A recent study has found that voice disorders may be linked to a heightened risk of dementia, independent of hearing loss. Researchers analyzed data from more than 833,000 adults aged 50 and older who visited primary care doctors over several years to explore connections between voice problems and cognitive decline.
The study, published in the Journal of Voice, revealed that individuals with both voice and hearing issues were more than twice as likely to develop cognitive impairment or dementia compared to those without either condition. Those with voice disorders but no hearing loss also faced a substantially increased risk, approximately 58% higher than individuals without these issues. Participants with hearing loss alone exhibited an elevated risk as well, though the study’s design makes it difficult to directly compare the relative risks between the conditions.
Voice disorders encompass a variety of abnormalities in vocal quality, pitch, and volume, affecting an estimated 18 million adults in the United States annually. These can manifest as hoarseness, strain, sudden pitch shifts, or other vocal irregularities. The underlying causes may include vocal cord nodules, cysts, inflammation, or age-related changes such as loss of tissue bulk and respiratory strength.
Robert Sataloff, senior study author and chair of Otolaryngology–Head & Neck Surgery at Drexel University College of Medicine, emphasized that many individuals may not recognize or seek treatment for voice abnormalities, as some changes are perceived as benign or even characteristic, such as a gravelly voice. A 2023 survey cited in the study found that nearly 40% of people experiencing voice issues did not pursue medical care.
The research tracked diagnoses of mild cognitive impairment, Alzheimer’s disease, and other dementias beginning one year after participants’ initial visits, following them until diagnosis or their last recorded visit. While the study identified an association between voice disorders and dementia risk, it was observational and cannot establish a causal relationship. Questions remain about whether treating voice conditions might mitigate dementia risk, though evidence exists that addressing hearing loss can reduce cognitive decline.
Experts not involved in the study offered theories about the connection between voice and brain health. Social isolation resulting from difficulty speaking could decrease social engagement, a known risk factor for dementia. Reduced vocal activity may also lead to less cognitive stimulation. Alternatively, shared neurological or biological changes could affect both voice function and memory.
Health professionals encourage those experiencing vocal changes to seek evaluation. Voice disorders may respond to therapy with speech-language pathologists or minor surgical interventions, depending on the cause. Diagnosing underlying medical conditions, such as thyroid disorders or neurological diseases, is also critical.
The findings suggest that monitoring voice changes could help identify individuals at increased risk for cognitive decline earlier, potentially prompting timely cognitive assessments. According to Sataloff, clinicians should consider cognitive screening when patients present with atypical voice characteristics, just as they do with hearing loss.