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Cerumen, hearing, and cognition in the elderly.

Ann M Moore1, John Voytas, Debra Kowalski

  • 1William Beaumont Hospital, Royal Oak, Michigan, USA. amm@peabody.com

Journal of the American Medical Directors Association
|June 17, 2003
PubMed
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Cerumen impaction is common in skilled nursing facility residents. Its removal significantly improves hearing and cognitive function, offering a safe and cost-effective intervention for this elderly population.

Area of Science:

  • Gerontology
  • Otolaryngology
  • Public Health

Background:

  • Cerumen impaction is a prevalent issue in elderly individuals, particularly those residing in skilled nursing facilities (SNFs).
  • Impacted cerumen can negatively affect hearing acuity and cognitive assessments, potentially leading to misdiagnosis or underestimation of an individual's true capabilities.
  • Addressing cerumen impaction is crucial for accurate health evaluations in this demographic.

Purpose of the Study:

  • To determine the prevalence of cerumen impaction among new admissions to a skilled nursing facility.
  • To assess the impact of cerumen removal on hearing function and cognitive status in elderly SNF residents.
  • To evaluate the efficacy of cerumen removal as an intervention in this population.

Main Methods:

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  • A prospective clinical trial with a pretest-posttest design was conducted in a 160-bed skilled nursing facility.
  • Twenty-nine new residents aged 65 and older participated, with cerumen removal performed using a cerumenolytic agent and water irrigation for those with 50% or more ear canal occlusion.
  • Audiometric evaluations and the Folstein Mini-Mental Status Exam (MMSE) were administered before and after cerumen removal; participants without impaction served as controls.

    • Main Results:

    • Cerumen impaction was found in 65.5% of the participants.
    • Following cerumen removal, 80% of impacted ears showed hearing improvement, compared to 3% of non-impacted ears (P < 0.001).
    • A statistically significant improvement in both hearing scores (0.26 vs. 0, P < 0.001) and MMSE scores (1.05 vs. -0.30, P < 0.01) was observed in the cerumen removal group compared to controls.

    Conclusions:

    • The majority of skilled nursing facility residents experience cerumen impaction.
    • Cerumen removal significantly enhances hearing and cognitive function in this population.
    • This simple, low-cost procedure offers substantial benefits for SNF residents, improving their overall well-being and assessment accuracy.