Objective:
Age-related neuromuscular decline affects both phonatory and swallowing function through shared laryngeal mechanisms. However, the relationship between perceived swallowing burden, voice symptoms, and acoustic signatures of laryngeal inefficiency remains unclear in community-dwelling older adults. This study examined whether self-reported swallowing difficulty aligns with voice symptoms and acoustic markers of impaired glottal control.

Method:
Thirty-two older adults (mean age = 69.4 ± 5.3 years; 56% female) without diagnosed voice/swallowing disorders completed the Eating Assessment Tool–10 (EAT-10), Voice Handicap Index–10 (VHI-10), and Voice Symptom Scale (VoiSS). Participants were classified as normal (EAT-10 < 3) or at risk (EAT-10 ≥ 3). Voice samples included sustained vowel, continuous speech, and pitch glides. Acoustic variables represented pitch/intensity ( F₀, dBv), spectral/cepstral noise (GNE, HNR, HFNO, CPPS), perturbation (jitter, shimmer), and composite indices (AVQI, ABI). Group differences were analyzed using the Mann–Whitney U test; associations were assessed using Spearman’s correlation. Variables with |ρ| ≥ 0.30 relative to the EAT-10 were entered into a principal component analysis (PCA).

Results:
EAT-10 correlated with both VHI-10 and VoiSS total. VoiSS subscales (Impairment, Physical, Emotional) also aligned with EAT-10. During pitch glides, participants at risk for swallowing difficulty demonstrated lower GNE and higher shimmer across amplitude perturbation measures, with trends for greater jitter (PPQ5) and HFNO. Pitch and intensity variables did not differ significantly. Across tasks, sixteen acoustic metrics correlated with EAT-10. PCA revealed three components explaining 82.6% of the total variance. The first component (61.4%); defined by higher shimmer, jitter, NHR, AVQI, and ABI and lower GNE and HNR, correlated with EAT-10, representing a shared laryngeal inefficiency.

Conclusions:
Older adults reporting higher swallowing burden also perceive greater vocal difficulty and exhibit acoustic signs of reduced glottal closure and phonatory stability. The convergence of perceptual and acoustic evidence supports a shared aerodigestive-effort mechanism linking phonation and swallowing. Acoustic assessment of dynamic voice tasks, such as pitch glides, may provide a complementary and non-invasive means of identifying early neuromuscular decline in aging.