The aging voice has complex issues including deterioration of the respiratory system, the vocal fold, resonant organs, muscle, posture, energy, etc. Once the voice is aged, it is often difficult to treat with current strategies, such as voice therapy and augmentation of the vocal fold. Prevention of voice aging is important, and anti-aging or preemptive medicine will be needed in the future. Caloric restriction (CR) is the most reproducible maneuver for extending lifespan. It is suggested that CR might activate sirtuin gene/protein, the main regulator of lifespan, which regulates cell repair, antioxidant effects, and apoptosis. Resveratrol (RSV) has been reported to be a CR mimetic driven by Sirtuin1 activation. RSV has a broad spectrum of activities that are beneficial to health, and may serve as a therapeutic or as an adjuvant agent in age-related voice disorders. Oxidative stress has a great impact on aging, and over-expression of reactive oxygen species is revealed to contribute to age-related histological changes of the vocal fold. It has also been proven that astaxanthin, a strong antioxidant, prevents age-related atrophy of the vocal fold. There are still many unclear aspects regarding the factors that affect voice aging that should be resolved in the future. Regenerative medicine should be useful in recovering the function of aged vocal folds. Currently, basic fibroblast growth factor is clinically usable, and positive effects on the regeneration of the vocal fold have been reported. Further improvements in regenerative medicine for the aged voice are needed.
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