Geriatric Dysphonia: Characteristics of Diagnoses in Age-Based Cohorts in a Tertiary Voice Clinic

Jeremy Applebaum, Aisha Harun, Ashley Davis, Alexander Tell Hillel, Simon R Best, Lee M Akst

Research output: Contribution to journalArticle

Abstract

Objective: An aging population has increased focus on geriatric otolaryngology. Those ≥65 years old are not a uniform population, however, and recent gerontology literature recognizes important physiologic differences between the young-old (ages 65-74 years), middle-old (75-84), and old-old (≥85). This study evaluates differences within these groups among dysphonia patients ≥65 years relative to diagnosis and voice-related quality of life (V-RQOL). Methods: Chart review of all new patients ≥65 years presenting to the Johns Hopkins Voice Center between April 2015 and March 2017 identified chief complaint, diagnosis, and self-reported voice handicap. Etiology of dysphonia diagnoses were classified. Diagnostic categories and V-RQOL were evaluated as functions of patient age and gender. Results: Of 839 new patients ≥65 years, 463 (55.2%) reported chief complaint of dysphonia, with the most common etiologies being vocal fold immobility (28.3%) and atrophy (21.6%). Younger cohorts were more likely to present with benign vocal fold lesion and vocal fold immobility, while older cohorts were more likely to present with atrophy (P =.016). The odds of having a diagnosis of vocal fold atrophy increased 7% with each year of life (odds ratio = 1.07; 95% CI, 1.03-1.11). V-RQOL scores were similar across gender and age categorization. Conclusion: Dysphonia patients ≥65 years are not a uniform group, and important differences exist in terms of diagnosis as a function of age. Knowledge of these differences may inform further investigations in the growing field of geriatric otolaryngology.

Original languageEnglish (US)
JournalAnnals of Otology, Rhinology and Laryngology
DOIs
StatePublished - Jan 1 2019

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Dysphonia
Geriatrics
Vocal Cords
Voice Quality
Atrophy
Quality of Life
Otolaryngology
Population
Odds Ratio

Keywords

  • dysphonia
  • geriatrics
  • V-RQOL
  • vocal fold atrophy
  • vocal fold immobility

ASJC Scopus subject areas

  • Otorhinolaryngology

Cite this

@article{e9ca8ecaf3a94fd8a3733b8b83ec7a3a,
title = "Geriatric Dysphonia: Characteristics of Diagnoses in Age-Based Cohorts in a Tertiary Voice Clinic",
abstract = "Objective: An aging population has increased focus on geriatric otolaryngology. Those ≥65 years old are not a uniform population, however, and recent gerontology literature recognizes important physiologic differences between the young-old (ages 65-74 years), middle-old (75-84), and old-old (≥85). This study evaluates differences within these groups among dysphonia patients ≥65 years relative to diagnosis and voice-related quality of life (V-RQOL). Methods: Chart review of all new patients ≥65 years presenting to the Johns Hopkins Voice Center between April 2015 and March 2017 identified chief complaint, diagnosis, and self-reported voice handicap. Etiology of dysphonia diagnoses were classified. Diagnostic categories and V-RQOL were evaluated as functions of patient age and gender. Results: Of 839 new patients ≥65 years, 463 (55.2{\%}) reported chief complaint of dysphonia, with the most common etiologies being vocal fold immobility (28.3{\%}) and atrophy (21.6{\%}). Younger cohorts were more likely to present with benign vocal fold lesion and vocal fold immobility, while older cohorts were more likely to present with atrophy (P =.016). The odds of having a diagnosis of vocal fold atrophy increased 7{\%} with each year of life (odds ratio = 1.07; 95{\%} CI, 1.03-1.11). V-RQOL scores were similar across gender and age categorization. Conclusion: Dysphonia patients ≥65 years are not a uniform group, and important differences exist in terms of diagnosis as a function of age. Knowledge of these differences may inform further investigations in the growing field of geriatric otolaryngology.",
keywords = "dysphonia, geriatrics, V-RQOL, vocal fold atrophy, vocal fold immobility",
author = "Jeremy Applebaum and Aisha Harun and Ashley Davis and Hillel, {Alexander Tell} and Best, {Simon R} and Akst, {Lee M}",
year = "2019",
month = "1",
day = "1",
doi = "10.1177/0003489419826133",
language = "English (US)",
journal = "Annals of Otology, Rhinology and Laryngology",
issn = "0003-4894",
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TY - JOUR

