Dysphonia in Nursing Home and Assisted Living Residents: Prevalence and Association With Frailty

Abstract

Objective Previous studies of geriatric dysphonia prevalence have been limited to ambulatory outpatient and senior communities. Our goal was to identify prevalence of dysphonia in nursing home residents and assisted living residents and search for correlations between indices of dysphonia and indices of frailty. Study Design Prospective epidemiological survey. Methods Residents of a vertically integrated senior care organization who were 65 or older and able to understand and complete the questionnaire were recruited to complete the Voice Handicap Index 10 (VHI-10) to assess for dysphonia (VHI-10 > 10 = dysphonia) and Vulnerable Elders Survey 13 (VES-13), a validated instrument to assess for frailty (VES >3 = frailty). Results A total of 119 residents were surveyed. Thirty-three percent of nursing home residents, and 25% of assisted living residents reported dysphonia with 29% of all respondents reporting dysphonia. The mean VHI-10 was 7.4, the median was 5, and the interquartile range was 2 – 12.5. There was a significant relationship between VHI-10 and VES-13 score (p = 0.029). There were no statistically significant relationships between frailty, age, or type of living and dysphonia or VHI-10. Conclusion There is a high prevalence of voice dysfunction in assisted living and nursing home residents. The correlation between VHI-10 and VES-13 suggests that voice declines as frailty increases.

Screening for Frailty in Canada’s Health Care System: A Time for Action

“…Assisted living is frequently said to cater to frail older adults, but few studies report on the proportion of assisted living residents who are frail (Freiheit et al, 2011 ;Hogan et al, 2012 ;Kanwar et al, 2013 ;Nichols, Varadarajan, Bock, & Blumin, 2015 ). In those that do, frailty is common however defi ned (Kanwar et al, 2013 ), but in comparison, frailty is generally felt to be more common and/or severe in long-term care homes (Nichols et al, 2015 ). Different approaches for detecting frailty among assisted living residents may lead to differing prevalence estimates.…”

“…It is unclear whether identifying the frailest among assisted living residents substantially helps pick out those at higher risk for adverse outcomes or can be used to direct their care. Predictive models improve only modestly in their ability to anticipate adverse outcomes like mortality, hospitalization, and moving to a higher level of care when frailty is added to characteristics such as age, sex, and co-morbidity (Hogan et al, 2012; Nichols et al, 2015). All residents in assisted living would benefit from a number of the approaches advocated for frail individuals such as advance care planning, encouraging physical activity, and careful stewardship of medications.…”

Idosos de uma antiga colônia brasileira de hanseníase: vulnerabilidade clínico-funcional e autopercepção vocal e auditiva

“…Uma pesquisa realizada com idosos ativos descreveu prevalência de desvantagem vocal de 9,7% (10) . Outra pesquisa desenvolvida com idosos de uma instituição de longa permanência nos Estados Unidos encontrou prevalência de desvantagem vocal superior (29%) a do presente estudo (24,8%) (27) . Sabe-se que idosos ativos a ser mais funcionais (24) .…”

Predicting frailty in older adults using vocal biomarkers: a cross-sectional study

“…One study indicated that voice-related handicaps differ between robust and frail older adults, particularly on the exhaustion and weight loss domains of the Fried frailty criteria [22], whereas another study suggested a low correlation between voice dysfunction and frailty in nursinghome and assisted-living residents [23]. Given the mixed or scarce evidence, the current study aimed to determine the relationship between frailty and acoustic parameters among older adults.…”