Laryngeal Aerodynamics in Healthy Older Adults and Adults With Parkinson's Disease

Abstract

Purpose: The present study compared laryngeal aerodynamic function of healthy older adults (HOA) to adults with Parkinson's disease (PD) while speaking at a comfortable and increased vocal intensity. Method: Laryngeal aerodynamic measures (subglottal pressure, peak-to-peak flow, minimum flow, and open quotient [OQ]) were compared between HOAs and individuals with PD who had a diagnosis of hypophonia. Increased vocal intensity was elicited via monaurally presented multitalker background noise. Results: At a comfortable speaking intensity, HOAs and individuals with PD produced comparable vocal intensity, rates of vocal fold closure, and minimum flow. HOAs used smaller OQs, higher subglottal pressure, and lower peak-topeak flow than individuals with PD. Both groups increased speaking intensity when speaking in noise to the same degree. However, HOAs produced increased intensity with greater driving pressure, faster vocal fold closure rates, and smaller OQs than individuals with PD. Conclusions: Monaural background noise elicited equivalent vocal intensity increases in HOAs and individuals with PD. Although both groups used laryngeal mechanisms as expected to increase sound pressure level, they used these mechanisms to different degrees. The HOAs appeared to have better control of the laryngeal mechanism to make changes to their vocal intensity. It is projected that more than 610,000 individuals will be affected by PD by 2030(Dorsey et al., 2007. Aging of the general population and increased prevalence of PD motivate the need to understand how age, disease state, and disease progression affect underlying speech subsystems. With the aging of the general population, and with an increased prevalence of individuals with PD, the first purpose of the current study was to investigate whether healthy older adults (HOAs) and individuals with PD perform similarly with respect to laryngeal function during speech. Further, as hypophonia (perceptually quiet voice) is a concern in individuals with PD, the second purpose of the current study was to assess whether HOAs and adults with PD and hypophonia were able to utilize the same laryngeal adjustments when increasing sound pressure level (SPL).Typically aging adults may experience qualitative voice changes as they age. One investigation of younger and older women reported that older women were no breathier than their younger peers (Gorham-Rowan & Laures-Gore, 2006). However, other studies described the voices of typically aging adults as having a breathy quality

A Pilot Study of the Effect of a Non-Contact Boxing Exercise Intervention on Respiratory Pressure and Phonation Aerodynamics in People with Parkinson’s Disease

“…During vocal communication, activation of the respiratory muscles represents the initiation of a coordinated process of respiratory-laryngeal-vocal tract activity leading to the generation of subglottal pressure, transglottal airflow, and phonation to produce voiced acoustic energy [5]. Subglottal pressure and transglottal airflow are negatively impacted by PD and contribute to the characteristic hypophonia exemplified by low volume and breathy voice quality [6,7]. This dysphonia can be present in mild form at disease onset, but typically transitions to greater levels of severity as the disease progresses over time and will eventually impact over 70% of all people with PD (PWPD) [8,9].…”