Old age and puberphonia, same pathology.

In adult males, voice changes primarily occur during puberty and can continue subtly into later life. During puberty, hormonal changes, particularly testosterone, lead to the larynx (voice box) growing, vocal cords lengthening and thickening, and the development of a deeper, more resonant voice. After puberty, voices may continue to develop and stabilize into the early twenties. Older males may experience some voice changes, including a possible increase in pitch, decreased volume, or vocal strength but these changes are often subtle. Also called presbyphonia or presbylaryngeus, these issues can develop due to vocal cord atrophy, diminished lung power, and lazy structures. The same findings are expected in puberphonia. So, treatment only activates the vocal tract. That is UMAR.