Changes in hearing thresholds over a 10-year period in a large population of older adults (2130) ranging in age from 48 to 92 years were documented. Pure-tone thresholds at frequencies from 0.5 to 8 kHz were evaluated at a baseline examination and 2.5, 5, and 10 years later. For younger age groups (50-69 years of age), threshold changes were generally greatest for higher frequencies; in older age groups (70-89 years of age), threshold changes were generally greatest for lower frequencies due to a ceiling effect at higher frequencies. At frequencies of 0.5, 1, 2, and 8 kHz, the pattern of 10-year changes in thresholds across audiometric frequencies was generally similar for men and women. Threshold changes at 4 and 6 kHz were relatively constant for all ages in men across the 10-year examination period; threshold changes at the same frequencies in women increased for the 48-59 and 60-69 years age groups and then tended to level off. Other than age and gender, the best baseline examination predictors of 10-year thresholds at a specific audiometric frequency were the baseline threshold at that frequency followed by the baseline threshold for the next higher test frequency.