Research Article|Articles in Press

Effects of Participation in a Structured Choral Program on the Voice of Older Adults



      To examine the effects of short-term and long-term engagement with structured choral singing on vocal function and quality of life outcomes in older adults.


      Two groups of older adult singers over 55 years, one with fewer than 4 semesters and one with 4 or more semesters singing in a chorale, were assessed at 3 time points: baseline, after 1 semester of singing, and either after 1 semester of rest or after 1 semester of rest and 1 semester more of singing. Acoustic and aerodynamic measures, voice-related quality of life ratings, and measures of singing accuracy were obtained. Percent change between time points were calculated to determine three outcomes: improvement, lack of change, or worsening of measures across time.


      Long-term average spectrum (LTAS), difference in first and second harmonics and estimated subglottic pressure were significantly more likely to improve after a semester of singing with less experience singers, and LTAS continued to improve after a semester of rest. Flow was significantly more likely to improve with more singing experience after a semester of singing. Aerodynamic variables consistently changed in more experienced singers and improvement was maintained over the three visits. No significant changes occurred over time for singing accuracy for any singer type. Self-perception of singing voice continued to improve with more singing experience.


      This study demonstrated that for older adults in good health, regular singing provided a mechanism for maintaining speaking voice over time.

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        • Kendall K.
        Presbyphonia: a review.
        Curr Opin Otolaryngol Head Neck Surg. 2007; 15: 137-140
        • Rojas S
        • Kefalianos E
        • Vogel A.
        How does our voice change as we age? A systematic review and meta-analysis of acoustic and perceptual voice data from healthy adults over 50 years of age.
        J Speech Lang, Hearing Res. 2020; 63: 533-551
        • Chodzko-Zajko W
        • Ringel RL
        Physiological aspects of aging.
        J Voice. 1987; 1: 18-26
        • Johnson A.
        Exercising the aging voice.
        Perspect SIG 3. 2018; 3: 12-18
        • Prakup B.
        Acoustic measures of the voices of older singers and nonsingers.
        J Voice. 2012; 26: 341-350
        • Siupsinskiene N
        • Lycke H.
        Effects of vocal training on singing and speaking voice characteristics in vocally healthy adults and children based on choral and nonchoral data.
        J Voice. 2011; 25: e177-e189
        • Lortie CL
        • Rivard J
        • Thibeault M
        • et al.
        The moderating effect of frequent singing on voice aging.
        J Voice. 2017; 31: 112-1e1
        • Maruthy S
        • Ravibabu P.
        Comparison of dysphonia severity index between younger and older Carnatic classical singers and nonsingers.
        J Voice. 2015; 29: 65-70
        • Barrichelo VMO
        • Heuer RJ
        • Dean CM
        • et al.
        Comparison of singer's formant, speaker's ring, and LTA spectrum among classical singers and untrained normal speakers.
        J Voice. 2001; 15: 344-350
        • Rothman HB
        • Brown Jr, WS
        • Sapienza CM
        • et al.
        Acoustic analyses of trained singers perceptually identified from speaking samples.
        J Voice. 2001; 15: 25-35
        • Blumin JH
        • Pcolinsky DE
        • Atkins JP.
        Laryngeal findings in advanced Parkinson's disease.
        Ann Otol, Rhinol & Laryngol. 2004; 113: 253-258
        • Perez KS
        • Ramig LO
        • Smith ME
        • et al.
        The Parkinson larynx: tremor and videostroboscopic findings.
        J Voice. 1996; 10: 354-361
        • Barnish J
        • Atkinson RA
        • Barran SM
        • et al.
        Potential benefit of singing for people with Parkinson's disease: a systematic review.
