Feeling hoarse as you get older? Here’s how to protect your voice

Written by JoAnna Sloggy, a speech language pathologist and singing-voice specialist at the UK Voice and Swallow Clinic. 

As you grow older, you may not be able to talk all day without your voice getting tired or hoarse. These vocal changes happen gradually and can cause multiple issues. Some find that to avoid straining their voice further, they start avoiding activities that they used to enjoy when these activities include a lot of talking.

People often complain of vocal tiredness (fatigue), vocal quality changes (such as roughness, scratchiness or hoarseness), changes in how high or low your voice can go, and increased vocal “work” (effort). These changes can be due to aging changes of the voice, or presbyphonia. Vocal quality changes are a result of changes to the voice box (larynx) and the vocal cords (vocal folds) which is called presbylarynges. The vocal folds need to be able to completely close and vibrate evenly for efficient voicing.

In some people, changes from aging cause the vocal fold muscles to weaken or lose muscle mass (atrophy). This can keep the vocal folds from closing all the way, making it harder to speak. This increased effort to talk causes the voice to tire more quickly. These vocal aging changes may even contribute to swallowing problems if the vocal fold gap grows large enough.

Diagnosis and treatment

This type of vocal change is usually diagnosed by an ear, nose and throat doctor (ENT) and a speech-language pathologist (SLP) who specializes in voice disorders. Once the vocal folds have been visualized and the diagnosis made, the primary way to restore the voice is to work with the voice SLP for specific vocal exercises designed to strengthen and rebalance the vocal folds and the surrounding musculature and other systems that work together for voice production.

If the vocal atrophy is bad enough, you may be recommended to see the ENT for a procedure that uses fillers to plump up the vocal folds to help them close. This type of “voice lift” is performed by an ENT or laryngologist (an ENT with specialized training in treating voice disorders). You may need to see the SLP following the procedure for exercises to rebalance your throat muscles. Once you have reached the improvement in vocal quality that you are pleased with, voice exercises to maintain this level of improvement are suggested to keep your voice strong.

Tips to help keep your voice healthy as you age

• See your doctor if hoarseness persists for more than one week. This may be the first sign of serious illness such as throat cancer.
• Use your voice – just like physical exercise keeps your muscles in shape, regular talking provides exercise to your vocal folds. While this is not usually enough to strengthen the vocal folds, it can help avoid further weakening from disuse.
• Sing – joining a choir is an excellent way to build some extra vocal strength through singing exercises.
• Practice good vocal hygiene.