The purpose of this study was to determine full-thickness rotator cuff tear prevalence in patients 65 and older and to correlate tears with comfort, function, and co-morbidities. Two-hundred shoulders without prior surgery were evaluated with a Simple Shoulder Test, a Constant Score, and ultrasound. Full thickness tear prevalence was 22%. Adjusting for age and gender, those with tears had lower scores than those without (P < .001 for each). Adjusting for many potential confounders, with a 10-year age increase, the odds of a tear increased 2.69-fold (P = .005). For those with tears, scores were no different for those who had seen a physician for their shoulder compared to those who had not. Full-thickness cuff tear prevalence was 22% in those 65 and older. Tear prevalence increased with increasing age. Shoulder scores were poorer for those with tears.