Voz do idoso: o avanço da idade gera diferentes impactos?
Aged voice: does advancing age generate different impacts?
Anna Beatriz de Paiva Gomes; Marcia Simões-Zenari; Kátia Nemr
Resumo
Objetivo: Verificar se existem diferenças em aspectos vocais entre idosos com presbifonia, divididos em três faixas etárias. Método: Participaram 60 idosos de ambos os sexos com idades entre 60 e 90 anos (média=72,3), com diagnóstico de presbifonia estabelecido em avaliação otorrinolaringológica. A partir da gravação das vozes foi realizada análise perceptivo-auditiva e acústica e os dados foram comparados por meio dos testes estatísticos com os participantes divididos nos grupos etários 60-70 anos, 71-80 anos e 81-90 anos. Resultados: Ainda que os idosos dos três grupos tenham apresentado alterações em aspectos vocais variados, como instabilidade e ruído em frequências graves, aqueles com mais de 80 anos apresentaram maior grau de disfonia, rugosidade, soprosidade e pitch. Também foram observados neste grupo maiores desvios em jitter, shimmer e irregularidade e a medida GNE no limite da normalidade. Todas as diferenças foram estatisticamente significativas. A maioria dos idosos dessa faixa etária apresentou ainda alteração no diagrama de desvio fonatório e quebra de frequência. Conclusão: Diversos aspectos perceptivo-auditivos e acústicos se apresentaram mais desviados nos idosos mais velhos, o que reforça a necessidade de serem consideradas essas especificidades tanto na avaliação dos efeitos do envelhecimento na voz quanto no desenvolvimento de ações para minimizar o declínio vocal.
Palavras-chave
Abstract
Purpose: To verify if there are differences in the vocal aspects of older people from three different age groups with presbyphonia diagnosis. Methods: Sixty older adults joined this study. They were both female and male, with an age range from 60 to 90 years old (average: 72.3) and with presbyphonia diagnosis established after otolaryngology evaluation. From their voice recordings, it was possible to make the acoustic and auditory-perceptual analysis. The data collected was compared through statistical tests considering the division of the participants into the following groups: 60-70 years old, 71-80 years old, and 81-90 years old. Results: Even though the older people from all of the three groups have presented deviation in multiple vocal aspects such as instability and vocal noise in low frequencies, those with more than 80 years old have presented a higher deviation of the general grade of dysphonia, roughness, breathiness, and pitch. In this group, it was also observed higher deviations in jitter, shimmer, vocal breaks, and the GNE measure on the edge of normality. All the differences were statistically significant. The majority of the older participants from that group presented even a deviation in the phonatory deviation diagram and frequency break. Conclusion: Various acoustic and auditory-perceptual aspects had a higher deviation in the older adults over 80 years old, which reinforces the need to consider those specificities in the evaluation of the vocal aging impacts and also in the development of actions to minimize vocal declination.
Keywords
Referências
1) Mezzedimi C, Di Francesco M, Livi W, Spinosi MC, De Felice C. Objective evaluation of presbyphonia: spectroacoustic study on 142 patients with Praat. J Voice. 2017;31(2):257.e25-32. http://dx.doi.org/10.1016/j.jvoice.2016.05.022 PMid:27427181.
» http://dx.doi.org/10.1016/j.jvoice.2016.05.022
2) Wong HYK, Ma EPM. Self-Perceived voice problems in a nontreatment seeking older population in Hong Kong. J Voice. 2021;35(4):597-603. http://dx.doi.org/10.1016/j.jvoice.2019.12.012 PMid:31911022.
» http://dx.doi.org/10.1016/j.jvoice.2019.12.012
3) Gregory ND, Chandran S, Lurie D, Sataloff RT. Voice Disorders in the elderly. J Voice. 2012;26(2):254-8. http://dx.doi.org/10.1016/j.jvoice.2010.10.024 PMid:21530163.
» http://dx.doi.org/10.1016/j.jvoice.2010.10.024
4) Kendall K. Presbyphonia: a review. Curr Opin Otolaryngol Head Neck Surg. 2007;15(3):137-40. http://dx.doi.org/10.1097/MOO.0b013e328166794f PMid:17483679.