        J Parkinson's Dis. 2016; 6: 473-484
        • Di Benedetto P
        • Cavazzon M
        • Mondolo F
        • et al.
        Voice and choral singing treatment: a new approach for speech and voice disorders in Parkinson's disease.
        Eur J Phys Rehab Med. 2009; 45: 13-19
        • Haneishi E.
        Effects of a music therapy voice protocol on speech intelligibility, vocal acoustic measures, and mood of individuals with Parkinson's disease.
        J Music Ther. 2001; 38: 273-290
        • Tanner M
        • Rammage L
        • Liu L.
        Does singing and vocal strengthening improve vocal ability in people with Parkinson's disease?.
        Arts & Health. 2016; 8: 199-212
        • Yinger OS
        • Lapointe LL.
        The effects of participation in a group music therapy voice protocol (G-MTVP) on the speech of individuals with Parkinson's disease.
        Music Ther Perspect. 2012; 30: 25-31
        • Moon S
        • Park J
        • Yang S.
        The effects of therapeutic singing on vocal functions of the elderly: a study on Korean elderly.
        J Voice. 2020; 36: 437.e1-437.e9
        • Stager SV
        • Sparks AD
        • Bielamowicz SA
        • et al.
        The role of choral singing in speaking voice preservation of aging adults.
        J Speech Lang Hear Res. 2020; 63: 2099-2114
        • Fiatarone MA
        • Marks EC
        • Ryan ND
        • et al.
        High-intensity strength training in nonagenarians: effects on skeletal muscle.
        J Am Med Assoc. 1990; 263: 3029-3034
        • Bach KK
        • Belafsky PC
        • Wasylik K
        • et al.
        Validity and reliability of the glottal function index.
        Arch Otolaryngol – Head Neck Surg. 2005; 131: 961-964
        • Hogikyan ND
        • Sethuraman G.
        Validation of an instrument to measure voice-related quality of life (V-RQOL).
        J Voice. 1999; 13: 557-569
        • Phyland DJ
        • Pallant JF
        • Benninger MS
        • et al.
        Development and preliminary validation of the EASE: a tool to measure perceived singing voice function.
        J Voice. 2013; 27: 454-462
        • Kempster GB
        • Gerratt BR
        • Abbott KV
        • et al.
        Consensus auditory-perceptual evaluation of voice: development of a standardized clinical protocol.
        Am J Speech-Lang Pathol. 2009; 18: 124-132
        • Cannito MP
        • Buder EH
        • Chorna LB.
        Spectral amplitude measures of adductor spasmodic dysphonic speech.
        J Voice. 2005; 19: 391-410
        • Larrouy-Maestri P
        • Morsomme D.
        Criteria and tools for objectively analyzing the vocal accuracy of a popular song.
        Logoped Phoniatrics Vocol. 2014; 39: 11-18
        • Smitheran JR
        • Hixon TJ.
        A clinical method for estimating laryngeal airway resistance during vowel production.
        J Speech Hearing Disord. 1981; 46: 138-146
        • Fisher KV
        • Swank PR.
        Estimating phonation threshold pressure.
        J Speech, Language, Hearing Res. 1997; 40: 1122-1129
        • Venkatachalam P
        • Dwivedi DP
        • Govindraj V.
        FEV1/FEV6 is effective as a surrogate for FEV1/FVC in the diagnosis of chronic obstructive pulmonary disease.
        Indian J Tuberc. 2021; 68: 230-235
        • Guralnick JM
        • Ferrucci L
        • Pieper DF
        • et al.
        Lower extremity function and subsequent disability: consistency across studies, predictive models and value of gait speed alone compared with the Short Physical Performance Battery.
        J Gerontol Series A. 2000; 55: M221-M231
        • Phyland DJ
        • Pallant JF
        • Thibeault SL
        • et al.
        Measuring vocal function in professional music teater singers: construct validation of the evaluation of the ability to sing easily (EASE).
        Folia Phoniatr Logop. 2014; 66: 100-108
        • Dalla Bella S
        • Giguère JF
        • Peretz I
        Singing proficiency in the general population.
        J Acoustic Soc Am. 2007; 121: 1182-1189