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Published on: July 24, 2013
Frailty Syndrome, Cognition, and Dysphonia in the Elderly
Robin A Samlan1, Mindy A Black1, Meira Abidov2
1Department of Speech, Language, and Hearing Sciences, University of Arizona, Tucson, Arizona; Department of Otolaryngology Head and Neck Surgery, University of Arizona College of Medicine, Tucson, Arizona.
Purpose:
The purpose of the current study is to determine the relation of frailty syndrome to acoustic measures of voice quality and voice-related handicap.
Methods:
Seventy-three adults (52 community-dwelling participants and 21 assisted living residents) age 60 and older completed frailty screening, acoustic assessment, cognitive screening, and the Voice Handicap Index-10 (VHI-10). Factor analysis was used to consolidate acoustic measures. Statistical analysis included multiple regression, analysis of variance, and Tukey post-hoc tests with alfa of 0.05.
Results:
Montreal Cognitive Assessment (MoCA) and exhaustion explained 28% of the variance in VHI-10. MoCA and sex explained 27% of the variance in factor 1 (spectral ratio), age and MoCA explained 13% of the variance in factor 2 (cepstral peak prominence for speech), and slowness explained 10% of the variance in factor 3 (cepstral peak prominence for sustained /a/). There were statistically significant differences in two measures across frailty groups: VHI-10 and MoCA. Acoustic factor scores did not differ significantly among frailty groups (P > 0.05).
Conclusions:
Voice-related handicap and cognitive status differed among robust and frail older adults, yet vocal function measures did not. The components of frailty most related to VHI-10 were exhaustion and weight loss rather than slowness, weakness, or inactivity. Based on these findings, routine screening of physical frailty and cognition are recommended as part of a complete voice evaluation for older adults.
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