A nurse is teaching a Health Promotion class at a local Senior Center. The nurse shares that typical changes of the ear related to the aging adult include which of the following options? (Select all that apply)

Auditory senescence involves sensorineural degeneration within the organ of Corti and stiffening of the tympanic membrane. Aging causes atrophy of the stria vascularis, leading to diminished neural transmission and sound processing. The ototoxic effects of long-term environmental noise exposure accumulate, resulting in irreversible cochlear hair cell loss and dysfunction. A. Increased moisture of cerumen: Aging typically results in decreased activity of apocrine glands, leading to drier, more impacted cerumen rather than increased moisture. This dry wax can obstruct the external auditory canal and contribute to conductive hearing loss. It is the opposite of the expected geriatric change. B. Presbyopia: This term refers to the age-related loss of ocular lens elasticity, resulting in a diminished ability to focus on near objects. While it is a typical aging change, it involves the visual system, not the ear. It is an irrelevant finding for an auditory health assessment. C. Presbycusis: This is the most prevalent form of age-related sensorineural hearing loss, occurring bilaterally and symmetrically. It results from progressive degeneration of the auditory nerve and inner ear structures. It significantly impairs speech discrimination, especially in environments with high levels of background noise. D. A high-tone frequency loss: The initial manifestation of presbycusis is the inability to perceive high-frequency sounds, such as consonants or high-pitched voices. This occurs because the hair cells at the base of the cochlea, which process high frequencies, are most vulnerable to age-related damage. It is a hallmark of geriatric auditory decline. E. Increased elasticity of the pinna: With advanced age, the dermal and cartilaginous structures of the external ear lose elasticity and collagen support. This leads to increased stiffness, drooping, or elongation of the pinna rather than increased elasticity. The skin becomes thinner and more prone to mechanical trauma.