Why Your Voice Changes as You Age

Age-related changes can impact how you sound — and some adults are more affected than others

Kimberly Goad,

AARP

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Published January 22, 2025

Photo Collage: AARP; (Source: Getty Images (2))

One of Michelle Adessa’s patients was a couple of years into retirement when he noticed a change in his voice. For seemingly no reason, it had become breathy and hoarse — something the 71-year-old hadn’t experienced over the course of his career in sales and marketing, recalls Adessa, a speech pathologist with the Cleveland Clinic’s Voice Center. He couldn’t help but notice it had gotten progressively worse in the six months since his wife died and he’d begun living alone.

Increasingly self-conscious, the patient began to withdraw socially. He stopped doing his regular readings at church and singing in the church choir; he begged off his weekly get-togethers at the local diner because friends, many of whom wore hearing aids, couldn’t hear him when he spoke.

By the time he went in search of a diagnosis — at the urging of his family — he was sure he had somehow done permanent damage to his voice. Turns out, he had a common, treatable condition called presbyphonia, or “aging voice.” Similar to how your abs, glutes, biceps and other muscles require regular exercise to stay strong, so do the muscles in your voice.

The vocal cords, also known as vocal folds, “are essentially muscle covered in vibratory tissue,” Adessa explains. “As we age, our muscles become weaker, a process called sarcopenia. It affects the body at large, and also the muscles inside the vocal folds. As the vocal folds thin — or atrophy — they don’t touch in the middle and let air escape when you talk. This can make the voice sound raspy, weak or breathy.”

That’s not the only factor at play. What’s known as respiratory drive — the intensity of your respiratory center’s output, which determines how much effort is required to breathe — “changes as we age, as does hearing,” Adessa says. “All of these changes can lead to the qualities that produce an aging voice.”

What does an aging voice sound like?

Besides breathiness and hoarseness, the symptoms of presbyphonia include lower volume and projection of your voice, difficulty being heard in noisy settings (like restaurants), a higher than normal pitch (if you’re a man), or lower (for women). Experts believe presbyphonia tends to go undiagnosed, so it’s difficult to know just how common aging voice is, but research suggests around 1 in 3 adults ages 60 and older have one or more of the symptoms above.

And although the condition is rarely serious, it’s important to see a laryngologist or ear, nose and throat (ENT) specialist if symptoms continue, to rule out other medical conditions like GERD (short for gastroesophageal reflux), cancer of the larynx, or neurological diseases such as spasmodic dysphonia or vocal fold paralysis.

“For example, a small tumor on the vocal folds can also produce raspiness. For that reason, anyone with voice changes that last longer than four weeks should see a doctor. This is particularly important for those with risk factors such as a history of smoking,” says Ted Mau, M.D., an otolaryngologist who specializes in voice disorders at UT Southwestern Medical Center.

If the exam shows that the vocal cords/folds are thin, stiffened, or have a gap between them when they close, the diagnosis is typically presbyphonia.

Treatment for an aging voice

You might think talking less would be a good way to preserve your voice or treat an aging one. Just the opposite. Like any muscle, your voice needs to be exercised to stay strong.

And while presbyphonia isn’t life-threatening, it “can impact your quality of life,” says Cristen Paige, a speech-language pathologist and senior clinician at Duke Voice Care Center. “People may ask you to repeat more often, which can be tiresome and frustrating. Sometimes you have to strain to be heard. You may also feel like you’re running out of air as you talk, which can be exhausting.”

Mau adds that many older adults already experience social isolation, and voice problems “can really exacerbate that.”

Voice therapy is considered the first-line treatment. Working with a speech pathologist, you’ll do vocal exercises that are designed to improve breathing, reduce straining when you speak and find the best pitch and volume.

“While nothing can restore the vocal folds to their 25-year-old glory, voice therapy focuses on improving what already works well,” Paige says. “Speech pathologists individually tailor exercises that capitalize on good and efficient breath support. We help people strategize how they can best be heard, whether that’s over the phone, when out to dinner, or even just talking to a loved one at home.”

But any use of your voice counts as exercise, Adessa adds. “Reading out loud to yourself or your grandchildren, talking on the phone, singing along to a song that you love on the radio — those are all ways to exercise the voice,” she says. “Maintaining good breath support is also essential. All the classic things we do for our health — such as cardiovascular exercise, getting enough sleep and reducing stress — can help to optimize breath support and vocal quality.”

If therapy doesn’t help, your doctor may recommend injections to plump up the vocal cords (an in-office, half-hour procedure that offers a temporary fix) or voice box implants to stabilize the vocal cords (a surgery known as thyroplasty that provides a permanent solution). “Both work by restoring a fuller bulk and straighter edge to the vocal folds, so the voice can be smoother and stronger,” Mau says.

As for Adessa’s patient, his voice improved after just three sessions of therapy. “He rejoined his choir and his weekly socializing at his local diner,” she says. “He now speaks with his daughter on the phone twice a week and even FaceTimes with his grandchildren so he can read to them.”

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Kimberly Goad is a New York-based journalist who has covered health for some of the nation’s top consumer publications. Her work has appeared in Women’s Health, Prevention, Health and Reader's Digest.