(0801) Association of Voice and Speech Difficulty and Dysphagia in Older Adults

Introduction: Patients with voice disorders can also have disruptions of swallowing as vocal fold function is vital for cough response and aspiration prevention. Age is known to adversely impact both voice and swallow function either through physiological weakening or comorbidities such as neurodegenerative diseases. However, the relationship between voice disorders and swallowing function is understudied in the aging population, and we hypothesize that there may be high rates of co-occurrence.

Methods: Our study utilized Round 11 (2021) of the National Health and Aging Trends Study (NHATS), which conducts detailed interviews on disablement, health, and quality of life among a nationally representative sample of Medicare beneficiaries. Voice and speech difficulty was defined by an affirmative response to problems with or use of rehabilitation services for speaking. Dysphagia was defined by an affirmative response to problems with or use of rehabilitation service for chewing or swallowing. We compared presence of voice and speech difficulty in those with and without dysphagia, controlling for demographic confounders and comorbidities via generalized logistic regression.

Results: We included 3,817 adults with a mean age of 82 years (SD: 6.7). The prevalence of voice and speech difficulty and dysphagia was 263 (7.8%) and 317 (11%) patients respectively. Of the patients, 120 (3.68%) reported both complaints. Those with dysphagia had 8.72 odds (95% CI 6.59-11.5, p = 3.98E-52) of reporting voice and speech difficulty after controlling for confounders of age, gender, race/ethnicity, presence of lung disease or stroke. In addition, both complaints were significantly correlated with age (p < 0.001 for both), although neither were significantly correlated to gender, and only voice and speech difficulty was significantly correlated with race/ethnicity (p = 0.4, p = 0.22, p = 0.03, respectively).

Conclusions: Among older adults, there is a significant co-occurrence of dysphagia and voice and speech difficulty. For older adults presenting with one complaint, evaluation should include screening for the other.