Impaired hearing can result from age-related changes in the auditory system. A condition called presbycusis, a hearing deficit secondary to aging, can occur from numerous sources such as noise, vascular or systemic diseases, poor nutrition, ototoxic drugs, and pollution. These exposures occurring over the life span can damage the delicate hair cells of the organ of Corti, cause calcification of the ossicles of the middle ear, and interfere with sound conduction. Tinnitus (ringing in the ear) may also occur secondary to the aging process. Visual and hearing losses in the older adult can result in physical and psychosocial problems. Early detection of these helps maintain a more productive lifestyle. The remaining sense undergo slight changes that decrease their reaction or threshold time, which results in slower response or diminished sensation