A new study led by researchers at Concordia University suggests that hearing ability plays a significant role in how older adults with mild cognitive impairment (MCI) manage everyday tasks that require both thinking and movement, such as walking while performing a mental activity.
Drawing on data from the multi-center SYNERGIC clinical trial, the study also found that targeted exercise and cognitive training can improve these dual-task abilities, though outcomes vary depending on hearing status and biological sex.
Hearing loss linked to worse dual-task performance
The analysis included 75 adults aged 60 to 85 with MCI who participated in a 20-week intervention combining physical exercise and/or computerized cognitive training. Researchers assessed participants’ ability to perform cognitive and motor tasks simultaneously, such as walking while counting backward or naming animals.
At baseline, individuals with poorer hearing, measured through both self-report and objective testing, demonstrated significantly worse dual-task performance. This included slower walking speed, greater gait variability, and reduced stability.
According to the study, these deficits were particularly evident in individuals with both hearing loss and lower cognitive scores, suggesting a compounding effect. The findings reinforce prior evidence that hearing loss is associated with declines in both cognitive and physical function.
Training shows benefits, especially for those with hearing loss
Participants were assigned to one of three intervention groups: combined aerobic and resistance exercise with cognitive training, exercise with sham cognitive tasks, or a placebo condition involving stretching and toning with sham cognitive training.
After 20 weeks, those in the combined exercise and cognitive training group showed the greatest improvements in dual-task performance, particularly in gait stability.
Notably, individuals with poorer hearing appeared to benefit the most from this multi-domain approach. Improvements in stride time variability, a key marker of gait stability, were observed primarily in participants with greater self-reported hearing difficulties.
The findings align with theories of neural plasticity and compensatory scaffolding, which suggest that targeted training may help the brain adapt to sensory and cognitive decline.
Sex differences highlight complex interactions
The study also identified important sex-related differences in how hearing loss affects dual-task performance.
At baseline, the relationship between hearing loss and reduced mobility and cognition was largely driven by male participants. Men with poorer hearing showed more pronounced deficits in dual-task gait and cognitive performance.
However, training outcomes varied by sex. Males with poorer objective hearing showed the greatest improvements following combined exercise and cognitive training. Females with better objective hearing also benefited from multi-domain training, particularly in gait measures. Females with higher self-reported hearing difficulties improved across training conditions, regardless of intervention type.
These findings suggest that both biological and perceptual aspects of hearing loss may influence outcomes differently across sexes.
Implications for fall risk and dementia prevention
Dual-task performance, such as walking while thinking, is considered an important indicator of functional independence and fall risk in older adults. The study reinforces the role of hearing loss as a modifiable factor influencing both cognitive and physical decline.
Importantly, the results suggest that non-pharmacological interventions, including structured exercise and cognitive training, may help mitigate these risks, even in individuals already experiencing cognitive impairment.
The authors noted that even in the pre-dementia stage, the severity of cognitive impairment appears to play a role in dual-task gait, underscoring the potential value of early intervention.
Toward more personalized interventions
The researchers conclude that hearing ability, cognitive status, and sex interact in complex ways to influence both baseline performance and responsiveness to intervention.
Multi-domain training, combining physical and cognitive exercises, appears particularly beneficial for individuals with hearing loss and lower cognitive function, pointing to the need for more personalized approaches to care.
Reference:
Downey RI, Petersen BJ, et al. (2026). 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. Frontiers in Aging Neuroscience.
Source: FAGN, Concordia Univ
