5 Ways Our Voices Change as We Age
Understading Presybyphonia and Age-Related Vocal Changes
Sharon Basaraba, Updated on February 03, 2020
Medically reviewed by Jenny Sweigard, MD
Table of Contents
If you’ve noticed that your voice doesn’t sound quite like it used to, it’s probably not your imagination. It is most likely due to a condition called presbyphonia in which the larynx (voice box) undergoes changes as part of the aging process.
What Is Presbyphonia?
Presbyphonia is characterized by aging-related changes to the vocal cords that notably alters a person’s voice. It is one of several types of a condition called dysphonia in which a person’s voice and voice quality can change for any number of reasons.
Presbyphonia is not dangerous, but it can influence a person’s ability to communicate and, in some cases, impair a person’s overall well-being (particularly if they are a singer or social creature).
The prefix presby- means “old” and the suffix -phonia means “voice.”
Presbyphonia can vary from one person to the next and manifest with certain characteristic signs and symptoms. Most symptoms develop gradually over time rather than abruptly, although some people only notice the changes when they are singing or raising their voice.
Many people experience a notable thinning of the voice as they age. The scientific term for this is vocal asthenia. It describes a less rich, less resonant sound and is a common complaint among older adults.1
As the folds of the vocal cords suffer muscle loss over time, they often become thinner and less pliable. Because they’re not vibrating as effectively or tightly together, the resulting voice doesn’t have the strength or resonance that it used to have.
Imagine that your larynx as a musical wind instrument. It requires effective vibration for a beautiful clear sound, and anything that interferes with the necessary closure of the vocal folds together will erode the quality of the sound you produce.
As vocal cords get stiffer with age—paired with injury to the larynx caused by reflux or smoking—they can become bowed and curve inward rather than vibrating tightly together. The result can be a scratchy, hoarse voice.2
Adults who are current smokers have a 1.8-fold increased risk of vocal hoarseness and other vocal problems compared to never-smokers.3
Changes in Volume
Aging can affect the projection and volume of the voice as well. In addition, while many older adults are able to maintain strong lung capacity, those with compromised respiratory systems—such as those with COPD—may find that their voices are quieter because they don’t have the breath support to maintain the force and volume to speak loudly.4
Changes in Pitch
Changes in pitch are common with aging. In women, the pitch typically drops over time, whereas a man’s pitch will typically rise slightly with age.1
Scientists don’t know exactly why this occurs, but it is assumed that, like other vocal shifts, changes in pitch may also be due to atrophy of the muscles in the vocal folds. In women, this may be due in part to hormonal changes associated with menopause.5
If your voice starts strong but fades throughout the day, vocal fatigue may be to blame. As with any type of fatigue, fatigue of the voice is use-related.
If your voice gets tired, it will tend to feel worse in the evening compared with earlier in the day. As a result, people used to conversing at dinner may find it more difficult to make their voices heard and can find themselves feeling tired and isolated.6
Psychological and Social Impact
People who have difficulty being heard in social situations may cope by speaking less, putting them at risk of withdrawal and depression. Although research has been conducted on the effects of hearing loss on quality of life, less has been done to assess the psychological impact of dysphonia and presbyphonia.
Some studies have shown that severe dysphonia can impact job performance, increasing the risk of absenteeism and decreasing job performance. 7
From a social standpoint, age may influence the psychological impact of presbyphonia. While it is common, for example, for a person with presbyphonia to feel isolated if they communicate with younger people, studies suggest that the impact may be less with people in nursing homes who understand that they have to compensate for these and other aging-related changes.8
There is no clear data about the prevalence of voice issues among older people. As a relatively new disorder, presbyphonia is largely understudied and treatment options remain uncertain.
Because scientists still have a limited understanding of the aging process, there is as of yet no specific strategy to prevent presbyphonia or ways to predict who will or will not be affected.
Tips for Good Vocal Hygiene
As a general rule, you may limit long-term injury to the larynx by practicing good vocal hygiene. Among some of the key tips:
- Drink plenty of water. Six to eight glasses a day is recommended.
- Avoid speaking too loudly or too softly. Both can stress your vocal cords.
- Avoid speaking or singing when your voice is hoarse or tired.
- Avoid noisy places where you have to raise your voice.
- Considered using a microphone when appropriate.
- Avoid or quit smoking.9
A Word From Verywell
If you are hoarse for more than two weeks—especially without a trigger like a cold or flu or if you are a long-time smoker—seek the advice of a doctor since you may be at risk of a more serious problem, including vocal cord nodules or even laryngeal cancer.
Minor issues like vocal fatigue and diminished volume can often be improved through voice therapy, in which a speech specialist can help you use your voice more effectively and with less effort.