Strengthening the Ear-to-brain Connection in Older Adults With Hearing Loss Through Engaging Web-based Gamified Auditory-cognitive Dual-task Training: a Randomized Controlled Trial

N/ANot Yet RecruitingNCT07730775

The Hong Kong Polytechnic University164 enrolled

Overview

Abstract Objectives To assess the effectiveness of a web-based gamified auditory-cognitive dual-task training (ACDT) in improving the everyday listening abilities of older adults with hearing loss (HL), including speech perception performance, cognition, and self-reported hearing. Hypothesis to be tested ACDT participants will show significantly greater improvements in 1) self-reported hearing; 2) speech perception-in-noise; 3) attention; 4) reasoning; and 5) dual-task of listening and working memory compared to the control group at week 6, immediately post-intervention, and week 24. Design and subjects A prospective, single-blinded, two-arm parallel randomized controlled trial with individual semi-structured interviews. 164 Chinese adults aged 60 years or older, who speak Cantonese or Putonghua, and have mild-to-moderate HL with a pure-tone average of 20-50 dB across octave frequencies 0.5 to 4kHz in both ears. Study instruments A web-based gamified auditory-cognitive dual-task training. Interventions This is a 12-week program conducted five times a week, with each session lasting 60 minutes, following a sequential dual-task training design. Each session includes auditory training in speech-in-noise, rapid speech, and competing speaker, and cognitive training focusing on executive function, perceptual-motor ability, memory, and complex attention. Main outcome measures Self-reported hearing (untrained); Speech perception in noise (trained), attention in listening and sustained selective attention (trained), reasoning (trained), and dual-task of listening and working memory; complex span working memory (trained). Data analysis Descriptive statistics, an independent sample t-test or chi square test, generalized estimating equation and thematic analysis will be used. Expected results ACDT significantly improves the everyday listening abilities of older adults with HL.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

SUPPORTIVE_CARE

Masking

DOUBLE

Enrollment

Interventions

Web-based gamified auditory-cognitive sequential dual-task training systemBEHAVIORAL

The intervention is a 12-week sequential dual-task training program delivered five times per week for 60 minutes per session. Each session includes 5 minutes of volume adjustment and orientation exercises, 25 minutes of adaptive auditory training in speech-in-noise, rapid speech, and competing-speaker listening, 25 minutes of culturally tailored cognitive games targeting executive function, memory, attention, and perceptual-motor skills, and a 5-minute wrap-up with communication strategies and long-term memory recall. The program uses real-life scenarios, individualized difficulty adjustment, audiovisual guidance, and gamified features such as praise, fireworks, likes, and leaderboards to enhance engagement.

ControlBEHAVIORAL

Participants will be instructed to complete web-based Chinese crossword puzzles 60 minutes per day and five days a week. Medium difficulty level will be selected for participants according to previous research.

Eligibility

Sex: ALLMin age: 60 Years

Medical Language ↔ Plain English

Inclusion Criteria: 1. Ethnic Chinese aged 60 years and above, who speak Cantonese or Putonghua; 2. Mild-to-moderate peripheral hearing loss diagnosed by a pure-tone average of 20-50 dB across octave frequencies of 0.5-4kHz in both ears; 3. Not using hearing aids; 4. Sensorineural hearing loss (defined as an air-bone gap across 0.5, 1, and 2 kHz\<15 dB); and 5) No cognitive impairment \[score of ≦2 on the 5-item Abbreviated Memory Inventory for the Chinese (AMIC)\]. Exclusion Criteria: 1. Previously took part in a training intervention study; 2. Diagnosed with a major neurocognitive disorder; 3. A history of symptomatic stroke or other disease of the central nervous system; speech/ language disorders; 4. A serious medical or psychiatric illness (e.g., severe depression, schizophrenia, bi-polar disorder) or a visual impairment that would interfere with engaging in web-based training.

Outcomes

Primary Outcomes

Hearing Handicap Inventory for the Elderly

will be measured using the Chinese Hearing Handicap Inventory for the Elderly (HHIE), which is a 25-item validated questionnaire that quantifies the emotional and social/situational effects of self-perceived hearing impairment to quantify hearing-related quality of life.