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Thinking outside the (voice) box: considering respiratory function in presbyphonia.
Brian Saccente-Kennedy1,2, Roganie Govender3,4
1Department of Speech and Language Therapy (ENT), Royal National Ear, Nose and Throat and Eastman Dental Hospitals, University College London Hospitals NHS Foundation Trust.
Current Opinion in Otolaryngology & Head and Neck Surgery
|March 16, 2026
Summary
Age-related respiratory decline significantly impacts vocal aging in presbyphonia. Targeted respiratory muscle training, combined with voice therapy, shows promise for improving vocal effort and reducing fatigue in older adults.
Area of Science:
- Gerontology
- Speech and Hearing Sciences
- Respiratory Medicine
Background:
- Presbyphonia is traditionally viewed as a laryngeal disorder.
- Emerging evidence highlights the under-recognized role of age-related respiratory decline in vocal aging.
Purpose of the Study:
- To review the literature on respiratory aging, speech breathing, and respiratory muscle function in older adults with presbyphonia.
- To evaluate rehabilitation strategies targeting respiratory systems for presbyphonia.
Main Methods:
- Systematic review of studies on respiratory aging and vocal function.
- Analysis of speech-breathing patterns and respiratory muscle performance in older adults.
- Evaluation of preliminary trials of voice and respiratory muscle strength training.
Main Results:
- Laryngeal changes do not reliably predict presbyphonia.
- Reduced respiratory function (lung elasticity, chest wall compliance, muscle strength) impacts speech breathing.
- Exuberant voice therapies and combined respiratory training show potential benefits for vocal effort and fatigue.
Conclusions:
- Respiratory aging significantly influences presbyphonia symptom severity.
- Integrating respiratory assessment and targeted training may improve diagnosis and therapy outcomes.
- Further research is needed to understand the interaction between respiratory and laryngeal factors and identify optimal candidates for respiratory rehabilitation.
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