Correlation Between Montreal Cognitive Assessment and Voice Therapy Outcomes in the Aging Treatment- Seeking Population

Not Applicable

Completed

• Conditions: Voice Disorders; Swallowing Disorder; Cognitive Impairment; Cognitive Decline; Voicebox Disorders
• Interventions: Behavioral: Speech Therapy; Behavioral: Swallowing Therapy; Behavioral: Upper Airway Therapy

• Registration Number: NCT05187910
• Lead Sponsor: University of California, San Francisco

Brief Summary

This study will investigate if the performance on the Montreal Cognitive Assessment (MoCA) is associated or predictive of the outcomes in voice, swallowing or upper airway therapy in the older laryngology treatment seeking patients. The relationship between the scores of MoCA and parameters in therapy will be analyzed. The outcomes of this study could potentially impact how investigators determine candidacy for therapy and develop patient treatment plans to meet their needs. This is a collaborative study with Emory Voice Center and the NYU Voice Center.

Detailed Description

Not available

Basic Information
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Recruitment & Eligibility
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Study & Design
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Trial Locations

Study Timeline

• Study Start: 2021-03-01
• Study First Submitted: 2021-11-04
• Study First Submitted QC: 2021-12-24
• Study First Posted: 2022-01-12
• Primary Completion: 2023-05-01
• Study Completion: 2023-07-01
• Status Verified: 2023-09
• Last Update Submitted: 2023-09-22
• Last Update Posted: 2023-09-26

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 57

Inclusion Criteria

• 60 years or older with voice/swallowing/upper airway complaints
• Multidisciplinary assessment by fellowship-trained laryngologist and voice/swallow/upper airway specialized speech-language pathologist
• Voice, Swallowing and/or Upper airway disorder diagnosis
• Candidate for voice, swallowing or upper airway therapy following interdisciplinary assessment.
• State willingness to participate in the study protocol

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Exclusion Criteria

• Under the age of 60 years old
• Previously diagnosed dementia
• Central neurological disorder
• Active psychotic disorder
• Recurrent or active major depressive disorder (PHQ-9 of 10 or greater)
• Patient not able to attempt the MoCA because of a severe hearing or visual impairment
• Patients who do not speak or understand English
• Tested with MoCA in the last month

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Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Patients with Voice Disorders	Speech Therapy	This is typically diagnosed by MDs in conjunction with Speech Language Pathologists (SLPs).
Patients with Swallowing Disorders	Swallowing Therapy	This is typically diagnosed by MDs in conjunction with Speech Language Pathologists (SLPs).
Patients with Upper Airway Disorders	Upper Airway Therapy	This is typically diagnosed by MDs in conjunction with Speech Language Pathologists (SLPs).

Primary Outcome Measures

Name	Time	Method
Change in Voice Handicap Index-10 Score Following Therapy	Recorded at initial clinic visit and follow-up visit after completion of speech therapy. Typically a time scale of 6-12 weeks depending on how soon speech/swallow/upper airway therapy is started.	The Vocal Handicap Index-10 (VHI-10) will be used to obtain a quick, reliable, and quantifiable measure of patients' own vocal handicap perception. In 2004, Rosen et al designed a new shortened version of the first and broadly used global handicap assessment tool for voice disorders, the VHI. This questionnaire comprises 10 questions from the original 30 questions of the VHI and was called the VHI-10. The VHI-10 is a powerful representation of the VHI (30 items) to quantify patients' perception of their voice handicap. The VHI-10 has also been shown to be reliable, valid, and sensitive in a wide range of voice disorders (Rosen et al., 2004). This has a minimum value of 0 and a maximum value of 40. A higher score means a worse outcome.
Change in Eating Assessment Tool-10 Score Following Therapy	Recorded at initial clinic visit and follow-up visit after completion of speech therapy. Typically a time scale of 6-12 weeks depending on how soon speech/swallow/upper airway therapy is started.	The EAT-10 is a 10-question self-assessment tool to identify adults who exhibit signs and symptoms that may be indicative of dysphagia and who may require further referral. The EAT-10 has begun to be used in research with older adults in different settings, including an aged care facility (Wakabayashi \& Matsushima, 2016), acute hospital care (Matsuo, Yoshimura, Ishizaki, \& Ueno, 2016), and the community (Momoki et al., 2017). In the aged care setting, EAT-10 results suggesting the presence of dysphagia have been shown to be independently associated with a risk of malnutrition and impaired functional status (Wakabayashi \& Matsushima, 2016). This has a minimum value of 0 and a maximum value of 40. A higher score means a worse outcome.
Change in Cough Severity Index Score Following Therapy	Recorded at initial clinic visit and follow-up visit after completion of speech therapy. Typically a time scale of 6-12 weeks depending on how soon speech/swallow/upper airway therapy is started.	Cough Severity Index (CSI) is a short and self-administered questionnaire for patients with self-perceived symptoms of cough in order to quantify severity of chronic cough relating to upper airway disease and facilitate treatment outcomes. CSI helps quantify severity of cough in patients with chronic cough (CC) related to the upper airway. This has a minimum value of 0 and a maximum value of 40. A higher score means a worse outcome.
Change in Dyspnea Index Score Following Therapy	Recorded at initial clinic visit and follow-up visit after completion of speech therapy. Typically a time scale of 6-12 weeks depending on how soon speech/swallow/upper airway therapy is started.	Dyspnea Index (DI) is intended to serve as a quick and efficient patient-completed questionnaire to measure upper-airway related symptoms. The DI, by traditional psychometric standards, has good psychometric properties for patients with symptoms of upper airway dyspnea. This has a minimum value of 0 and a maximum value of 40. A higher score means a worse outcome.

