An older client reports to a nurse. "My daughter says there is something wrong with my hearing. I am not so sure. Yes, I have some problems hearing, but I am 78 years old. What does she expect? I noticed that at Christmas dinner, with all the racket around, I had some trouble. I think it is that my granddaughters mumble a lot, just like all young people. I guess it has been getting steadily worse; it seems to be both ears as well." Based on the client's description, the nurse suspects which of the following?

A. A perforated eardrum typically causes sudden hearing loss, pain, or drainage from the ear, and usually affects one ear—not both. B. Otosclerosis is a hereditary condition involving abnormal bone growth in the middle ear that leads to conductive hearing loss, usually starting in one ear and affecting younger adults. C. Tinnitus is characterized by ringing or buzzing in the ears, not by gradual, bilateral hearing loss or difficulty hearing in noisy environments. D. Presbycusis is age-related sensorineural hearing loss that occurs gradually in both ears. It commonly involves difficulty hearing high-pitched sounds and distinguishing speech in noisy environments—exactly as described by the client.