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What is Old People's Voice and Why Does It Happen?

A few days ago, TGB reader and my good friend Wendl left a comment wondering about her recent vocal changes:

”...weaker, cracky, hoarse, reedy, phlegmy, etc. I think my vocal cords actually started changing when I retired and stopped talking all day. Use 'em or lose 'em?”

We all know what Wendl is talking about – I call it old people's voice - and she has done a good job of describing it in almost the same words as the medical professionals do. They call it presbyphonia which just means “changes associated with the ageing voice.”

I spent way too much time online looking for an audio example for us and found mostly actors doing impressions of old people's voices so that will have to do.

Here is a pretty good one titled: Older Woman: Voice Acting. There are three variations. The closest to what we're discussing today is the first and it ends at :45 seconds. You can skip the rest of the video.

Geriatric otolaryngology is the study of the ear, nose, mouth, throat, larynx and pretty much anything else from the neck and above as it relates, in this case, to old people.

Otolaryngologists used to be called “ear, nose and throat doctors: or ENT for short.

The Australian website entwellbeing is remarkably consistent with Wendl's description of this condition of the voice,

”...the inability to produce adequate sound using the vocal mechanism. People with presbyphonia may experience:

Occasional or frequent breaks in their voice
A breathy vocal quality
Laryngeal tension
Sudden interruptions in the normal flow of speech – stoppages in phonation
Reduced pitch and loudness

NBC News explains the underlying causes:

”When we age, our vocal chords weaken and become drier...Weakened and dry vocal chords become stringy, which prevent normal vibration, causing higher pitched voices that sound thin.

“And the transformations in the respiratory system and chest mean we have less power behind our voices. Even the joints in our vocal chords can become arthritic, contributing to problems.”

There are good descriptions of the five ways our voices change at the verywell website. Here's their take on how pitch changes:

”According to Clark Rosen, professor of otolaryngology at the University of Pittsburgh and director of the University's Voice Center, a woman's pitch typically drops over time, whereas a man's pitch actually rises slightly with age.

"'We don't know exactly why this occurs,' says Rosen. 'Like other vocal shifts, changes in pitch may also be due to atrophy of the muscles in the vocal folds, and in women it may be thanks in part to hormonal changes leading up to and past menopause. We do know there's quite a consistent pitch change by gender.'"

You will find equally clear explanations for the other four changes at verywell.com.

Although benign vocal changes are common as we age, Rosen says they can occasionally be a warning:

”If you're hoarse for more than two weeks - especially without a trigger like a cold or flu or if you are a long-time smoker - seek out the advice of your doctor since you may be at risk of a more serious problem like vocal cord nodules or even laryngeal cancer.”

Disease aside, there are treatments for “old people's voice.” Otolaryngologist and Director of the Johns Hopkins Voice Center Lee Akst says that “Good vocal hygiene, such as staying well-hydrated and not yelling or screaming is a must,” and speech therapy can be effective:

”Akst notes that most patients improve with voice therapy alone. While they may not sound like they did when they were 40, voice therapy helps promote a stronger voice.

“For those still struggling to be heard, a procedure called vocal cord augmentation involves injecting a synthetic filler into the deepest muscle layer of the vocal folds. This more invasive therapy can last from just a few months, to a permanent change in the case of a surgical implant.

"'It's an uncomfortable procedure, with a risk of side effects like bleeding,' says Akst. 'It works best in conjunction with voice therapy, and if you were to choose only one course of treatment, you'd do better with just voice therapy.'”

Or, unless people really cannot hear you, you could just live with it. I know quite a few people with presbyphonia and have no trouble understanding them.


What an interesting topic and well timed for me because I was alarmed about the hoarseness of my voice just this past month. However, for me it turned out to be a harmless side effect of some medication I was on and once I got off it, my voice got back to 'old person' normal.

Many years ago, In college, I took an elective course called Public Speaking.
The course was taught by a WNYC announcer by the name of Richard Pyatt.
Besides teaching us how to speak to large groups of people and not be frightened, he gave us tips on how to make your voice, not only last longer, but sound better too.
He told us that one of the problems was that most people have not learned to speak diaphragmatically as opposed to nasally.

For me, singing in good choruses all my life seems to have postponed the changes associated with aging voice -- probably because I learned long ago how to breathe from the diaphragm. I'm almost 77 and I think I still sound the way I always did. I wonder if singing, even singing regularly in church or the shower, might help?

I only notice it when I answer the phone after not speaking for a while. Embarrassing when people don't think it's me! Thanks for the information, although I don't think I'll be opting for the dubious 'treatments'!

This article is so right on. Having returned to singing in my 80's after a 15-year hiatus, it has been quite a challenge. All of those symptoms make it difficult. One not mentioned, but not universal, is the effect on the breathing due to anatomical changes, as in my case scoliosis that compresses my diaphragm-- which makes my lifelong diaphragmatic breathing as a trained singer nearly impossible. Also, my frustrations about memory problems with words were eased by an article I just read about Barbara Cook, which confirmed that loss of words in songs and needing to use "cheat sheets" was inevitable in old age. Fortunately, even though it "ain't what it used to be" my wisdom and experience are appreciated, since I am in a field (traditional folk) where age is not an issue.

I agree with Jean when she referenced singing. My mother maintained a strong voice singing hymns in church until the end and I too enjoy the chance to give voice that way. I never was musical and I crack sometimes now, but I wonder if one factor in the aging voice is that many of us stop having such opportunities at all.

Oh goodie, another fun thing to look forward to.

Thanks, Ronni, I should have mentioned this before I decided to see my ENT about my concerns. (My vocal cords are fine, symptoms probably just due to aging and slight reflux.) Great research!

Yeah, PiedType, just one more thing to "like" about old age. So far I think I've retained most of my voice, but I suppose it will decline like everything else.

At the end of the school year, I received letters and notes from the little scholars I met while volunteering at their elementary school. One of them mentioned how she loved my "rickety little voice." Honestly, I had NO idea my voice had become small, much less rickety! Guess it's because my voice is the same age as me--81.

I had great results with speech therapy and physiotherapy. Last year I noticed "old lady voice" in myself and it was impinging on my professional life. So I walked into therapy and today — my voice gets tired occasionally, but most of the time it's perfectly fine whether singing and speaking. Big phew!

I knew my voice was changing into an "old lady's voice" that sounded different, but I didn't realize that it had become weak until people started saying "I can't hear you." It is very weak now as I think I am talking normally, but I have to practically shout to be heard.

I envy Tony Bennett who can still make them hear in the furthest corner of the balcony (and without a microphone). I think the singers are on to something.

Here is my experience with this: voice training and singing helps; aerobic exercise helps with the singing voice.

Oh yes have experienced the waivery voice, first I thought was an aftermath of a bad throat, then realised it was permanent. I love singing old hindi songs, but now when I sing sounds more like I am reciting as I get breathless and my voice kind of goes off. Also think that when I shifted to complete dentures from partial ones 3 years ago it added to it....but anyways at 81 I am happy to be alive and kicking and the fact that I still remember all the lyrics.

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