How does our voice change as we age? (Rojas et al., 2020)

Purpose: Approximately 30% of adults over the age of 50 years present with altered vocal function. Our understanding of how these changes manifest acoustically and perceptually is derived from relatively modest-sized studies using a diversity of tools. Voice changes can arise from the onset of disease or disorder, but also age-related physiological changes, which may not reflect pathology as such. Here, we bring together data on acoustic, perceptual, and instrumental assessments (electroglottography), with the aim of gaining a better understanding of the changes occurring across these measurement domains. We consider these changes in the context of different acoustic features, software programs, and perceptual protocols.Method: Studies of voice function in healthy older adults over the age of 50 years were sought. Literature was systematically searched with 746 abstracts reviewed. Forty-seven studies were included in the review. A meta-analysis of included studies compared voice acoustic parameters between sex and age. Sixteen acoustic parameters collected from 1,475 participants were analyzed in the meta-analysis. These included some previously unpublished analyses using data provided by authors of included studies.Results: Data from the systematic review suggest that older individuals are perceived to present with higher overall scores of dysphonia and roughness, breathiness, strain, and instability. Acoustically, males have significantly higher scores on measures of perturbation, including noise-to-harmonic ratio and absolute jitter. The meta-analysis outcomes suggest that participants aged 80–89 years produce significantly higher fundamental frequency, jitter percent, shimmer percent, and shimmer in decibels compared to participants aged 60–69 years and a significant increase in relative average perturbation, jitter percent, and shimmer in decibels compared to participants aged 70–79 years. Limited data were available comparing acoustic measures using the same acoustic software.Conclusions: Variations in fundamental frequency and frequency and amplitude perturbation increase as healthy adults age. It was difficult to draw definitive conclusions based on existing literature due to variability in hardware used, limited descriptions of study cohorts, or missing data from statistical analysis.I. Tables S1–S15. Comparison between males and femalesII. Tables S16–S39. Comparison by age —a) Tables S16–S23. 60–69 vs. 70–79 —b) Tables S24–S31. 60–69 vs. 80–89 —c) Tables S32–S39. 70–79 vs. 80–89III. Tables S40–S54. Comparison between males and females by age (60 to 69) – (70 to 79) – (80 to 89) IV. Tables S55–S62. Comparison between males and females using the same acoustic analysis software —a) Tables S55–S59. Multidimensional Voice Program (MDVP) —b) Tables S60–S62. PRAATRojas, S., Kefalianos, E., & Vogel, A. (2020). How does our voice change as we age? A systematic review and meta-analysis of acoustic and perceptual voice data from healthy adults over 50 years of age. Journal of Speech, Language, and Hearing Research. Advance online publication. https://doi.org/10.1044/2019_JSLHR-19-00099

目的：约30%的50岁以上的成年人表现出声音功能的改变。我们对这些变化在声学及感知层面的理解主要来源于规模相对较小的、采用多样化工具的研究。声音的改变可能源于疾病或失调的初发，亦或与年龄相关的生理变化，后者可能并不反映具体的病理状态。在本研究中，我们将声学、感知和仪器评估（如声带电图）方面的数据汇集在一起，旨在更深入地理解这些测量领域中的变化。我们将这些变化置于不同的声学特征、软件程序及感知协议的背景下进行考量。方法：旨在寻找50岁以上健康成年人的声音功能研究。系统性地检索文献，共审查了746篇摘要。纳入回顾性分析的共有47项研究。对纳入的研究进行荟萃分析，比较了性别和年龄之间的声音声学参数。在荟萃分析中，分析了来自1,475名参与者的16个声学参数。这些参数包括一些以前未发表的分析，使用了纳入研究作者提供的数据。结果：系统综述的数据表明，老年人被认为在声带不协调、粗糙、气息、紧张和不稳定等方面具有更高的总体得分。在声学上，男性在扰动度量的指标上（包括噪声与谐波比和绝对抖动）显著高于女性。荟萃分析的结果表明，80至89岁的参与者与60至69岁的参与者相比，其基频、抖动百分比、闪烁百分比和闪烁分贝均显著提高，与70至79岁的参与者相比，相对平均扰动、抖动百分比和闪烁分贝也有显著增加。使用相同声学软件比较声学测量的数据有限。结论：随着年龄的增长，基频和频率及振幅扰动的变化逐渐增大。由于硬件使用的差异性、研究队列描述的有限性或统计分析中数据的缺失，基于现有文献难以得出确定的结论。I. 表S1-S15.男性和女性之间的比较II. 表S16-S39.按年龄比较——a) 表S16-S23. 60-69岁与70-79岁b) 表S24-S31. 60-69岁与80-89岁c) 表S32-S39. 70-79岁与80-89岁III. 表S40-S54.按年龄比较的男性和女性（60至69岁）——（70至79岁）——（80至89岁）IV. 表S55-S62.使用相同声学分析软件的男性和女性之间的比较——a) 表S55-S59. 多维语音程序（MDVP）b) 表S60-S62. PRAATRojas, S., Kefalianos, E., & Vogel, A. (2020). 随着我们年龄的增长，我们的声音是如何变化的？来自50岁以上健康成年人的声学和感知声学数据的系统综述和荟萃分析。言语、语言和听力研究杂志。在线预发表。https://doi.org/10.1044/2019_JSLHR-19-00099