title: The Aging Voice: Influence of Respiratory and Laryngeal Changes.
abstract: OBJECTIVE
  To evaluate the impact on voice quality of 2 pathogenic factors involved in age-related dysphonia: glottal gap and decline in respiratory function.
  
  
  METHODS
  Cross-sectional prospective.
  
  
  METHODS
  Tertiary referral center.
  
  
  METHODS
  A total of 105 healthy patients ≥65 years old were included, with a maximum phonation time ≤15 seconds for men and ≤12 seconds for women. Laryngostroboscopy and spirometry were conducted to assess the glottal gap and respiratory function, and 4 profiles were defined according to their combination: glottal deficit, respiratory deficit, combined deficit, and no deficit. Differences across profiles in phonation times, acoustic parameters, and GRBAS scale and Voice Handicap Index-10 scores were analyzed according to Kruskal-Wallis and Mann-Whitney nonparametric tests. Multiple regression was performed to estimate the influence of each pathogenic factor.
  
  
  RESULTS
  Respiratory deficit was the most frequent profile (37%). When compared to the other groups, patients with combined deficit had shorter phonation times for men (8.5 seconds; Kruskal-Wallis, P = .009) and women (7.8 seconds; P = .003), worse jitter (8.3%; P = .001), GRBAS scale (5.8; P < .001), and Voice Handicap Index-10 (7.7; P = .002).
  
  
  CONCLUSIONS
  Age-related respiratory and laryngeal changes have a negative impact on vocal quality, especially when both deficits are present.
authors.affiliation: Department of Otolaryngology, Hospital Universitario Ramón y Cajal, University of Alcalá de Henares, Madrid, Spain miguel.vaca.gonzalez@gmail.com.
authors.forename: Miguel
authors.initials: M
authors.lastname: Vaca
authors.affiliation: Department of Otolaryngology, Hospital Universitario Ramón y Cajal, University of Alcalá de Henares, Madrid, Spain.
authors.forename: Elena
authors.initials: E
authors.lastname: Mora
authors.affiliation: Department of Otolaryngology, Hospital Universitario Ramón y Cajal, University of Alcalá de Henares, Madrid, Spain.
authors.forename: Ignacio
authors.initials: I
authors.lastname: Cobeta
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000502:physiology*; D003430:Cross-Sectional Studies; D055154:Dysphonia / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008297:Male; D010699:Phonation / Q000502:physiology; D011446:Prospective Studies; D013147:Spirometry; D049489:Stroboscopy; D014833:Voice Quality / Q000502:physiology*
keywords: glottal gap; presbyphonia; respiratory aging; vocal aging