Purpose: To identify age-related changes in the auditory and vestibular systems in normal older subjects followed serially over time. Methods: Pure tone hearing levels, speech reception threshold, speech discrimination scores, and vestibule-ocular responses were measured in 57 normal older subjects (mean age, 82) on 5 yearly examinations. Results: There was a significant (P < .001) increase in pure tone threshold averages (about 1 dB per year) and speech reception threshold averages (about 2 dB per year), and a significant (P < .001) decrease in discrimination scopes (about 2% per year) over the 5 years of follow-up. There was a significant (P < .05) amplitude-dependent decrease in gain and increase in phase lead of the vestibule-ocular reflex and a significant (P < .01) decrease in gain of visual-vestibular responses at low frequency sinusoidal stimulation over the 5 examinations. Years 1 to 5 differences in individual subjects were significantly (P < .01) correlated across auditory and vestibular tests, but not between auditory and vestibular tests (P > .01). Conclusion: This is the first longitudinal study to show age-related decreases in auditory and vestibular responses in normal older subjects. Because the age-related changes in the auditory system were not correlated with age-related changes in the vestibular system, the 2 systems may age at different rates in the same individual. These changes likely result from degeneration in both peripheral and central structures, although age-related changes in the central nervous system probably are more important from a functional point of view. Copyright (C) 1999 by W.B. Saunders Company.