Hearing Loss Overwhelms the Aging Brain
Summary: Can exercise and brain games stop the decline that leads to falls and dementia? A new study using data from the SYNERGIC clinical trial says yes—but your hearing and your sex play a major role in the results.
Researchers followed 75 adults with Mild Cognitive Impairment (MCI) through a 20-week program of physical and cognitive training. They discovered that while poor hearing significantly hampers “dual-tasking” (the ability to walk and think at the same time), the brain remains remarkably plastic. Even those with the most severe impairment showed major improvements in stability and walking speed after the intervention.
Key Facts
- The Dual-Task Trap: Participants with hearing loss walked more slowly and had less stable gaits when asked to perform mental tasks like counting backward, a major predictor of fall risk.
- The Plasticity Proof: Despite having both hearing loss and MCI, participants in the combined exercise and brain-training group showed the most significant improvements in walking stability.
- Sex Differences in Results: * Males: Those with objective (tested) hearing loss saw the biggest gains.
- Females: Those with self-reported hearing loss showed the most improvement, suggesting different psychological or physiological perceptions of hearing health between sexes.
- The Progression Factor: Not everyone with MCI develops dementia, but the study proved that even in this “pre-dementia” stage, cognitive severity directly impacts how well a person can walk.
- Non-Drug Solution: The 20-week intervention involved increasing the intensity of aerobic and resistance training alongside computerized brain exercises—all of which can be adapted for home use.
Source: Concordia University
Cognitive and physical training can help older adults with mild cognitive impairment (MCI) maintain or improve their ability to move and think simultaneously, but hearing ability and sex influence outcomes, according to a new Concordia-led study.
The researchers used data from the SYNERGIC clinical trial, a multi-institutional study of how exercise and brain training can improve cognition, mobility and falls in older adults.
Their study followed 75 adults between the ages of 60 and 85 with mild cognitive impairment before and after a 20-week intervention involving physical training and cognitive exercises.
The researchers specifically looked at how hearing loss affected dual-task performance — walking while performing mental activities like counting backwards or naming animals. Hearing loss was self-reported and objectively assessed following a following a common test of hearing acuity.
The team found that poor hearing was strongly linked to worse dual-task performance. Participants with poor hearing were found to walk more slowly, have less stable gait and have more difficulty walking and carrying out cognitive tasks simultaneously.
The effects were even more pronounced in individuals who reported poor hearing and had lower cognitive performance. They scored worst on dual-task measures.
“We already know that males tend to get hearing loss earlier in life and it tends to be more severe than in females,” says lead author Rachel Downey (PhD 25).
“But this is the first documented study to demonstrate this relationship between hearing loss and dual-task performance in male participants.”
“The study is especially novel because it looks at this within a sample of people with MCI,” adds supervising author Karen Li, a professor in the Department of Psychology and director of the Laboratory for Adult Development and Cognitive Aging.
“Even for individuals in the pre-dementia stage — and not everyone who has MCI will progress to dementia — we see that the severity of cognitive impairment plays a role in their dual-task gait.”
The study was published in the journal Frontiers in Aging Neuroscience.
Sex and hearing loss type shape key differences
The paper also demonstrates that targeted physical and computerized cognitive training can noticeably improve dual-task performance.
Participants completed one of the following interventions:
- exercise (aerobic and resistance-training) and a sham cognitive training (watching videos, performing simple Internet searches)
- both exercise and cognitive training
- a placebo (toning and stretching exercises with sham cognitive training).
“The intensity of the exercise increased every four weeks, so it was about more than just maintaining aerobic-resistance capacity,” notes Berkley Petersen, co-author and PhD candidate.
After the 20-week intervention period, the researchers found that participants in the exercise and cognitive training group showed the greatest improvement in walking stability while performing cognitive tasks. The biggest improvement was found among males with higher levels of objective hearing loss.
However, among females, those with self-reported hearing loss showed the most improvement. The researchers note that while the relationship in males between self-reported and objective hearing loss was strong, it was weaker among females— suggesting that they may be more worried about hearing loss and over-reporting it, or vice versa.
Participants in the placebo group showed little to no improvements or exhibited declines in performance following the study period.
Declines and risks are treatable
“This study shows that even if an individual has poor hearing and poor cognitive performance, their brain is still plastic enough to benefit from this kind of training,” Downey says.
