Based on the first large study on the association of diagnosed voice disorders with cognitive decline, people who, without hearing loss, experience reduced voice quality - in terms of pitch, clarity, loudness, reduced vocal range, or other voice disorders - may be 58 percent more likely to develop cognitive impairment or dementia compared with people without voice disorders.
According to Medical Xpress, the findings of this study, which show that voice disorders may be a more precise early indicator of cognitive decline than hearing loss alone, were recently published in the Journal of Voice.
According to the US National Institutes of Health, about 17.9 million adults in the US reported having a problem with their voice in the past 12 months, and this problem lasted at least one week for 9.4 million of them. The study’s findings are particularly important because four out of ten people who develop a voice disorder do not see a doctor, while they may be at higher risk of cognitive decline.
According to NIH statistics, more than six million people in the US have Alzheimer’s or another type of dementia, and this number is projected to more than double by 2060. Early diagnosis allows a person to plan more comprehensively for financial management and preparation for future health problems, thereby enabling the best possible quality of life.
How did researchers compare the risks?
Robert Sataloff, the study’s lead author and a professor at Drexel University, said: “If you have a disorder that affects your voice quality, or if you feel pain when speaking or singing, it’s natural to participate less in social activities or other cognitively stimulating activities. We already see this in patients with Parkinson’s. Voice disorders in these patients often appear before other physical signs of the disease.”
The research team reviewed data from 833,417 patients during routine primary care visits. Patients were followed for at least one full year after diagnosis of a voice disorder or hearing loss. The researchers compared patients diagnosed with voice disorders to a control group of patients without voice or hearing problems to determine which individuals later developed dementia or cognitive impairment.
The group found that among people without voice disorders, the association between cognitive decline and voice disorders was stronger than the association between cognitive decline and hearing loss.
These findings challenge the common focus on hearing loss as an indicator for detecting cognitive decline. However, the study’s data did not conflict with previous research on the link between hearing loss and dementia.
Voice disorders had a more prominent association
Hearing loss is considered the largest modifiable risk factor for dementia, and this group’s data confirmed that. According to the results, hearing loss was associated with a 27 percent increased risk of cognitive decline compared with matched control groups.
The link between hearing loss and cognitive decline is well documented. For example, a study published in The Lancet showed that counseling and hearing aid use over three years reduced the rate of cognitive change in older adults at higher risk of cognitive decline.
Sataloff said: “Our research shows that voice disorders may be an earlier and stronger sign of cognitive decline compared with hearing loss alone.”
He added: “We saw the strongest association with dementia in patients who had both voice disorders and hearing loss, but the important point was that the risk in people with voice disorders and without hearing loss was higher than in patients who had only hearing loss. It may be beneficial for many of these patients to consult an otolaryngologist so that they can facilitate cognitive assessment and help patients develop an appropriate care plan.”
Researchers also found that people with both voice disorders and hearing loss tended to be older and had higher rates of conditions such as high blood pressure, heart disease, and type 2 diabetes.
The authors said future research should examine whether certain specific voice disorders are more strongly associated with future cognitive decline and whether treating voice disorders, like treating hearing problems, can slow the course of cognitive decline.