Seniors with vocal problems want treatment but aren't getting it

The breathy, hoarse voice of senior citizens is often thought to be a normal sign of aging. But doctors at the Duke Voice Care Center say that's a false perception that needs to change. And they've discovered that it may partially explain why seniors who want treatment for the condition aren't seeking it. That's a problem, added Seth Cohen, M.D., a Duke otolaryngologist and the study's lead author, because voice and swallowing concerns can lead to serious quality of life issues including anxiety, depression and social withdrawal.

Nearly 20 percent of the 248 octogenarians studied by the Duke researchers had dysphonia, the medical term for hoarseness, weakness or loss of voice. Fourteen percent had dysphagia or painful swallowing. Approximately three-quarters of the respondents (77.6% for dysphonia and 79.4% for dysphasia) had not sought treatment, even though more than half (55.9%) expressed interest in getting help.

"Voice and swallowing issues are serious concerns and people who want medical care are not getting it," says Cohen of the research presented at the 2008 annual meeting of the American Academy of Otolaryngology-Head and Neck Surgery in Chicago, IL. "Is it because they have so many medical problems and these issues are getting pushed aside or overlooked? We don't know. What we do know is these medical concerns have a huge impact on quality of life, and more people should be aware of the treatments available and be able to obtain help."

Previous studies have reported that nearly one-fourth of elderly individuals believe vocal and swallowing problems are a normal part of aging, a perception found to be even more common among those who actually suffer. The Duke physicians surmise that this may lead some elderly people to accept their difficulties and not seek treatment.

Half of those surveyed were unaware that treatment existed. This is a concern, says Cohen, because symptoms of depression were found to be more common among those affected. And, previous studies have reported a connection between the conditions and increased depression, anxiety and social withdrawal.

Cohen says part of the problem may be under-recognition. Primary care physicians are currently managing the many medical conditions elderly people routinely face, and may not be discussing voice and swallowing problems with their patients. Regardless, Cohen says the Duke data shows that needs to change.

"Our results highlight the need for better education of the general public and, primary care providers," Cohen said. "Whether this effort leads to increased awareness and/or better outcomes for these patients is the basis of further study. But for now, we know these problems have a significant negative impact on quality of life, and obtaining appropriate treatment can make a big difference."

Source: Duke University Medical Center