84-94
- Morphological and functional aspects of the senile larynx.Folia Phoniatr Logop. 2006; 58: 151-158
- Voice disorders in the elderly.J Voice. 2012; 26: 254-258
- Presbylarynx: does body muscle mass correlate with vocal atrophy? A prospective case control study.Laryngoscope. 2021; 131 (Epub ahead of print. PMID: 32401382): E226-E230https://doi.org/10.1002/lary.28685
- Early effects of smoking on the voice: a multidimensional study.Med Sci Monit. 2004; 10: 649-656
- Cutoff point at voice handicap index used to screen voice disorders among persian speakers.J Voice. 2013; 27: 130.e1-130.e5https://doi.org/10.1016/j.jvoice.2012.08.007
- A new method of classifying prognostic comorbidity in longitudinal studies: development and validation.J Chronic Dis. 1987; 40: 373-383
- Studies of illness in the aged. The index of ADL a standardized measure of biological and psychosocial function.JAMA. 1963; 185: 914-919
- Gait assessment for neurologically impaired patients. Standards for outcome assessment.Phys Ther. 1986; 66: 1530-1539
- Geriatric Depression Scale (GDS): recent evidence and development of a shorter version.Clin Gerontologist. 1986; 5: 165-173
- Acoustic measures of the voices of older singers and nonsingers.J Voice. 2012; 26: 341-350https://doi.org/10.1016/j.jvoice.2011.05.007
- Comorbidity in older adults: nosology of impairment, diseases, and conditions.J Gerontol A Biol Sci Med Sci. 2007; 62: 296-300https://doi.org/10.1093/gerona/62.3.296
- Assessing functional capacity and factors determining functional decline in the elderly: a cross-sectional study.Acta Med Port. 2019; 32: 654-660https://doi.org/10.20344/amp.11974
- Muscle atrophy in patients with type 2 diabetes mellitus: roles of inflammatory pathways, physical activity and exercise.Exerc Immunol Rev. 2016; 22: 94-109
- Dysphonia caused by inhaled steroids: recognition of a characteristic laryngeal abnormality.Thorax. 1983; 38: 813-821
- Assessment of clinical and social characteristics that distinguish presbylaryngis from pathologic presbyphonia in elderly individuals.JAMA Otolaryngol Head Neck Surg. 2018; 144: 566-571https://doi.org/10.1001/jamaoto.2018.0409
Published online: January 16, 2021
Accepted: December 21, 2020
© 2021 The Voice Foundation. Published by Elsevier Inc. All rights reserved.