» http://dx.doi.org/10.1097/MOO.0b013e328166794f
5) Kost KM, Sataloff RT. Voice disorders in the elderly. Clin Geriatr Med. 2018;34(2):191-203. http://dx.doi.org/10.1016/j.cger.2018.01.010 PMid:29661332.
» http://dx.doi.org/10.1016/j.cger.2018.01.010
6) Angadi V, McMullen C, Andreatta R, Dietrich M, Uhl T, Stemple J. Biobehavioral measures of Presbylaryngeus. J Voice. 2020;34(3):415-25. http://dx.doi.org/10.1016/j.jvoice.2018.11.005 PMid:30503609.
» http://dx.doi.org/10.1016/j.jvoice.2018.11.005
7) Martins RH, Gonçalvez TM, Pessin AB, Branco A. Aging voice: presbyphonia. Aging Clin Exp Res. 2014;26(1):1-5. http://dx.doi.org/10.1007/s40520-013-0143-5 PMid:24068559.
» http://dx.doi.org/10.1007/s40520-013-0143-5
8) Menezes LN, Vicente LCC. Envelhecimento vocal em idosos instucionalizados. Rev CEFAC. 2007;9(1):90-8. http://dx.doi.org/10.1590/S1516-18462007000100012
» http://dx.doi.org/10.1590/S1516-18462007000100012
9) Gois ACB, Pernambuco LA, Lima KC. Factors associated with voice disorders among the elderly: a systematic review. Braz J Otorhinolaryngol. 2018;84(4):506-13. http://dx.doi.org/10.1016/j.bjorl.2017.11.002 PMid:29331352.
» http://dx.doi.org/10.1016/j.bjorl.2017.11.002
10) Miranda GMD, Mendes ACG, Silva ALA. Population aging in Brazil: current and future social challenges and consequences. Rev Bras Geriatr Gerontol. 2016;19(3):507-19. http://dx.doi.org/10.1590/1809-98232016019.150140
» http://dx.doi.org/10.1590/1809-98232016019.150140
11) Behlau M, Rocha B, Englert M, Madazio G. Validation of the Brazilian Portuguese CAPE-V Instrument-Br CAPE-V for Auditory-Perceptual Analysis. J Voice. 2020. In press.http://dx.doi.org/10.1016/j.jvoice.2020.07.007 PMid:32811691.
» http://dx.doi.org/10.1016/j.jvoice.2020.07.007
12) ASHA: American Speech-Language-Hearing Association. Consensus Auditory-Perceptual Evaluation of Voice (CAPE-V). ASHA Special Interest Group 3, Voice and Voice Disorders [Internet]. Washington: ASHA; 2009 [citado em 2020 Abr 24]. Disponível em: https://www.asha.org/uploadedFiles/ASHA/SIG/03/CAPE-V-Procedures-and-Form.pdf
» https://www.asha.org/uploadedFiles/ASHA/SIG/03/CAPE-V-Procedures-and-Form.pdf
13) Sulter AM, Schutte HK, Miller DG. Standardized laryngeal videostroboscopic rating: differences between untrained and trained male and female subjects, and effects of varying sound intensity, fundamental frequency and age. J Voice. 1996;10(2):175-89. http://dx.doi.org/10.1016/S0892-1997(96)80045-2 PMid:8734393.
» http://dx.doi.org/10.1016/S0892-1997(96)80045-2
14) Aquino FS, Silva MA, Teles LC, Ferreira LP. Características da voz falada de idosas com prática de canto coral. CoDAS. 2016;28(4):446-53. http://dx.doi.org/10.1590/2317-1782/20162015109 PMid:27652927.
» http://dx.doi.org/10.1590/2317-1782/20162015109
15) Meirelles RC, Bak R, Cruz FC. Presbifonia. Revista do Hospital Universitário Pedro Ernesto. 2012;11:77-82.
Submetido em:
24/04/2020
Aceito em:
30/10/2020
Facebook
Google+
Twitter
LinkedIn
Mendeley
StumbleUpon
CiteULike
Reddit
Email