There's a lot of advice about how to keep skin smooth and muscles strong as we get older, yet there's an aspect to ageing that most of us never consider — our voice.

Not only can the quality of our voice be as 'ageing' as wrinkles, but experts also say we should take steps to preserve the voice, as not doing so risks social isolation, even depression.

Last month, the singer Lulu, 75, said she regularly exercises her voice to preserve it and doesn't speak before noon on days that she is performing.

'It surprises most people that the voice is part of the ageing process, but it is,' says Ruth Epstein, a consultant speech and language therapist based in London. 

'The vocal folds [within the larynx, or voice box] are some of the smallest muscles we have. If we think about what happens to other muscles as we age, it's obvious they are affected too.'

Singer Lulu, 75, said she regularly exercises her voice to preserve it and doesn't speak before noon on days that she is performing

While there's lots of advice about how to keep skin smooth and muscles strong as we get older, there is very little advice about how to keep our voices young (Stock image)

As we age, our voices can get quieter, less expressive and increasingly tremulous, but 20 per cent of older adults — according to research published last year in the American Journal of Speech-Language Pathology — will develop a voice disorder, where the voice doesn't work as it should, becoming weak or wavery, for example.

These changes can have far-reaching effects, even leading to depression. 'Many people accept their voice is weaker as they get older and they become withdrawn and communicate less,' says Ruth Epstein. 

'There is a profound emotional impact.' There are multiple reasons for these changes. 'Over time, our vocal folds become stiffer and less flexible,' she explains.

'There's also a reduction in muscle mass that starts affecting the speed, force and endurance of the laryngeal muscles [which control vocal volume and strength].

'There's reduced sensitivity in these muscles as they shrink with age, which affects their ability to contract.' This can make our voices hoarser.

'Meanwhile,' she adds, 'a reduction in hyaluronic acid in the tissue [which acts as a lubricant] and the muscle-wasting associated with age leaves us with thinner, stiffer vocal folds.

'Mucus production also reduces and our lung capacity diminishes, which can all change our voice.'

Women's voices are more susceptible because their vocal folds are more delicate. However, with age, both sexes can find their voices become more monotonous 'because the larynx drops, extending the length of the vocal tract and altering the sound,' says Ruth Epstein.

As we age, our voices can get quieter but 20 per cent of older adults  will develop a voice disorder, where the voice doesn't work as it should, becoming weak or wavery (Stock image)

'Male and female voices lower from about 65. The cartilage in the male larynx gets thinner and male voices grow reedier. Women's voices just get deeper.'

Our voices become quieter as we're less able to increase volume, and tremors are also more common. To stave off these changes, maintaining fitness is key.

'Ageing of the voice is a biological thing, not just about your actual age,' says Ruth Epstein. 'People who regularly go to the gym or do 10,000 steps a day won't sound as old. It's about thinking of the voice as part of the body.'

You also need to protect your vocal cords by, for example, avoiding junk food or eating just before bed. 'If you eat late and then retire, the likelihood is acid secretions will travel to the back of the throat,' she says. 'This can cause irritation.'

There are targeted approaches, too, she adds. 'We're currently looking at new treatments that combine laryngeal and respiratory-focused exercises to treat the ageing voice.'

She says that increasing water intake to seven or eight glasses a day, and using steam inhalation, can help — the steam passes over your vocal cords, lubricating them. 'I always tell people to join a choir and I encourage older people not to do online shopping but to get out and speak to people, as chatting will help keep the laryngeal muscles toned.'

People who use their voice at work aren't more at risk. 'On the contrary,' says Ruth Epstein. 'If you use your voice professionally the muscles will be more agile.

'A teacher might not suffer from the ageing process as much as someone who is a librarian. It's use it or lose it.'