Sociodemographic characteristics and treatment response among aging adults with voice disorders in the United States

Abstract

IMPORTANCE Aging adults face unique barriers to care and have unique health care needs with a high prevalence of chronic conditions. A high proportion of individuals in this group have voice disorders, in part due to age-related changes in laryngeal anatomy and physiologic features. These disorders contribute significantly to health care costs and remain poorly understood. OBJECTIVE To describe sociodemographic characteristics and response to treatment among aging adults with voice disorders. DESIGN, SETTING, AND PARTICIPANTS A cross-sectional study using the 2012 National Health Interview Survey was used to evaluate adults who reported voice disorders in the past 12 months. Self-reported demographics and data regarding health care visits for voice disorders were analyzed. Statistical analysis was conducted from March 1, 2017, to February 1, 2018. MAIN OUTCOMES AND MEASURES Self-reported voice disorders, whether or not treatment was sought, which types of professionals were seen for treatment, and whether or not the voice disorder improved after treatment. RESULTS Among 41.7 million adults in the United States 65 years or older, 4.20 million (10.1%; 2 683 199 women and 1 514 909 men; mean [SE] age, 74.5 [0.3] years) reported having voice disorders. Of those with voice disorders, 10.0%(95%CI, 8.3%-11.7%) sought treatment. Of individuals seeking treatment, 22.1% (95%CI, 7.9%-36.3%) saw an otolaryngologist and 24.3%(95%CI, 10.6%-38.0%) saw a speech language pathologist. By controlling for race/ethnicity, income, sex, and geography, it was found that men were less likely than women to report voice disorders (36.1%[95%CI, 31.7%-40.5%] vs 63.9%[95%CI, 59.5%-68.3%]; odds ratio, 0.70; 95%CI, 0.57-0.86). Race/ethnicity, income, and geography were not significantly associated with the likelihood that an individual 65 years or older reported voice disorders. A greater percentage of elderly adults seeking treatment than not seeking treatment reported improvement in symptoms (32.4%; 95%CI, 17.9%-47.0% vs 15.6%; 95%CI, 10.4%-20.8%). Among adults treated for a voice disorder, a lower proportion of adults 65 years or older reported improvement in symptoms with treatment compared with adults younger than 65 years (32.4%; 95%CI, 17.9%-47.0% vs 56.0%; 95%CI, 42.5%-69.6%). CONCLUSIONS AND RELEVANCE A small percentage of older adults with voice disorders seek treatment; even fewer are treated by an otolaryngologist or a speech language pathologist. A greater percentage of those who undergo treatment experienced symptomatic improvement compared with those who did not undergo treatment. These trends highlight the need for greater access to and awareness of services available to older adults with voice disorders.