Earwax poses risks for elderly
Of all the indignities that come with aging, excessive earwax may be the most insidious. Don’t laugh. That greasy, often gross, buildup occurs more often in older ears than those of the young, experts say. And when it goes unrecognized, it can pose serious problems, especially for people who live in nursing homes and assisted living centres.
“The excessive amount [of earwax] can cause hearing loss or ringing in your ears. Some people experience vertigo, which increases the risk of falling,” said Jackie Clark, a board-certified audiologist who is president of the American Academy of Audiology. “Right now, we see some correlation between hearing loss and cognitive decline.”
Earwax — which is not really wax at all, but a substance called cerumen that binds with dirt, dust and debris — is normally produced by the body as a way to clean and protect the ears. In most people, the self-cleaning process works fine.
But in others — including about 10 per cent of young children, 20 per cent of adults and more than 30 percent of elderly and developmentally disabled people — the wax collects to the point where it can completely block the ear canal.
Up to two-thirds of people in nursing homes may suffer from that condition, known as impaction, according to 2017 guidelines for removal of impacted earwax issued by the American Academy of Otolaryngology-Head and Neck Surgery Foundation.
In 2016, federal Medicare recipients logged nearly 1.7 million earwax removal services at a cost of more than $51 million, according to payment records analyzed by Kaiser Health News.
“In elderly patients, it’s fairly common,” said Dr. Seth Schwartz, a Seattle otolaryngologist who led the most recent update of the guidelines. “It seems like such a basic thing, but it’s one of the most common reasons people present for hearing-related problems.”
It’s so bad that Janie York, of Omaha, Nebraska, started Hear Now mobile hearing solutions, one of a growing number of businesses devoted to cleaning hearing aids and checking the ears of elderly people living in residential care settings.
The effects in the elderly can be immediate. A small 2014 study by Japanese researchers found significant improvements in hearing and cognitive performance in elderly patients with memory disorders when impacted cerumen was removed.
Too often, though, earwax in the elderly goes unnoticed.
“I’m seeing 15 people here, but what about the other hundred?” York said.