Frailty Syndrome, Cognition, and Dysphonia in the Elderly

Abstract

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.