老年人的喉部發聲功能和口腔輪替運動

The Vocal Phonation and Oral Diadochokinetic Movement in the Elderly

目的：口腔輪替運動(oral diadochokinetic movement, oral DDK)速率和最長發聲時長(maximum phonation duration, MPD)是臨床上重要的言語相關功能指標，本研究比較老年人和年輕成人在DDK和母音延長作業的表現，檢視老化對發聲和口腔動作功能的影響。方法：臺灣地區130位老年人和年輕成人參與，其中66位是65歲以上的長者(平均71歲)，64位是年輕成人(平均24歲)。進行MPD和DDK速率測量，錄音取樣後以聲學頻譜方式進行時長和速率的分析。結果：老年組MPD(平均15秒)顯著較成人組MPD(平均18秒)為短，男性MPD顯著較女性為長。老人組男性的基頻(平均137Hz)顯著較成人組男性(平均124Hz)為高，老年組女性基頻(平均170Hz)顯著地較成人組女性(平均216Hz)為低。老年組三種交替動作速率(AMR)(雙唇、齒槽、舌根)和序列動作速率(SMR)速率皆顯著較成人組的為慢。結論：老年人和年輕成人在MPD、基頻和DDK速率有顯著差異，老化對於嗓音發聲以及口腔動作控制與協調有不利的影響，本研究老年和成人組的發聲和DDK常模資料可供臨床言語功能評估時之參照。

Objectives. The oral diadochokinetic movement (DDK) rate and the maximum phonation duration (MPD) are important speech-related functional indicators. This study compared the performance of older adults and younger adults in DDK and vowel prolongation tasks to explore the effect of aging on vocal phonation and oral motor function.
Methods. One hundred and thirty adults participated in this study. Among them, sixty-six were adults over 65 years old (mean, 71) and sixty-four younger adults below 40 years old (mean, 24). The maximum phonation duration (MPD) and fundamental frequency (F0) were measured from the vowel prolongation task, and three alternating motion rates (AMRs) (/pa/, /ta/, /ka/) and a sequential motion rate (SMR, e.g. /pataka/) were measured from the oral DDK task. Acoustical analysis was utilized to analyze the duration and DDK rates data.
Results. The MPDs of the elderly group (mean,15 sec) were significantly shorter than those of the young adult (mean, 18 sec). The MPDs of males were longer than those of the females. The F0s of the elderly males (mean, 137Hz) were significantly higher than those in the young male adult group (mean, 124Hz), while the F0s of the elderly females (mean, 170Hz) were significantly lower than those in the young female group (mean, 216Hz). The AMRs for the elderly were significantly slower than those of the young adults. Likewise, the SMRs for the older adults were significantly slower than the young adults.
Conclusion. There were significant differences between the elderly and young adults regarding these phonation and speech motor measures indicating that aging has adverse effects on voice phonation, as well as oral motion control. The phonation and DDK norm data of the elderly and adult groups in this study can be used as a reference for clinical speech function assessment.