Aging-related vocal cord atrophy: This is the most common cause of hoarseness in the elderly due to the natural aging process, which can lead to thinning and atrophy of the vocal cords, resulting in voice changes.

Gastroesophageal reflux disease (GERD): Stomach acid reflux can irritate the vocal cords, leading to hoarseness. This condition is common in the elderly and can be exacerbated by age-related decreases in lower esophageal sphincter tone.
Vocal cord polyps or nodules: These growths can develop on the vocal cords due to voice overuse or strain, leading to hoarseness. While more common in younger individuals, they can still occur in the elderly.
Hypothyroidism: This condition can cause vocal cord swelling and hoarseness. It is more common in women and can occur at any age, including in the elderly.

Laryngeal cancer: Although less common, laryngeal cancer can present with hoarseness and is more likely to occur in older adults with a history of smoking. Early detection is crucial for effective treatment.
Vocal cord paralysis: This can be caused by a variety of conditions, including stroke, thyroid surgery, or tumors affecting the recurrent laryngeal nerve. It requires prompt evaluation to determine the underlying cause and appropriate management.

Amyloidosis: A condition characterized by the deposition of amyloid proteins in various tissues, including the larynx, which can lead to hoarseness. It is rare and typically presents with systemic symptoms.
Sarcoidosis: An autoimmune disease that can affect the larynx and cause hoarseness, although this is a rare manifestation of the disease.
Relapsing polychondritis: A rare autoimmune disorder that can cause inflammation of the laryngeal cartilages, leading to hoarseness and other respiratory symptoms.