Secondary Outcome Measures

Name	Time	Method
Change in Voice Fundamental Frequency as Measured in the VoiceEvalu8 App Following Therapy	Recorded at initial clinic visit and follow-up visit after completion of speech therapy. Typically a time scale of 6-12 weeks depending on how soon speech/swallow/upper airway therapy is started.	Candidates of voice and/or upper-airway therapy will be assessed by acoustic instruments that record and analyze the speaker's voice. Standard clinical measures will be taken.
Change in Acoustic Voice Quality Index (AVQI) as Measured in the VoiceEvalu8 App Following Therapy	Recorded at initial clinic visit and follow-up visit after completion of speech therapy. Typically a time scale of 6-12 weeks depending on how soon speech/swallow/upper airway therapy is started.	Candidates of voice and/or upper-airway therapy will be assessed by acoustic instruments that record and analyze the speaker's voice. Standard clinical measures will be taken.
Change in DIGEST Scale Score Following Therapy	Recorded at initial clinic visit and follow-up visit after completion of speech therapy. Typically a time scale of 6-12 weeks depending on how soon speech/swallow/upper airway therapy is started.	Candidates of swallowing therapy (patients with dysphagia) will undergo standard instrumental swallowing assessment to assess tongue strength and swallowing safety. The minimum score is a 0 and the maximum score is a 4. A higher score is a worse outcome and poorer swallowing safety.
Change in Voice Cepstral Peak Prominence (CPP) as Measured in the VoiceEvalu8 App Following Therapy	Recorded at initial clinic visit and follow-up visit after completion of speech therapy. Typically a time scale of 6-12 weeks depending on how soon speech/swallow/upper airway therapy is started.	Candidates of voice and/or upper-airway therapy will be assessed by acoustic instruments that record and analyze the speaker's voice. Standard clinical measures will be taken.
Change in Iowa Oral Performance Instrument (IOPI) Following Therapy	Recorded at initial clinic visit and follow-up visit after completion of speech therapy. Typically a time scale of 6-12 weeks depending on how soon speech/swallow/upper airway therapy is started.	Candidates of swallowing therapy (patients with dysphagia) will undergo standard instrumental swallowing assessment to assess tongue strength.
Change in Functional Oral Intake Scale (FOIS) Score Following Therapy	Recorded at initial clinic visit and follow-up visit after completion of speech therapy. Typically a time scale of 6-12 weeks depending on how soon speech/swallow/upper airway therapy is started.	Candidates of swallowing therapy (patients with dysphagia) will undergo standard instrumental swallowing assessment to assess tongue strength and swallow function. The minimum score is a 1 and the maximum score is a 7. A 7 means a better outcome/diet without restrictions. A 1 would mean no intake orally.

Trial Locations

Locations (4)

NYU Voice Center; 🇺🇸 New York, New York, United States

UCSF Voice and Swallowing Center; 🇺🇸 San Francisco, California, United States

Cornell Medical Center; 🇺🇸 New York, New York, United States

Emory Voice Center; 🇺🇸 Atlanta, Georgia, United States