T1 - Geriatric Dysphonia

T2 - Characteristics of Diagnoses in Age-Based Cohorts in a Tertiary Voice Clinic

AU - Applebaum, Jeremy

AU - Harun, Aisha

AU - Davis, Ashley

AU - Hillel, Alexander Tell

AU - Best, Simon R

AU - Akst, Lee M

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Objective: An aging population has increased focus on geriatric otolaryngology. Those ≥65 years old are not a uniform population, however, and recent gerontology literature recognizes important physiologic differences between the young-old (ages 65-74 years), middle-old (75-84), and old-old (≥85). This study evaluates differences within these groups among dysphonia patients ≥65 years relative to diagnosis and voice-related quality of life (V-RQOL). Methods: Chart review of all new patients ≥65 years presenting to the Johns Hopkins Voice Center between April 2015 and March 2017 identified chief complaint, diagnosis, and self-reported voice handicap. Etiology of dysphonia diagnoses were classified. Diagnostic categories and V-RQOL were evaluated as functions of patient age and gender. Results: Of 839 new patients ≥65 years, 463 (55.2%) reported chief complaint of dysphonia, with the most common etiologies being vocal fold immobility (28.3%) and atrophy (21.6%). Younger cohorts were more likely to present with benign vocal fold lesion and vocal fold immobility, while older cohorts were more likely to present with atrophy (P =.016). The odds of having a diagnosis of vocal fold atrophy increased 7% with each year of life (odds ratio = 1.07; 95% CI, 1.03-1.11). V-RQOL scores were similar across gender and age categorization. Conclusion: Dysphonia patients ≥65 years are not a uniform group, and important differences exist in terms of diagnosis as a function of age. Knowledge of these differences may inform further investigations in the growing field of geriatric otolaryngology.

AB - Objective: An aging population has increased focus on geriatric otolaryngology. Those ≥65 years old are not a uniform population, however, and recent gerontology literature recognizes important physiologic differences between the young-old (ages 65-74 years), middle-old (75-84), and old-old (≥85). This study evaluates differences within these groups among dysphonia patients ≥65 years relative to diagnosis and voice-related quality of life (V-RQOL). Methods: Chart review of all new patients ≥65 years presenting to the Johns Hopkins Voice Center between April 2015 and March 2017 identified chief complaint, diagnosis, and self-reported voice handicap. Etiology of dysphonia diagnoses were classified. Diagnostic categories and V-RQOL were evaluated as functions of patient age and gender. Results: Of 839 new patients ≥65 years, 463 (55.2%) reported chief complaint of dysphonia, with the most common etiologies being vocal fold immobility (28.3%) and atrophy (21.6%). Younger cohorts were more likely to present with benign vocal fold lesion and vocal fold immobility, while older cohorts were more likely to present with atrophy (P =.016). The odds of having a diagnosis of vocal fold atrophy increased 7% with each year of life (odds ratio = 1.07; 95% CI, 1.03-1.11). V-RQOL scores were similar across gender and age categorization. Conclusion: Dysphonia patients ≥65 years are not a uniform group, and important differences exist in terms of diagnosis as a function of age. Knowledge of these differences may inform further investigations in the growing field of geriatric otolaryngology.

KW - dysphonia

KW - geriatrics

KW - V-RQOL

KW - vocal fold atrophy

KW - vocal fold immobility

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