Geriatric Dysphonia: Characteristics of Diagnoses in Age-Based Cohorts in a Tertiary Voice Clinic

Abstract

Objective: An aging population has increased focus on geriatric otolaryngology. Those ≥65 years old are not a uniform population, however, and recent gerontology literature recognizes important physiologic differences between the young-old (ages 65-74 years), middle-old (75-84), and old-old (≥85). This study evaluates differences within these groups among dysphonia patients ≥65 years relative to diagnosis and voice-related quality of life (V-RQOL). Methods: Chart review of all new patients ≥65 years presenting to the Johns Hopkins Voice Center between April 2015 and March 2017 identified chief complaint, diagnosis, and self-reported voice handicap. Etiology of dysphonia diagnoses were classified. Diagnostic categories and V-RQOL were evaluated as functions of patient age and gender. Results: Of 839 new patients ≥65 years, 463 (55.2%) reported chief complaint of dysphonia, with the most common etiologies being vocal fold immobility (28.3%) and atrophy (21.6%). Younger cohorts were more likely to present with benign vocal fold lesion and vocal fold immobility, while older cohorts were more likely to present with atrophy ( P = .016). The odds of having a diagnosis of vocal fold atrophy increased 7% with each year of life (odds ratio = 1.07; 95% CI, 1.03-1.11). V-RQOL scores were similar across gender and age categorization. Conclusion: Dysphonia patients ≥65 years are not a uniform group, and important differences exist in terms of diagnosis as a function of age. Knowledge of these differences may inform further investigations in the growing field of geriatric otolaryngology.

Influence of vocal and aerodynamics aspects on the voice-related quality of life of older adults

“…One study revealed that there are no differences in the V-RQOL scores between elderly men and women, as well as in the different categories of young-old, middle-old and old-old. 29 …”

Characterization of Geriatric Dysphagia Diagnoses in Age‐Based Cohorts

“…Age categorization was in accordance with an existing schema from the emerging literature highlighting the physiologic differences that occur with aging: young-old encompassed those aged 65 to 74 years, middle-old comprised those aged 75 to 84 years, and old-old included individuals aged ≥85 years. 14 - 16 …”

“…Exact patient age at the date of visit was calculated from the date of birth and date of visit and used for assignment to the appropriate age subgroup. Age categorization was in accordance with an existing schema from the emerging literature highlighting the physiologic differences that occur with aging: young‐old encompassed those aged 65 to 74 years, middle‐old comprised those aged 75 to 84 years, and old‐old included individuals aged ≥85 years 14–16 …”

“…Age categorization was in accordance with an existing schema from the emerging literature highlighting the physiologic differences that occur with aging: young-old encompassed those aged 65 to 74 years, middle-old comprised those aged 75 to 84 years, and old-old included individuals aged 85 years. [14][15][16] Underlying diagnosis was retrieved from chart review, and dysphagia assessment was performed as clinically indicated, including some combination of history, physical examination, speech-language pathology assessment, flexible laryngoscopy, and follow-up diagnostic tests, such as videofluoroscopic swallow study (modified barium swallow), esophagram (barium swallow), esophagogastroduodenoscopy (EGD), esophageal manometry, and 24-hour esophageal pH monitoring. For assignment of isolated cervical spine abnormalities as the primary diagnosis, patients must have demonstrated significant arthritic or postsurgical spine changes on imaging in the absence of any other identifiable cause of dysphagia.…”

<p>Impact of Metabolic Syndrome Components in High-Risk Cardiovascular Disease Development in Older Adults</p>

“…In the literature, the results of its use have been of utmost importance in CVD primary prevention. 13,14 Therefore, the present study aims to analyze the influence between the MS components and the independent risk for CVD in older adults. The initial hypothesis was that older adults with a higher number of MS components have a higher risk of developing CVD.…”