The man in the exam chair at the Henry Ford voice clinic explains his dilemma, saying in a raspy voice that he thinks he has something in his throat.
There’s the theory that he might have breathed in glass particles while standing close to a car window that shattered. Dr. Robert Stachler, an ear, nose, and throat doctor and specialist in voice and swallowing disorders, discovers something more prosaic: a lesion on one of the vocal cords likely caused by chronic acid reflux.
This is the highly technical nature of Stachler’s job: Using intricate cameras and a keen eye, he can identify underlying medical issues that affect the way we feel and sound when we talk. But that doesn’t mean he can’t appreciate the much more nuanced, personal, and mysterious qualities of what he deals with daily. “Let’s face it,” he says with a sly smile as he sits in his office at Henry Ford Hospital in Detroit. “Who doesn’t love a sexy voice?”
Every voice is distinct. The “sexy” ones have the power to attract. Others can repulse. Research shows that attractive voices often go hand in hand with attractive physical features. And then there’s the element of age. Researchers also know we can distinguish fairly accurately between older and younger people just by listening to their voices.
Unfortunately, what generally passes for “sexy,” youthful vocal qualities — smooth, not raspy; higher pitches in females, lower pitches in males — are just as susceptible to the aging process as other parts of the body that get more attention. Yet in a culture that places a premium on appearance, the need to preserve the voice doesn’t exactly register as high as, say, maintaining supple skin. In our quest for the fountain of youth, experts agree our voices are getting drowned out.
“We take our voices for granted, for sure,” says Freda Herseth, chair of the voice department at the University of Michigan and a singing-voice specialist. She should know. As a professional opera singer, she’s had to pay attention to her voice all her life. She understands, however, why most people don’t give it a second thought. “Why should people think about [the voice]? We don’t grow up learning how to speak. It’s just something we do by rote.”
But unlike the relatively vain threat of losing our looks, various medical studies have shown that even moderate presbyphonia, or age-related changes to the voice, can reduce quality of life. These vocal changes can be physiological — related to aging alone — or pathological, as when something as common as acid reflux directly affects the vocal cords. Whatever the cause, quality of life can begin to erode as people become more aware or embarrassed of how they sound. They may start to avoid social situations, which can have a ripple effect on other aspects of their lives. Herseth says the voice is a fingerprint of who we are, and when we no longer sound like ourselves, it’s a jarring experience.
Beyond social implications, people with age-related vocal disorders may simply experience extreme discomfort or frustration over the strain to maintain normal pitch. They may tire easily when trying to speak “normally.” Sometimes neglecting to get help can make matters worse. The aging voice may be a complex problem, but one that is “very apropos,” says Stachler, as the first wave of baby boomers head toward old age and become more conscious of the overall approach they must take to maintain vitality.
A simple anatomy lesson: Everyone’s vocal folds or “cords,” which are basically two muscles covered by layers of tissue, will weaken over time. In women, the covering of the vocal cords tends to thicken, causing female voices to sound lower, usually during their 60s and beyond. In men, however, the muscles themselves tend to atrophy, which can cause a man’s voice to register slightly higher in tone as he ages. Depending on the severity of the changes, a voice might start to sound weak, thin, breathy, or unsteady with reduced projection.
Studies have estimated that between 12 and 35 percent of the elderly will at some point experience these types of changes to their voice because of aging alone. But just like applying sunscreen to ward off wrinkles, there are some pretty basic ways to help retain a more youthful voice.
“This may sound simple, but you’d be surprised at how many people neglect to drink water,” says Herseth, who coaches singers and conducts vocal therapy for those with vocal disorders. “Especially as we get older, we don’t feel thirsty, even though the body needs hydration.” When vocal cords are properly hydrated, Herseth explains, they’ll vibrate better.
Stachler says vocal health is straightforward. What’s bad for the body is bad for the voice. He tells patients: “Don’t drink. Don’t smoke. Eat healthy. Exercise.”
“A healthy voice goes along with a healthy body. If you look good, you sound good.” In fact, keeping youthful qualities of your voice is another reason to exercise. Strong lung function equates with strong airflow, and “ample airflow is so important for the voice,” Herseth says. “Without it, we lose the ability to project.”
There are several treatment options for presbyphonia. If, however, an adult ever experiences hoarseness for more than two weeks, Stachler warns not to ignore it. It probably has nothing to do with age. “The voice is often the first indicator that something systemic is going on,” he says. Two potentially serious conditions that can manifest themselves in the voice are central neurologic disorders and neoplasia (benign tumors that can turn cancerous).
Once a doctor has ruled out underlying medical conditions, speech or vocal therapy is usually the first (and only) step needed to restore voice quality. Experts say it’s remarkably effective. Using exercises that concentrate on posture and improving airflow, Herseth says she nearly always sees progress.
“We may not be able to get back to how we sounded in our 20s,” she says, “but I think we can definitely get back to our best voice possible.”