Outcome of 10 years of ear and hearing screening in people with intellectual disability in Europe: A multicentre study

Cerumen impaction: Prevalence and associated factors in the United States population

Objective

To examine the prevalence of cerumen impaction in a nationally representative sample of the US population and the association of cerumen impaction with sociodemographic factors, hearing loss, and tinnitus.

Methods

The cohort included 14,230 individuals aged ≥12 years who completed otoscopy and audiometry in NHANES (2005-2016). Cerumen impaction (partial/complete) was determined by otoscopy. Hearing level was defined by speech-frequency pure-tone average (PTA). Multivariable regression analysis was performed to identify factors associated with cerumen impaction.

Results

The prevalence of any cerumen impaction was 18.6% [95% CI: 17.3%-19.9%] among individuals ≥12 years and 32.4% [29.9%-35.1%] among those ≥70 years. The prevalence of bilateral partial and complete cerumen impaction was 6.3% [5.6%-7.1%] and 1.2% [1.0%-1.9%], respectively. Any cerumen impaction was associated with male sex (OR 1.77 [1.5-2.1]), identifying as Black race (vs. Caucasian, OR: 1.78 [1.5-2.9]), lower level of education (OR: 0.84 [0.71-0.98]), and older age (OR: 1.02 [1.01-1.03]). After adjusting for sociodemographic and clinical factors, complete impaction was associated with increased PTA (right ear: β = 4.1 dB [2.4-5.8 dB], left ear: β = 1.9 dB [0.46-3.4 dB]), but not with tinnitus.

Conclusions

Cerumen impaction is highly prevalent in the US population, especially among older adults, and has disproportionate sociodemographic impacts. Complete impaction is associated with a small, statistically significant elevation in PTA, but there is no association with tinnitus. These findings emphasize the need to implement and disseminate best practices for ear hygiene and cerumen management broadly and equitably.

Level of Evidence

2B.

Hearing Loss Diagnosis and Management in Adults with Intellectual and Developmental Disabilities

Hearing loss is a common concern in patients with intellectual and developmental disabilities (IDD), and early detection and intervention are crucial to prevent negative impacts on communication, cognition, socialization, safety, and mental health. Despite a lack of the literature specifically focused on hearing loss in adults with IDD, there is a substantial body of research demonstrating the prevalence of hearing loss in this population. This literature review examines the diagnosis and management of hearing loss in adult patients with IDD, with a focus on primary care considerations. Primary care providers must be aware of the unique needs and presentations of patients with IDD to ensure appropriate screening and treatment. This review highlights the importance of early detection and intervention, as well as the need for further research to guide clinical practice in this patient population.

Postural balance problems in people with intellectual disabilities: Do not forget the sensory input systems

BACKGROUND

This pilot study aimed to explore the impact of visual, auditory and vestibular dysfunctions on the postural balance performance in adults with intellectual disabilities. Additionally, a comparison was made between the subjects with intellectual disabilities and a control group concerning static and dynamic balance tasks.

METHOD

Thirty adults with intellectual disabilities and 25 control subjects received a postural balance assessment. Additionally, the experimental group was subjected to a visual, auditory and vestibular screening.

RESULTS

The experimental group performed significantly worse and/or showed more sway compared to the control group for all balance tasks (p < .01) except the timed up and go test. Within the experimental group, a significant positive correlation (r_s (24) = 0.513, p = .007) was observed between the number of failed sensory screening items and the number of failed balance tasks.

CONCLUSIONS

These findings suggest significant involvement of peripheral sensorial deficits in the balance problems that people with intellectual disabilities often experience.