Figures Of Speech: Your Voice May Give Clues To Cognitive Decline

One of the most distinct and individual characteristics we possess is our voice. We each have a unique sound and style of speaking, whether influenced by geography, family, or the language we speak. We also may have a distinct vocabulary, favorite words or phrases, or specific names we use to identify items or people. So if the sound of our voice changes, or our speaking style suddenly begins to differ, do those changes mean anything, or are they just a natural byproduct of growing older? Does it matter that we appear to be searching for words mid-sentence, or that our voice and sentence structure are not as fluid as they once were? Well, several recent studies suggest that changes in voice quality or speaking style may be early clues that your brain health is at risk.

A new study in the Journal of Speech, Language and Hearing Research used AI technology to detect subtle speech patterns that could predict how someone would fare on a cognitive test. In this study of 76 neurologically healthy adults, aged 65 to 75, 4 specific speech patterns were found to be “sensitive indicators” of brain health. In particular, speech patterns that included pauses or hesitations, the use of filler words such as “um,” difficulty retrieving words, or certain speech rhythms were all predictive of how the person would do on a cognitive test. The more fluid the speech, the better the thinking skills of the person were functioning. While you should not assume that your occasional use of the word “um” or your occasional pause to retrieve a word means that your cognitive skills are declining (these are often just natural factors that accompany aging), this study does suggest that assessment of speech might someday be available as an early screening tool for cognitive decline. In fact, speech analysis may be able to pick up subtle brain changes before serious damage begins. For more on this study and its implications for early detection of cognitive problems, clear your throat and click here. 

Another new study, this one examining voice disorders, including changes in voice quality, pitch, or volume, also offers clues to the connection between cognitive decline and speaking. Published in the Journal of Voice, this research was the first large-scale analysis of the connection between voice disorders and cognitive decline. Data from more than 800,000 adults aged 50 and older, followed over the course of several years, appear to show that voice disorders are tied to dementia risk. While we know that hearing loss is a risk factor for dementia, and we know that hearing loss is linked to voice disorders, this study attempted to discern whether voice disorders on their own (which affect up to 18 million adults annually) might have implications for dementia risk. What the study found was that people diagnosed with voice disorders had a 58% higher risk of dementia than the control group, and the strongest link between dementia and voice disorders occurred in participants who also had hearing loss. But even those participants with no hearing loss who had voice disorders were at a greater risk of dementia than participants who only had hearing loss. Thus, a voice disorder may be a strong sign that a person is at risk for cognitive decline. There can be many causes of voice disorders as one gets older, including loss of nerve endings or respiratory strength, nodules or cysts on vocal cords, or acid reflux. While this study doesn’t give a clear understanding of the connection between a voice disorder and dementia risk, theories about the connection point to the social isolation that may accompany a voice disorder, or the subdued brain activity you may experience if you are not speaking as much. What all of this points to is that you should not assume a voice disorder is natural or just a nuisance. It may be amenable to treatment, and it may be indicative of a more serious problem. Either way, when you or a loved one detect a change in your voice tenor, pitch, or volume, it may be time to raise your voice and check in with an expert for advice.