This column is inspired by one of my patients. At age 75, she sings, sings well, and gets paid for it. And she is not alone—there is a great number of successful singers who continue to perform well past menopause and into what used to be considered old age.
I often joke that the word “old” has somehow dropped out of our vocabulary. People are just “older,” until they are suddenly “elderly.” And the older singer often continues to have a career which, with appropriate modifications, can continue for years.
Aging is a complex process that affects all parts of the body. Rates of aging and its effects vary, depending on your genes as well as many environmental factors. While we have no control over our genes, we can significantly influence and slow the rate of gradual deterioration by taking control of our environment.
There are a number of ways that the aging voice can be identified. They include decreased ability to power and sustain, loss of color and projection, and decreased neuromuscular control. I will address each of these areas in turn.
The ability to power and sustain depends on the flexibility and capacity of the lung and thorax, as well as strength and control of the abdominal and pelvic muscles. This is an area that can be significantly improved and maintained with aging by some simple measures. I refer to exercise, diet, and weight control. Exercising the abdominal and pelvic muscles is different from aerobic exercise and involves the stretching and slow contracting of the muscles. Deep breathing exercises, such as with yoga, keep the thorax and its muscles flexible. The abdominal muscles and the postural muscles of the back can be strengthened by sit-ups, leg raises, and crunches, adjusted to the strength and ability of the individual. The muscles of the pelvic floor can be strengthened by Kegel exercises, which lift the floor of the pelvis. Slow exercises are the best, since these muscles normally contract slowly, and we are interested not only in strength but also in mindful control of contraction, relaxation, and moment-to-moment position. The purpose of exercise is to retain muscle mass and control over contraction, thereby providing a good power source for the voice.
Another important aspect is the ability to approximate the vocal folds and maintain resistance against the upward pressure and flow of air from the lungs. Loss of muscle mass and flexibility also affects the vocal folds. As the folds decrease in substance, there is a tendency to overly approximate them (hyperadduction) in order to achieve an adequate degree of closure. This requires greater muscular effort and neuromuscular tone and may exaggerate vocal tremor and wobble. Loss of color is commonly seen in older singers. This is due to a combination of changes affecting the vocal folds and the supraglottic resonators. Loss of tissue substance and tone changes the acoustic characteristics of these areas.
The hyperadduction needed to approximate the vocal folds may have an unintended effect of also approximating the false folds. This can alter the resonance immediately above the vocal folds, where the “ring” is normally generated. Another unintended effect of greater contraction is elevation of the larynx which, in turn, not only changes the shape and resonant frequencies of the pharynx but can also impair the ability to smoothly negotiate the passaggio.
The aging vibrato has specific characteristics, including wider excursion, loss of control, and loss of a tonal center. Since all of these vary with the amount of neuromuscular effort, it would make sense that the louder and more effortfully one sings, the more these characteristics are exaggerated. The sound can additionally be affected by an underlying tremor which is unrelated to singing and can manifest any muscular activity (benign essential tremor).
To take stock of the damage then, we hear in the aging voice the tendency towards decreased power and projection, decreased ability to sustain, decreased color and flexibility, and a deteriorating vibrato. Since different parts of the vocal tract deteriorate at different rates, the sum total of these effects will vary from singer to singer as aging continues.
What to do? Actually, there is a great deal that can be done to prolong your vocal career! Here are some thoughts, from my experience—and, more importantly, from my patients.
As already mentioned, maintaining muscular tone and neuromuscular control will delay some of these changes. Exercises for your core (abdomen and pelvis), breathing, and vocal exercises will keep your vocal tract toned (and tuned!) into older age. While cardiac fitness is generally healthy, exercises which strengthen the slow-contracting muscles are especially relevant. Yoga and Tai Chi strengthen not only muscles but also the conscious control of the brain over your body.
What about diet? A healthy weight is important. Try to avoid rapid or significant weight loss, since the muscles are now less able to adjust and will contract less effectively against the decreased resistance. Maintaining the normal weight of past years is ideal in this regard. As muscles inevitably weaken, it is actually easier to support with a bit of extra abdominal bulk. The French laryngologist Jean-Jacques Abitbol has suggested that a bit of extra fat (what he calls the Rubens vs. the Modigliani body type) actually mitigates for the loss of hormones after menopause and protects the voice.
As you adjust your diet (we typically burn, and need, less calories as we age), make sure to eat healthful foods: a good mixture of fresh fruits and vegetables, adequate roughage, and fewer simple carbs. Vitamins may help, but supplements are just that—supplemental to, not a replacement for, good food. In this regard, I find the current advertising trend to promote protein shakes as a food replacement to healthy people ridiculous: just eat your food and move your bowels. It is better for you—and pushing on the toilet may even improve your support!
Be vigilant in terms of general health issues which may affect your voice but are mistaken for aging. Two important ones are mild and subclinical hypothyroidism and mild cases of Parkinsonism. These often manifest early in the voice and can be medically treated.
And now we come to the most important area, which is the brain—both as the control center for all neuromuscular activity and as the seat of intelligence, general and musical. Even as we age, the brain has a tremendous amount of plasticity and reserve. This means that it can learn new ways of achieving tasks and resourcefully work around deficits.
On a conscious level, we need to accept the reality of an aging voice. But those with determination and musical intelligence can see this as an exciting challenge. A meaningful work of art need not be an epic poem—it can be a haiku. A small painting with a subtle color palette can be just as evocative as a heroic canvas that covers the wall. And who is to say that a Puccini aria is intrinsically greater art than “Gretchen am Spinnrade”?
So, the wisdom of acceptance is the necessary first step. But this is followed by the ingenuity and determination that takes the voice in new directions. The intelligent singer is the one who, while relishing the memory of past glories, takes clear-eyed stock of the present and uses all of his or her abilities, technique, anatomy, experience, and intelligence to continue to perform.
Once a singer has a clear inventory of his or her resources, the next step is to adjust the repertoire to make use of those considerable abilities. For singers who have spent their lives working up to certain roles, this is a paradigm shift: increasingly, you no longer fit the voice to the role, but the role to the voice. An older bass-baritone patient of mine had developed a wobbly vibrato with some loss of tonal center, but he has continued to give fine performances of buffo roles and patter arias. These minimize his weakness, the long sustained notes which would reveal some loss of color or controlled vibrato. Rather, they emphasize his strength: text, articulation, and artistic interpretation, all unimpaired.
A story can be well told in many ways. Several months ago, I had the pleasure of attending a performance by jazz pianist and singer Barbara Carroll. Carroll, 88 years old, not only played extremely well but sang wonderfully. The tune, told half in words, half in song, was articulated with finesse, intimacy, and always with a twinkle in her eye. No one in the audience felt like we had to cut her any slack or to indulge her with deference to her age. She just had all of us in the palm of her hand.
Aging is a reality, and the aging of the voice is a gradual and inevitable process that the older singer faces daily. But can we look at this as a challenge? With good general health care to keep the vocal tract strong and flexible, and the intelligence and curiosity to keep reinventing your performance, the pleasure of singing will be part of your life for a long time—not just as a wistful memory but as a vital and relevant gift.
