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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
Summary
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:
- 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.
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