Adult Speech

Disorders of speech, language, and hearing are frequently found among older adults. These people often find themselves at distinct disadvantages on social, economic, and personal levels. With the number of older adults growing rapidly, and with the increased numbers of survivors of illnesses and accidents which can result in speech, language, and hearing disorders, more older adults with communication problems will be encountered. They require understanding of family and friends as well as services from communication disorder professionals.

Disorders of communication may result from hearing impairment, stoke, cancer, disease of the larynx, parkinsonism, or other neurological disorders. The communication disorders may vary widely and include difficulty with speaking and with understanding verbal message. The effects may be frustrating and bewildering and may lead to withdrawal and isolation. Participation on any social or economic level may become difficult or impossible because of the disorder itself or the emotional consequences.

What are the disorders of communication which most affect older people?


Dysarthria interferes with normal control of the speech mechanism. Speech may be slurred or otherwise difficult to understand due to lack of ability to produce speech sounds correctly, maintain good breath control, and coordinate the movements of the lips, tongue, and larynx. Diseases such as parkinsonism, multiple sclerosis, and bulbar palsy, as well as strokes and accidents, can cause dysarthria. Communication skills often may be improved by appropriate treatment.


Complex problems, which may result in varying degrees are a reduced ability to understand what others are saying, to express oneself, or to be understood. Some individuals with this disorder may have only mild difficulties recalling names or words. Others may have problems putting words into their proper order in a sentence. The ability to understand oral directions, to read, to write, and to deal with numbers may also be disturbed. Strokes are the major cause of aphasia in the older population. It has been estimated that there are over 1 million adults with aphasia in the United States today many can be helped to communicate more effectively.

Voice Problems

Laryngectomy, surgical removal of the larynx (voice box), due to cancer affects approximately 9000 individuals each year, most of whom are older. They can usually learn to speak again by learning esophageal speech, by using an electronic device, or by surgical implant of voice prosthesis. Other forms of disease may result in complete or partial loss of the voice. Most the these problems can be treated.

Hearing Problems

It is estimated that of the approximately 27 million Americans over the age of 65, as many as 50%, may be affected by hearing impairment. The hearing loss observed as part of the aging processes called “presbycusis.” Many of those with presbycusis describe the problems as being able to “hear” what others are saying, but being unable to understand what is being said. This condition can lead to withdrawal from personal interactions of all types. Family or friends may confuse the disorder with “forgetfulness” or “senility”. A hearing aid can often improve communication for older people with hearing loss.

Other Communications Problems

Brain diseases that result in progressive loss of mental faculties may affect memory, orientation to time, place and people, and organization of thought processes, all of which may result in reduced ability to communicate.

Why are communication disorders serious problems for older people?

Our communication system, which involves speaking, hearing and understanding the speech of others; reading, writing, is a unique human achievement. It plays a vital role in all aspects of life – jobs, families and recreation. When communication processes are damaged by disorders of speech, language or hearing, the affects are always serious.

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Speech and Pediatric Clinic
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