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Earwax Impaction and the ElderlyThe build-up and impaction of earwax tends to be more frequent and problematic in the elderly. As you age, your ceruminous glands tend to shrink and the earwax that is secreted has a harder and dryer consistency. This makes the earwax more difficult to move along to the ear canal's outer edges. As such, earwax in older individuals is more difficult to expel. The result is a higher likelihood of developing build-up and impaction of cerumen. Hearing Impairment and Mental Status Two clinical studies* have shown that the build-up of earwax is associated with hearing and mental impairment in the elderly. One study from Michigan demonstrated in individuals aged 65 and over that, both hearing and cognition improved significantly after removal of cerumen. In fact, hearing improved in 80% of those that had impacted ears. Scores on the MMSE (a 30-point cognition test that helps to understand a person's degree of mental impairment) also improved, an average 1 point. * 1) Moore et. al. J Am Med Dir Assoc. 2002. 2) Sugiura et. al. Nihon Ronen Iqakkai Zasshi 2012
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A larger and more recent study (about 800 individuals aged 60 to 88 years) corroborates these findings. While the incidence of cerumen impaction in the Japanese elderly is estimated at 10%, the study demonstrated that individuals with a lower MMSE tend to have a greater frequency of impaction than those without. A greater number of individuals (23%) with some degree of mental impairment were showed to have a cerumen ear impaction.
If you and someone you know is starting to show signs of showing signs impaired hearing or cognition, the ears might be a good place to start. Earwax build-up or impaction should definitively be ruled out before moving on to other possible reasons for impaired hearing and / or cognition. Particularly in the elderly population.
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