Investigating the Relationship Between Voice Characteristics and Presbyphagia in Geriatric Population

Aging is a significant risk factor for dysphagia. Speech and swallowing share the same anatomical and neurophysiological mechanisms and are closely related functions. Therefore, speech assessment can serve as a valuable tool for predicting the risk of dysphagia. Presbyphagia is a term that describes the impact of aging on swallowing function. This study aims to investigate the relationship between acoustic and aerodynamic parameters of voice and speech and presbyphagia in the normal geriatric population.

A total of 96 individuals aged 65 and above participated in the study. Acoustic voice analysis was administered utilizing PRAAT software. In aerodynamic assessments, maximum phonation time (MPT) and the s/z ratio were assessed, whereas speech rate and vocal coordination were analyzed through diadochokinetic (DDK) measurements. Swallowing function was assessed using the eating assessment tool (EAT-10) and the timed water swallow test (TWST), while nutritional status was analyzed with the mini nutritional assessment-short form. Participants were classified as dysphagic or non-dysphagic based on their EAT-10 scores, with established cut-off values used to identify individuals at risk for dysphagia. The relevant parameters were first examined for differences between dysphagic and non-dysphagic groups, followed by a comparative assessment of factors influencing presbyphagia between the 65-79 and >80 age groups.

Among the participants, 66 individuals were found to be at risk for dysphagia, while the remaining 30 were not. Comparisons between the two groups revealed a statistically significant difference in swallowing capacity measured by TWST (P = 0.006). Another significant difference was also observed in the MPT parameter between dysphagic and non-dysphagic groups (P = 0.001). The comparisons based on age groups showed statistically significant differences in EAT-10 and TWST scores (P = 0.005; P = 0.001). Additionally, significant differences were found in MPT and DDK rate between age groups (P = 0.001; P = 0.001). Correlation analyses indicated that the relationship between fundamental frequency and EAT-10 and TWST was moderately significant (r = 0.423, P = 0.029; r = -0.542, P = 0.010), and that there was a strong and significant relationship between MPT and both EAT-10 and TWST (r = -0.741, P = 0.016; r = 0.729, P = 0.001). Furthermore, a strong negative correlation was found between the TWST and DDK rate (r = -0.734, P = 0.001).

This study concludes that the assessment of voice and swallowing functions in the geriatric population is crucial for the early diagnosis of presbyphagia. Reduced respiratory support, inadequate oral-motor movements, deficiencies in vocal cord closure control, and weak airflow control have been identified as risk factors for presbyphagia. The findings emphasize that monitoring these functions plays a critical role in diagnosing presbyphagia.