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Subjective and Objective Evaluation of Voice in Persian Elderly Speakers
Mahshid Hozhabr1, Seyyed Saeed Ahmadi2, Saeedeh Hajebi Khaniki3
1Université Paris Cité, UFR de Linguistique - Grands Moulins, Paris, France.
Aim:
This study investigated the relationship between subjective (patient-based and clinician-based) and objective (acoustic) voice evaluation parameters in Persian elderly speakers.
Study Design:
A cross-sectional study was conducted to explore the abovementioned relationships.
Methods:
Ninety-two elderly participants (50 females, 42 males; aged 60 years and above) were recruited. The Persian version of the Aging Voice Index (AVI) was used for patient-reported assessment. Acoustic measures, including jitter, shimmer, harmonic-to-noise ratio (HNR), and cepstral peak prominence (CPP) were analyzed using Praat software. The auditory-perceptual evaluation was conducted using the GRBAS scale by skilled, experienced clinicians.
Results:
Based on GRBAS ratings, 41.9% of voices were normal, 51.6% mild, and 6.5% moderate dysphonia. CPP significantly differed across severity groups for both /i/ (P = 0.019) and /a/ (P = 0.006), with lower CPP corresponding to greater dysphonia. AVI also varied across groups (P = 0.020), with values increasing in mild dysphonia and decreasing in moderate dysphonia. AVI showed weak and nonsignificant correlations with CPP (|r| < 0.23, P > 0.22) and acoustic measures (|r| < 0.20, P > 0.08). Female speakers demonstrated lower jitter and shimmer and higher HNR for /a/ (P = 0.044, P = 0.013, and P = 0.028, respectively), while F0 was significantly higher in females for both vowels (P < 0.001). AVI did not differ by gender (P = 0.807). Age showed a significant positive correlation with shimmer for /a/ (r = 0.211, P = 0.043), with stronger age-related increases in shimmer and decreases in HNR among males (P ≤ 0.008).
Conclusion:
The findings reveal a complex relationship between the subjective and objective voice measures in elderly speakers. While GRBAS ratings correlated moderately with acoustic parameters, patient-reported AVI scores showed no significant relationship with objective measures. These results emphasize the importance of using multiple assessment tools for the comprehensive evaluation of voice disorders in aging populations.
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