Acoustic analysis of the voice in patients with Parkinson's disease and hypokinetic dysarthria / Análisis acústico de la voz en pacientes con enfermedad de Parkinson y disartria hipocinética

Background and aim: Most patients with Parkinson's disease (PD) develop speech disorders during the course of the disease. These disorders severely affect the speech intelligibility and vocal quality of these people. The aim of this paper is to characterize the voice and speech of subjects with PD through the automatic analysis of voice recordings. We also study whether there is a relationship between the acoustic parameters extracted from the recordings and the quality of the voice perceived by the subjects themselves. Materials and methods: This is a descriptive correlational study in which 20 subjects with PD and 20 healthy controls were compared. The subjects with PD completed the VHI-30 instrument and performed sustained phonation of different vowels in Spanish. The stage of the disease was also evaluated using the Hoehn and Yahr scale. Results: There are greater vocalic changes in subjects with PD than in healthy controls. In particular, significant differences were found for the vowel space area, intensity, F0, jitter and shimmer. No statistically significant associations were found between these acoustic parameters and the voice quality as perceived by the subjects with PD. Conclusions: Acoustic analysis of voice and speech may be of great help in characterizing the state of hypokinetic dysarthria in PD patients. In addition, automatic tools of this type could be used in the future in a complementary manner to facilitate identifying treatment needs in PD patients.(AU)

Antecedentes y objetivo: La mayoría de pacientes con enfermedad de Parkinson (EP) desarrollan trastornos del habla durante el curso de la misma. Estos trastornos afectan gravemente la inteligibilidad del habla y la calidad vocal de estas personas. El objetivo de este trabajo es caracterizar la voz y el habla de personas con EP mediante el análisis automático de grabaciones de voz. También se estudia si existe la relación entre los parámetros acústicos extraídos de las grabaciones y la calidad de la voz percibida por los propios sujetos. Materiales y métodos: Se trata de un estudio descriptivo correlacional en el que se compararon 20 sujetos con EP y 20 controles sanos. Los sujetos con EP completaron el instrumento VHI-30 y realizaron fonación sostenida de distintas vocales en español. Asimismo, se evaluó el estadio de la enfermedad utilizando la escala de Hoehn y Yahr. Resultados: Hay mayores cambios vocálicos en las personas con EP que en los controles sanos. En particular, se encontraron diferencias significativas para el área del espacio vocálico, la intensidad, F0, el jitter y el shimmer. No se encontraron asociaciones estadísticamente significativas entre esos parámetros y la calidad de voz percibida por el propio sujeto. Conclusiones: El análisis acústico de la voz y el habla puede ser de gran ayuda para caracterizar el estado de la disartria hipocinética en pacientes con EP. Además, este tipo de herramientas automáticas podrían facilitar la detección de necesidades de tratamiento de los pacientes con EP.(AU)

Loneliness in older people from Spain and Mexico: a comparative analysis / Soledad en personas mayores de España y México: un análisis comparativo

Abstract It has been found that suffering loneliness increases the probability of anxiety and depression. The importance of studying loneliness is due to the negative consequences that this phenomenon can generate on the mental and physical health of elderly people. The objective of this study was to analyze the influence of loneliness in old age and their form of coexistence, and determine whether there are differences depending on the cultural group analyzed, Spain or Mexico. A quantitative design with a comparative scope was used. A total number of 691 older adults (40.2% men and 59.8% women) age 60 years-old or older from Spain (42.7%) and Mexico (57.3%) were selected to take part in this study through convenience sampling. Instruments included a sociodemographic data section, consisting of questions about age, sex, education, marital status and with whom the participants lived. Also the ESTE scale of loneliness was used, which measures the existing deficits in the support of the individual at family, marital and social level, as well as the feelings resulting from such deficits. Hypothesis tests were processed using the χ2 coefficient, the contingency coefficient and the t-test for independent samples, with a significance level of p ≤. 050. Results showed that cultural differences according to the country of origin have weight on the prevalence of situations of loneliness in the elderly. Evidence was found that in both samples, demographic characteristics such as sex, education, and marital status, make a difference in the characterization of loneliness, and that there is a relationship between the demographic factors of elderly people and the onset of loneliness. The study underlines the importance that cultural background and demographic characteristics have on loneliness and how these aspects should be considered as risk factors for the development of loneliness in the older adults.

Resumen Se ha encontrado evidencia de que la soledad incrementa la probabilidad de presentar problemas de ansiedad y depresión en personas mayores, razón por la cual se hace importante el estudio de las consecuencias negativas de este fenómeno sobre la salud mental y física de estas personas. El objetivo de este trabajo fue analizar la influencia de la soledad en la vejez y en la forma de convivencia de los adultos mayores, así como determinar si existen diferencias en función del grupo cultural analizado (España y México). Para esto, se utilizó un diseño cuantitativo con alcances comparativos, en el que participaron 691 adultos mayores (hombres = 40.2 %, mujeres = 59.8 %) de 60 o más años (M = 71.49, DE = 7.41), residentes de España (42.7 %) o México (57.3 %), seleccionados por medio de un muestreo por conveniencia. Para el análisis, por medio de la aplicación de un apartado sobre datos sociodemográficos y la escala ESTE de soledad -que mide los déficits existentes en el soporte del sujeto a nivel familiar, conyugal y social, así como los sentimientos resultantes de tales déficits-, se procesaron pruebas de hipótesis con el coeficiente χ2, el coeficiente de contingencia y la prueba t para muestras independientes -con un nivel de p ≤ .050-. Los resultados demostraron que las diferencias culturales según el país de pertenencia tienen peso sobre la prevalencia de situaciones de soledad en el adulto mayor; que en ambas submuestras las características demográficas hacen diferencia en la caracterización de la soledad; y que hay evidencia de una relación entre los factores sociodemográficos de las personas mayores y la aparición de la soledad. El estudio subraya la importancia del entorno cultural y de las características demográficas sobre la soledad, elementos que se deben tener en cuenta como factores de riesgo para el desarrollo de soledad en las personas mayores.

Mental health symptoms and verbal fluency in elderly people: Evidence from the Spanish longitudinal study of aging.

OBJECTIVES: Depression and loneliness are highly prevalent in old age. Moreover these mental health symptoms adversely affect the verbal fluency of the elderly. We examined the relationship between depression and loneliness with verbal fluency in people aged 50 years or older. METHOD: Research data were collected during the pilot study of the Longitudinal Aging Study in Spain (ELES) in which a representative sample of non-institutionalized Spanish older people was assessed. Here, the cross-sectional data for 962 participants were analysed using hierarchical regressions, controlling for age, education level, overall cognitive functioning, social networks and satisfaction with family. RESULTS: Higher levels of cognitive functioning were associated with higher verbal fluency. Females showed higher levels of phonological fluency. Neither depression nor loneliness were significant predictors of phonological fluency but loneliness was a significant predictor of semantic fluency. For mild levels of loneliness, the rate of decline in semantic fluency slows in the oldest ages. In contrast, for severe loneliness the rate of decline in semantic fluency increases in the oldest ages. CONCLUSIONS: Depressive symptoms, loneliness and cognitive impairment are all prominent in ageing and therefore their impact on ageing needs to be better understood. Early detection of loneliness, along with the implementation of intervention for individuals diagnosed with loneliness is advisable in order to avoid negative repercussions for the verbal fluency of these individuals.