The surprising symptom that experts say is an early sign of dementia
HEARING loss has long been recognised as a risk factor for dementia and cognitive decline. Now, new research suggests that vocal changes could provide another early signal of cognitive problems, alerting doctors and patients to consider screening and pay closer attention to brain health.
A study published in the Journal of Voice found that people with voice disorders were more likely to face cognitive decline than people without vocal challenges. People with both a voice disorder and hearing loss had the highest risk of cognitive decline, about double that of the control group.
“Until this paper, people basically have not been aware that there is any relationship between voice abnormalities and cognitive decline,” says study author Robert T. Sataloff, M.D., D.M.A., F.A.C.S., the chair of the Department of Otolaryngology-Head and Neck Surgery, and senior associate dean for Clinical Academic Specialities at Drexel University College of Medicine. “Having biomarkers of cognitive decline creates opportunities for people to recognise cognitive problems early and potentially intervene.”
What the study found
Dr. Sataloff’s team collected data from a decade’s worth of patient medical records. People diagnosed with vocal disorders such as loss of voice or change in vocal quality, pitch, or volume were compared with patients with hearing loss and control patients.
“This study has shown that voice abnormalities are even stronger biomarkers than hearing loss,” says Dr Sataloff.
“Hearing loss is associated with about a 27% increased hazard risk of cognitive decline. Voice disorders have a 58% increased risk of cognitive decline, more than double, so it is now the most powerful biomarker we have that tells us that we need to be sensitive to cognitive problems at present and over time.”
The link between your voice and your brain health
The connection between the sound of your voice and the status of your brain might come down to a few factors. One is that vocal changes could be symptoms of underlying neurological changes inside the brain.
Another is that voice changes can make communication more difficult, causing people to bow out of social interactions that would help stimulate their brains and support cognitive health.
“Patients with age-related voice changes may have soft, breathy voices at the same time their contemporaries develop hearing loss,” says Dr Sataloff. “They talk, people can't hear what they say, and eventually, it's just not worth the effort, and they withdraw.”
When to tell a doctor about vocal issues
Many people assume that vocal changes are annoying yet harmless. However, hoarseness, breathiness, voice fatigue, and other symptoms can be signs of voice misuse, reflux, benign growths, or even cancer.
“If someone has a voice change—the voice gets hoarse or soft or breathy or starts to break and lose control—the person should find out why,” says Dr. Sataloff. Seek care from an otolaryngologist who specializes in voice disorders and can help you find and treat the cause. The earlier a diagnosis is made, the more effective the treatment, according to Dr. Sataloff.
“People often tolerate voice abnormalities, which leads to delays in diagnosis,” says Dr. Sataloff. “That's been problematic from a medical, vocal fold standpoint, but now it looks as if it might also be problematic from a cognitive decline standpoint.” There might be opportunities to recognise cognitive decline early and intervene.
How to boost your vocal and brain power
The good news in all of this? There’s one habit that may benefit both vocal and cognitive health—and it’s actually fun: belting your favorite tunes.
“Involvement in singing, in choirs, and in other musical performances has a documented effect on health and wellness,” says Dr. Sataloff.
It may sound surprising, but one study found that older adults who sang in a choir scored higher on verbal flexibility, the ability to quickly think of words beginning with a particular letter, than people in a control group.
People who take voice lessons—speaking, singing, or both—prevent the kinds of problems that arise from voice misuse or excessive use, Dr Sataloff explains. “This is important to people, not just actors and singers, but people like school teachers, supervisors in factories who have to talk over noise, football players, basketball coaches, other people who have to talk over noise,” he says.
“If they get the basic training that comes with initial singing lessons or initial speech training, then they learn how to avoid those problems.”
The bottom line
Your voice, your hearing, and your cognition are all linked together—and they’re all worth paying attention to.
“We need more research,” Sataloff says. “We don't know yet whether treating voice disorders is the same as treating hearing loss or if it slows cognitive decline, but we suspect that that will be the case, and that research is going to get started very shortly.”
If you or someone you love is experiencing changes in their voice or their ability to hear well, it’s time to see a doctor.
