A 72-year-old retired accountant presents with progressive bilateral hearing difficulty over several years, particularly troublesome in noisy restaurants and group conversations. He reports difficulty understanding women's and children's voices while hearing his son's deeper voice more clearly. Examination reveals normal otoscopy, Type A tympanograms bilaterally, and Weber test at 512 Hz does not lateralize. Rinne test shows air conduction greater than bone conduction bilaterally. Pure-tone audiometry demonstrates the pattern marked **A** in the diagram. Which of the following BEST describes the pathophysiological basis of this audiometric finding?
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