{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T08:45:59Z","timestamp":1792053959202,"version":"4.4.0"},"reference-count":22,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T00:00:00Z","timestamp":1785715200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T00:00:00Z","timestamp":1785715200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2026,11]]},"abstract":"ABSTRACT<\/jats:title>\n \n Objectives<\/jats:title>\n Alzheimer's disease and related dementias (AD\/ADRD) can lead to deterioration in voice and swallowing. Vocal fold atrophy (VFA), seen with aging and neurodegenerative disease, results in thin\/bowed vocal folds with incomplete glottic closure during voicing and swallowing, leading to breathy voice from air leakage. Magnitude of VFA in AD\/ADRD has not been previously studied. This study compared endoscopic measures of VFA in AD\/ADRD patients with age\u2010matched controls.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n Thirteen patients with a diagnosis of AD (\n n<\/jats:italic>\n \u2009=\u20093), Lewy body dementia (\n n<\/jats:italic>\n \u2009=\u20093), vascular dementia (\n n<\/jats:italic>\n \u2009=\u20091), or multiple\u2010etiology dementias (\n n<\/jats:italic>\n \u2009=\u20096) presenting to a tertiary laryngology practice were included in this cross\u2010sectional study. Demographics, Consensus Auditory\u2010Perceptual Evaluation of Voice (CAPE\u2010V), Voice Handicap Index\u201010, and stroboscopic still images were obtained. Images were analyzed for bowing index (BI), normalized glottal gap area (NGGA), and normalized mucosal wave amplitude (NMWA). Two age\u2010matched controls were selected for each patient, yielding 13\n AD<\/jats:sc>\n \/ADRD patients and 26 controls (1:2 ratio).\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Mean age for patients was 80\u2009\u00b1\u200910\u2009years. AD\/ADRD patients demonstrated higher BI scores compared with controls (4.51; 95% CI [1.39, 7.63];\n p<\/jats:italic>\n \u2009=\u20090.008). AD\/ADRD patients displayed significantly lower NMWA values (\u22128.2; 95% CI [\u22129.8, \u22126.6];\n p<\/jats:italic>\n \u2009<\u20090.0001). No significant difference seen in NGGA between groups (0.26; 95% CI [\u22121.69, 2.43];\n p<\/jats:italic>\n \u2009=\u20090.7).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n This is the first study to quantify VFA in AD\/ADRD patients. Endoscopic measures revealed significant atrophic differences compared with age\u2010matched controls. These measures may serve as potential laryngeal indicators of neurodegenerative involvement in ADRD, though larger studies are needed to establish clinical utility.<\/jats:p>\n <\/jats:sec>\n \n Level of Evidence<\/jats:title>\n 3.<\/jats:p>\n <\/jats:sec>","DOI":"10.1002\/lary.70761","type":"journal-article","created":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T01:24:32Z","timestamp":1785806672000},"page":"4896-4902","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Vocal Fold Atrophy in Patients With Alzheimer's Disease and Related Dementias"],"prefix":"10.1002","volume":"136","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-1453-1897","authenticated-orcid":false,"given":"Byron","family":"Kim","sequence":"first","affiliation":[{"name":"University of Washington School of Medicine Seattle Washington USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carson","family":"Miller","sequence":"additional","affiliation":[{"name":"University of Washington School of Medicine Seattle Washington USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shruti","family":"Dhingra","sequence":"additional","affiliation":[{"name":"University of Washington School of Medicine Seattle Washington USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mahdi","family":"Al\u2010Ghezi","sequence":"additional","affiliation":[{"name":"University of Washington School of Medicine Seattle Washington USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emily","family":"Wilson","sequence":"additional","affiliation":[{"name":"Division of Laryngology, Department of Otolaryngology\u2014Head and Neck Surgery University of Washington School of Medicine Seattle Washington USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8933-5477","authenticated-orcid":false,"given":"Neel K.","family":"Bhatt","sequence":"additional","affiliation":[{"name":"Division of Laryngology, Department of Otolaryngology\u2014Head and Neck Surgery University of Washington School of Medicine Seattle Washington USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,3]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cger.2022.07.005"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.30394"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1177\/000348949710600702"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.3233\/JAD\u20102010\u20101316"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1590\/1980\u20105764\u2010DN\u20102021\u20100073"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000000240"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1468\u20101331.2008.02503.x"},{"issue":"2","key":"e_1_2_10_9_1","first-page":"E62","article-title":"Quantitative Analysis of Vocal Fold Vibrations in Vocal Fold Atrophy Using High\u2010Speed Digital Imaging","volume":"125","author":"Yamauchi A.","year":"2015","journal-title":"Laryngoscope"},{"issue":"1","key":"e_1_2_10_10_1","first-page":"134","article-title":"Quantitative Analysis of Videostroboscopic Images in Presbylarynges","volume":"15","author":"Bloch C. S.","year":"2001","journal-title":"Journal of Voice"},{"issue":"10","key":"e_1_2_10_11_1","first-page":"2484","article-title":"A Quantitative Measure of Vocal Fold Bowing: The Bowing Index","volume":"123","author":"Senior B.","year":"2013","journal-title":"Laryngoscope"},{"issue":"5","key":"e_1_2_10_12_1","first-page":"603","article-title":"Quantitative Glottal Gap Area Analysis Using Videostroboscopy","volume":"32","author":"Spieker M. R.","year":"2018","journal-title":"Journal of Voice"},{"issue":"6","key":"e_1_2_10_13_1","first-page":"771","article-title":"Quantitative Analysis of Mucosal Wave Amplitude in Age\u2010Related Vocal Fold Atrophy","volume":"28","author":"Imagawa H.","year":"2014","journal-title":"Journal of Voice"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000004717"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005537\u2010200409000\u201000009"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1044\/1058\u20100360(2010\/09\u20100105)"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.31942"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvoice.2014.10.017"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvoice.2015.05.018"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1002\/alz.13859"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.resp.2005.04.015"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.28158"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.otc.2019.03.001"}],"container-title":["The Laryngoscope"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/lary.70761","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/lary.70761","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/lary.70761","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T08:09:22Z","timestamp":1792051762000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/lary.70761"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,3]]},"references-count":22,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2026,11]]}},"alternative-id":["10.1002\/lary.70761"],"URL":"https:\/\/doi.org\/10.1002\/lary.70761","archive":["Portico"],"relation":{},"ISSN":["0023-852X","1531-4995"],"issn-type":[{"value":"0023-852X","type":"print"},{"value":"1531-4995","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,3]]},"assertion":[{"value":"2026-02-22","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-07-10","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-03","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}