Baby boomers have long used exercise, surgery and collagen as they try to slow the processes of aging.
Now some are flocking to do the same with what is usually a dead giveaway: a voice that sounds "old." Research shows that older people's voices often develop breathiness, weakness and loss of range or quality from causes that include disease, changed use of their voices and "presby- laryngis," also known as "aging of the larynx."
Boomers those born between 1946 and 1964 will likely object even more than today's patients to a lessened ability to speak and be heard clearly, said Dr. Robert Buckmire, a University of North Carolina otolaryngologist, who works with a team that includes speech therapist Ellen Markus.
From precise vocal-function exercises to laryngeal surgery to collagen injections that plump thinning vocal cords, doctors and therapists use a variety of approaches to ward off aging effects on patients' voices.
Self-image, basic communication and professional reputation are at stake for the increasing number of patients who have sought help. An often-cited study from the '90s found that listeners tended to rate an older voice as "doddery," "vague" and "rambling," while giving more credibility to the same words from a younger speaker.
Buckmire keeps all of this in mind when he refers patients such as retiree Ray Carpenter to the center for therapy.
"I am dealing with voice problems, hearing problems and vision problems, but I'm smart as a whip," joked Carpenter, 85, as he began a session in Markus' office.
Markus, a graduate of the Eastman School of Music, works daily with singers and talkers on the three elements that produce vocal sound:
The respiratory system, or the breath behind the sound.
The vocal cords, which open and close to produce sound.
The resonance system the throat, tongue, teeth and lips which amplify and articulate the sound.
"OK, let's say, 'Hello, he, he,' " she said.
"Now, say 'Hope he will.'
" 'Heap it on. Hit the wall. Hop on.' "
Carpenter dutifully repeated the phrases, emphasizing the 'h' sounds as Markus had.
"I want you to use those belly muscles; the belly is supporting all of this," she said.
Just as trained singers use their diaphragms, Markus said, Carpenter should be able to feel the organ supporting his lungs as he pushes air upward for speech. She took him through a series of nonsense syllables designed to improve his volume, tone and endurance.
Studies have shown that these kinds of exercises often increase vocal output and other measures of healthy speech.
Buckmire pointed out that the muscles of the larynx and other organs involved in speech can't be bulked up by exercise the way the body's large muscles can.
"When you talk about the voice, there are changes with muscles, change in connective tissue with age, and that's a very natural change," he said.
A person recorded at age 30 and again at age 70 will sound noticeably different because of the diminished bulk of the vocal cords, he said. Lung capacity also tends to diminish with passing years, weakening the voice.
Changes in the brain can bring tremors and other signs of aging.
But there's a bright side to the picture, as well.
"Although things change and do age, the voice output is not condemned to change," Buckmire said. "When we get to strategies to improve the voice or maintain the voice, it's about maintaining all processes and gaining endurance. We know that people can successfully sing at a very high level into their 80s, but it takes more technique and practice."