Theory of Mind (ToM) is a crucial factor in the social integration of the elderly. Nonetheless, there has been a dearth of research into the relationship between ToM and presbycusis, even though presbycusis is a very common pathology among people over 65 years of age. The aim of this study is to analyze the functioning of the two types of ToM (affective and cognitive ToM) in aging populations, as well as to examine the components of ToM connected to ironic language, all in order to determine whether people with presbycusis show a similar ToM profile to those without any hearing loss. The sample consisted of 69 participants with a mean age of 75. Of the participants, 52 had some degree of hearing loss. Some participants with hearing loss used a hearing aid. All participants were asked to complete six ToM tasks. The results show that age influences ToM scores, especially for cognitive and irony recognition tasks. This decline in ToM was greater in participants experiencing mild cognitive impairment and also among those with hearing loss. Among participants with presbycusis, those who used a hearing aid obtained better results than those who did not. Gender and sociocultural background were not found to be significant variables. The results point to a need to monitor both hearing and cognitive abilities, especially those related to ToM, and to offer specific treatment whenever possible to avoid social alienation.