JMIR Publications

ABSTRACT

Background:

Everyday listening ability is essential for individual health and wellbeing. Age-related hearing loss (ARHL) is associated with reduced communication engagement, social isolation, loneliness, cognitive decline and increased dementia risk. Interventions that simultaneously targeting auditory processing and cognitive function, particularly within engaging, ecologically valid contexts, could offer greater benefits compared to unimodal approaches. However, culturally adapted web-based gamified auditory-cognitive dual-task training (ACDT) tailored for older adults with ARHL remains underexplored. Currently, few auditory or auditory-cognitive training are available in Chinese languages, creating linguistic and cultural barriers for older adults.

Objective:

This study aimed to 1) assess the feasibility and acceptability of ACDT performed at home among older Chinese adults with ARHL; and 2) examine its preliminary effects on global cognition, hearing, social engagement and loneliness. It was hypothesized that the intervention group would demonstrate greater improvements in global cognition, hearing and social engagement compared with the control group.

Methods:

Sixty community-dwelling older adults with mild-to-moderate ARHL were randomized 1:1 to either ACDT or a waitlist control in a single-blinded pilot randomized control trial. Demographic data and outcomes collected at baseline, week-6, and week-12. Post-intervention interviews assessed feasibility and acceptability of ACDT.

Results:

A total of 60 participants were randomized (mean age = 67.65 years, SD = 4.78; 75% male). ACDT demonstrated a high level of feasibility and acceptability. The ACDT group showed significant improvements in focused attention (mean change = –0.15, p = 0.018, d = –0.46), and divided attention (mean change = –0.21, p = 0.002, d = –0.63). Significant cognitive improvements on the HK-MoCA were identified in naming (r = 0.000, p = 0.046) and visual cognition (r = 1.826, p = 0.017) in the intervention group, while no significant improvements were found in the control group. Both groups reported significant decreases in emotional hearing handicap, with the control group showing a slightly higher improvement (r = 11.870, p = 0.042) than the intervention group (r = 10.130, p = 0.032). Linear mixed model analysis revealed a small to moderate group effect (Cohen’s d = 0.38) in 5-minute delayed recall on AVLT, with fixed effects explaining 69% of the variance (marginal R² = 0.69). A significant time×group interaction was observed for left-ear thresholds (p=0.013). Qualitative analysis identified three key themes: 1) Intervention coherence and participants’ affective attitude toward ACDT; 2) Perceived benefits in cognition, information acquisition, and self-awareness from ACDT; 3) Perceiving ACDT as less burdensome with enhanced self-efficacy.

Conclusions:

Future iterations should incorporate AI-enhanced personalization. Large-scale randomized control trials with diverse samples and active control conditions are needed to confirm sustained effects on auditory and cognitive health, dual-task listening-cognitive abilities, and real-world functioning. Clinical Trial: ClinicalTrials.gov PRS Identifier: NCT06486285