Aging in the nasal tissues produces anatomical and physiological changes in the elderly. The elderly have a generalized decrease in body water content of 7%, and with the degeneration of mucus-secreting cells, the effectiveness of the mucociliary system is reduced with frequent symptoms of nasal stuffiness. The fragmentation and weakening of the cartilage of the septum also causes airflow changes contributing to nasal stuffiness. The elderly also experience hormonal and metabolic changes which affect the physiologic nasal function. Epistaxis is relatively common in the elderly, and aging changes in the vascular system such as atherosclerosis contribute to the severity of epistaxis. The majority of nosebleeds in the elderly originate anteriorly due to dryness and local trauma.