Evaluation of the aging patient’s voice by means of the VHI correlated to the DS16 and the SF-36

Objective vocal changes linked to the age have been largely studied these last 20 years. However, few authors have showed an interest in the subjective evaluation of the aging voice.
Our research aimed the study of the aging voice by means of the Voice Handicap Index (VHI) Jacobson et al., (1997) in 90 subjects divided into three groups: « 30 elderly subjects in a nursing home », « 30 elderly subjects living at home » and « 30 young subjects » as the control group. We compared the results from these three groups and controlled for several variables such as age, living place, personality, dependency and repetition, that can have an impact on the VHI score. The DS16 (Denollet, 1998) and the SF-36 (Ware et al, 1993) were used to test personality and dependency.
Our results showed that the scores on the global and physical scales are higher for all groups at the retest (p=0,046; p=0,015).
Although the VHI seems adapted to the aging subject, some improvements are suggested concerning the items addressing the professional life and social life (F8, F16, F22, E24 et E29). We also observe correlations between the three subscales (p<0,001). Concerning the DS16, the personality trait « negative affect » and « social inhibition » are correlated to the global score at the test and the retest (P=0,002 ; P =0,001 and P=0,048 ; P=0,015). Type-D personality raises the physical scores (P=0,018 ; P=0,006) and the global scores (P=0,014 ; P=0,003). Moreover, the VHI is correlated to 6 dimensions of general health related quality of life and with the global score of the SF-36 (P<0,001). The elderly subjects obtain higher functional (P=0,007 ; P=0,006), physical (P=0,009 ; P<0,001) and global (P=0,003 ; P<0,001) scores than the young subjects. Moreover, the subjects living in a nursery home obtain a higher emotional score on the univariate analysis (P=0,008 ; P=0,02) than those living at home. At the multivariate analysis, the variable « nursery home » has a significant impact on the functional score (P=0,02). Finally, a multivariate linear regression shows that the variable sex increases all the scores at the VHI (P=0,048 ; P=0,044 ; P=0,03 ; P=0,023) and the variable « dependency » (P<0,001) increases the emotional, physical and global score.
Although vocal quality in the elderly might seem only slightly altered, age is a factor that increases functional, physical and global scores at the VHI. However, sex, dependency and personality type are also influencing vocal self-evaluation and can moderate the effect of age.