Acoustic Markers of Laryngeal Function and Swallowing Safety in Community-Dwelling Older Adults: An Exploratory Study.

The study was small and exploratory: 32 older adults were assessed, and only 7 met the airway invasion risk threshold. The risk group included mostly penetration, with only one participant showing true aspiration, so it cannot be read as a test for aspiration detection. Many acoustic variables were screened (65 features), and no PAS-related acoustic finding survived the stricter false-discovery check, so the acoustic associations are candidate signals. The sample was community-dwelling and excluded neurological disease, active head and neck pathology, and tracheostomy, so results do not generalise to common clinical dysphagia populations. The design was cross-sectional, so it cannot show whether acoustic features predict later swallowing safety. Different acoustic measures came from different tasks (pitch glide perturbation versus connected speech noise), so task effects cannot be separated from acoustic effects. The HFNO odds ratio was large because of predictor scaling, not because HFNO has a large clinical effect. Recording conditions and signal quality may have influenced spectral noise measures.

The authors declared no conflicts of interest and no competing financial interests.

Do not use high-frequency noise or the model accuracy numbers to decide who is aspirating. The risk group had only seven participants, no PAS-related acoustic finding survived the stricter false-discovery check, and the large odds ratio for HFNO reflects scaling rather than effect size.