Department of Chinese Medicine, China Medical University Hospital, No. 2, Yude Road, North District, 40447, Taichung, Taiwan.
Graduate Institute of Integrated Medicine, China Medical University, No.91, Hsueh-Shih Road, North District, Taichung, 40402, Taiwan.
BMC Geriatr. 2022 Jul 1;22(1):549. doi: 10.1186/s12877-022-03237-7.
Frailty is a common issue in the aging population. Given that frailty syndrome is little discussed in the literature on the aging voice, the current study aims to examine the relationship between frailty and vocal biomarkers in older people.
Participants aged ≥ 60 years visiting geriatric outpatient clinics were recruited. They underwent frailty assessment (Cardiovascular Health Study [CHS] index; Study of Osteoporotic Fractures [SOF] index; and Fatigue, Resistance, Ambulation, Illness, and Loss of weight [FRAIL] index) and were asked to pronounce a sustained vowel /a/ for approximately 1 s. Four voice parameters were assessed: average number of zero crossings (A1), variations in local peaks and valleys (A2), variations in first and second formant frequencies (A3), and spectral energy ratio (A4).
Among 277 older adults, increased A1 was associated with a lower likelihood of frailty as defined by SOF (odds ratio [OR] 0.84, 95% confidence interval [CI] 0.74-0.96). Participants with larger A2 values were more likely to be frail, as defined by FRAIL and CHS (FRAIL: OR 1.41, 95% CI 1.12-1.79; CHS: OR 1.38, 95% CI 1.10-1.75). Sex differences were observed across the three frailty indices. In male participants, an increase in A3 by 10 points increased the odds of frailty by almost 7% (SOF: OR 1.07, 95% CI 1.02-1.12), 6% (FRAIL: OR 1.06, 95% CI 1.02-1.11), or 6% (CHS: OR 1.06, 95% CI 1.01-1.11). In female participants, an increase in A4 by 0.1 conferred a significant 2.8-fold (SOF: OR 2.81, 95% CI 1.71-4.62), 2.3-fold (FRAIL: OR 2.31, 95% CI 1.45-3.68), or 2.8-fold (CHS: OR 2.82, 95% CI 1.76-4.51, CHS) increased odds of frailty.
Vocal biomarkers, especially spectral-domain voice parameters, might have potential for estimating frailty, as a non-invasive, instantaneous, objective, and cost-effective estimation tool, and demonstrating sex differences for individualised treatment of frailty.
衰弱是老龄化人口中的常见问题。鉴于衰弱综合征在有关衰老声音的文献中讨论较少，本研究旨在探讨衰弱与老年人声音生物标志物之间的关系。
招募了年龄≥60 岁并前往老年门诊就诊的参与者。他们接受了衰弱评估（心血管健康研究[CHS]指数；骨质疏松性骨折研究[SOF]指数；疲劳、抵抗、活动、疾病和体重减轻[FRAIL]指数），并被要求大约 1 秒发出持续的元音/a/。评估了四个声音参数：平均零交叉数（A1）、局部峰谷变化（A2）、第一和第二共振峰频率变化（A3）和光谱能量比（A4）。
在 277 名老年人中，A1 增加与 SOF 定义的衰弱可能性降低相关（比值比[OR]0.84，95%置信区间[CI]0.74-0.96）。A2 值较大的参与者更有可能衰弱，这是根据 FRAIL 和 CHS 定义的（FRAIL：OR 1.41，95%CI 1.12-1.79；CHS：OR 1.38，95%CI 1.10-1.75）。在三个衰弱指数中观察到性别差异。在男性参与者中，A3 增加 10 点，衰弱的几率增加近 7%（SOF：OR 1.07，95%CI 1.02-1.12）、6%（FRAIL：OR 1.06，95%CI 1.02-1.11）或 6%（CHS：OR 1.06，95%CI 1.01-1.11）。在女性参与者中，A4 增加 0.1 可显著增加 2.8 倍（SOF：OR 2.81，95%CI 1.71-4.62）、2.3 倍（FRAIL：OR 2.31，95%CI 1.45-3.68）或 2.8 倍（CHS：OR 2.82，95%CI 1.76-4.51，CHS）衰弱的几率增加。
声音生物标志物，尤其是光谱域声音参数，可能具有作为一种非侵入性、即时、客观和具有成本效益的估计工具来估计衰弱的潜力，并表现出衰弱的性别差异，以进行个体化治疗。
