Speech Changes in Older Adults

Published In Health & Safety

July 17th, 2016

Did you know that your voice and manner of speaking may change with age?

As we age, the reality is that our voices change. Some people also experience changes in their ability to speak and communicate. These changes can make some feel like they are losing their edge, or worse, losing control over an important physical function.

For what it is worth, most of this is predictable and normal. Our purpose here is to discuss some of these changes, many of which are “normal,” and to help you understand what may be going on. BUT, and this is a big BUT, we are not medical professionals, and as such, our discussion here should not be interpreted as, or substituted for, medical advice. If you are concerned about a change in your voice, speech or communication, you should see a doctor right away to find out if these changes are indicative of a serious health issue.

Age-Related Changes Affecting Vocal Production

Normal aging may cause tissue, glandular, and muscular changes in the jaw, tongue, salivary glands and throat. The vocal mechanism is specifically affected by age. Weakness, reduced intensity, hoarseness, trembling, and alteration in vocal pitch often characterizes the voice of older adults. These changes are related to the aging of the larynx and supporting structures. Common in the aging process is an increase in calcium and hardening of the cartilage of the larynx. There may also be decreased blood supply to those parts of the body that produce and affect voice tonality, and a decrease in respiration that can affect vocal production. Voice pitch generally increases in aging males and decreases in women. Jittering of the voice may increase because of reduced neuromuscular control (Normal Aging Changes in Speech, Language, and Swallowing, American Speech and Hearing Association, January/February 1999)

Factors Impacting Speech and Communication

Sensory, cognitive, and neurological factors play a role in speech changes and communication skills in older adults.

Among the sensory factors that have big implications on speech production are vision and hearing.

  • Decreased visual acuity has direct and indirect implications on communication. Visual input is integral to typical communication. Nonverbal cues supplement verbal communication. Therefore, the lack of sight, or reduced vision, reduces the ability to pick up on nonverbal cues, making conversation more difficult. Indirectly, loss of vision may result in reduced social interaction, greater social isolation, and a reduced chance to talk to and learn from others.
  • Decreased hearing is also a factor in speech clarity and tonality. Hearing changes are associated with loss of sound sensitivity, especially for higher frequency sounds. In turn, this causes problems with speech recognition ability, especially in the presence of background noise.

Cognitive factors can also play a major role. The slower speed of mental processing that comes with age can affect speech and language functions such as list production (for example, ‘name 15 items that begin with the letter g’), picture naming, auditory comprehension, and working memory. Working memory is especially interesting because it involves a person’s ability to simultaneously remember and manipulate information. In speech, working memory is important because, if impaired, the individual is less able to process complex sentences or recall verbal or written information, especially if given at the same time. That inability can result in third-parties communicating less with the older adult, and he or she with them.

Finally, Neurological problems can also adversely affect a person’s speech. Three common problems are:

  • Aphasia which is the loss of the ability to understand, process, or express language. Nonfluent or expressive aphasia is the loss of the ability to express thoughts in speech or writing. Fluent or receptive aphasia is the loss of the ability to understand spoken or written speech. The most common causes of aphasia are stroke or trans-ischemic attack (TIA).
  • Dysphonia, which is a speech disorder that gives a hoarse quality to the voice. It can be caused by an injury to the nerve that affects the larynx or a tumor in the brain stem. It also has other possible causes that are not related to nervous system problems.
  • Dysarthria, which is a problem with pronunciation and the rhythm of speech. A person with this problem may seem to stumble over words. This symptom may be caused by a degenerative disease, such as parkinsonism.

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