“The risk of falling grows with aging. When you add on hearing loss and cognitive impairment, it gets even higher,” Li says.
“There are a lot of practical health care implications for this kind of work because it’s all non-pharmacological and involves exercises that can be done at home.”
Key Questions Answered:
A: It’s about cognitive load. When you have hearing loss, your brain has to work harder to process sound, leaving fewer “resources” available for balance and walking. When you add a mental task (like talking or planning), the brain becomes overwhelmed, leading to stumbles or slower movement.
A: Absolutely not. Lead author Rachel Downey emphasizes that the brain remains plastic. Even participants with poor hearing and low cognitive scores saw their walking stability improve significantly after the 20-week training, proving the brain can “re-wire” itself even in the early stages of impairment.
A: The study found that men’s self-reports matched their actual hearing tests closely, while women’s did not. This suggests women might be more sensitive to early changes in hearing (reporting it before a test catches it) or are more concerned about the impact. This perception actually helped the women benefit more from the training.
Editorial Notes:
- This article was edited by a Neuroscience News editor.
- Journal paper reviewed in full.
- Additional context added by our staff.
About this MCI and auditory neuroscience research news
Author: Patrick Lejtenyi
Source: Concordia University
Contact: Patrick Lejtenyi – Concordia University
Image: The image is credited to Neuroscience News
Original Research: Open access.
“The effect of hearing ability on dual-task performance following multi-domain training in older adults with mild cognitive impairment: findings from the SYNERGIC trial” by Rachel I. Downey, Berkley J. Petersen, Niroshica Mohanathas, Jennifer L. Campos, Manuel Montero-Odasso, Louis Bherer, M. Kathleen Pichora-Fuller, Nick W. Bray, Amer M. Burhan, Richard Camicioli, Sarah Fraser, Teresa Liu-Ambrose, Maxime Lussier, Laura E. Middleton, Frederico Pieruccini-Faria, Natalie A. Phillips, and Karen Z. H. Li. Frontiers in Aging Neuroscience
DOI:10.3389/fnagi.2025.1716733
Abstract
The effect of hearing ability on dual-task performance following multi-domain training in older adults with mild cognitive impairment: findings from the SYNERGIC trial
Background:
Hearing loss is one of the largest potentially modifiable risk factors for dementia and is linked with poor cognitive-motor dual-task performance (e.g., walking while performing a cognitive task). Hearing loss is more prevalent and severe in males, whereas dementia is more prevalent in females.
Physical exercise and cognitive interventions appear promising in improving dual-tasking in older adults; however, it is currently unclear whether hearing ability affects training efficacy on dual-task outcomes in older adults with mild cognitive impairment (MCI), and whether sex influences this effect.
Objective:
The primary aim of this study was to examine whether hearing ability affects dual-task performance at baseline and after training in individuals with MCI, and whether sex further influences these relationships, irrespective of intervention arm.
Methods:
Secondary data was analysed from 75 participants with MCI (Mage = 73.66 ± 6.67) enrolled in the SYNERGIC trial. Hearing ability was assessed using self-report and behavioral measures. Participants completed a 20-week intervention: (1) Exercise (aerobic-resistance exercise + sham cognitive training; n = 31), (2) Multi-Domain Training (aerobic-resistance exercise + cognitive training; n = 32), or (3) Placebo Training (balance and toning exercises + sham cognitive training; n = 12). Primary outcomes included dual-task gait and cognitive performance.
Results:
At baseline, poorer hearing predicted worse dual-task performance, particularly in males. Dual-task gait variability significantly improved following Multi-Domain Training in participants with a greater degree of self-reported hearing complaints. Sex-stratified analyses revealed that females with more hearing complaints improved more across all interventions, while in the Multi-Domain group, males with poorer objective hearing and females with better hearing showed the greatest gains. Additionally, in those with poorer hearing, lower cognitive scores (MoCA) predicted greater improvements after Multi-Domain Training, but a decline after Placebo Training.
Conclusion:
Hearing ability, sex, and cognitive status appear to interact to influence the effects of exercise and cognitive training on dual-task performance in older adults with MCI. Multi-Domain Training appears particularly beneficial for those with hearing loss (who are male and/or have lower cognitive status), highlighting the need for personalized interventions to preserve function and slow decline in this at-risk population.
Clinical trial registration:
https://www.clinicaltrials.gov/ct2/show/NCT02808676, NCT02808676.
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