Voice disorders could be a more reliable early indicator of dementia than hearing loss, according to new research from Drexel University in Philadelphia, Pennsylvania.
The findings come from the first major study to examine diagnosed voice disorders and cognitive decline, which is a recognised sign of dementia involving memory loss and reduced thinking abilities that can be mistaken for normal ageing.
Higher dementia risk linked to voice disorders
The researchers found that people experiencing declining voice quality without any hearing loss may face a 58% higher risk of dementia compared to those without a voice disorder.
The link between hearing loss and increased dementia risk is well-documented, with brain changes and social isolation thought to play a role. However, this study challenges whether hearing loss should remain the primary focus for diagnosing cognitive decline.
Study findings and expert comment
Published in the Journal of Voice in September, the study's authors are urging further research into whether voice disorders show a stronger connection to cognitive decline than hearing loss, and whether treating voice disorders could slow its progression.
"If you have a voice disorder that impacts how your voice sounds or if it's painful when you attempt to talk or sing, it's only natural to participate less often in brain-supporting social or other engaging activities," said Robert Sataloff, MD, a professor and chair in Drexel's College of Medicine and a senior author of the study. "We already see this in patients with Parkinson's disease, in which voice disorders often precede other physical signs of the disease."
Researchers analysed data from more than 833,000 patients during annual GP appointments in America, starting at least a year before they received a diagnosis of either a voice or hearing loss disorder. The study found a stronger connection between cognitive decline and voice disorders compared to hearing loss without voice problems.
"Our work shows that voice disorders may be an earlier and stronger sign of cognitive decline than hearing loss alone," said Sataloff. "We found the strongest link with dementia among patients experiencing a voice disorder and hearing loss; but importantly, we found that those with a voice disorder and no hearing loss were at greater risk than patients who experience hearing loss only. It may be valuable for many of these patients to talk with an otolaryngologist who can arrange a cognitive assessment to help patients develop an appropriate care plan."
Early symptoms of dementia
Per the NHS, common early symptoms of dementia are often mild and may "only very gradually" get worse. These include memory loss, difficulty concentrating, struggling to follow a conversation or find the right word, being confused about time and place, and mood changes.
