Hearing Loss Impairs Dual-Task Walking and Thinking in Older Adults with Cognitive Decline

A groundbreaking study led by researchers at Concordia University has unveiled critical insights into how hearing ability and biological sex affect the complex interaction between cognition and mobility in older adults with mild cognitive impairment (MCI). Utilizing data from the SYNERGIC clinical trial, the research highlights the profound challenges imposed by hearing loss on dual-task performance — specifically, the capacity to walk while simultaneously engaging in cognitive tasks, an ability pivotal to everyday functioning and fall prevention.

Dual-task performance is essential for safely navigating complex environments, requiring the brain to coordinate motor and cognitive processes concurrently. However, the new findings demonstrate that hearing loss, particularly when combined with cognitive decline, significantly impairs this multitasking ability. Through both self-reported assessments and objective audiometric tests, the study delineates a clear association between diminished hearing acuity and deteriorated gait stability and coordination during dual-tasking.

The investigators followed 75 adults aged 60 to 85 diagnosed with MCI, a condition characterized by noticeable but not debilitating cognitive decline which often precedes dementia. Over a meticulously monitored 20-week intervention period, participants engaged in physical exercise regimens coupled with computerized cognitive training designed to enhance neuroplasticity and functional capacity. These interventions aimed to simultaneously bolster motor skills and cognitive faculties, directly targeting the intertwined decline often observed in the elderly.

Notably, the study illuminates sex-based differences in outcomes. Male participants with objectively confirmed hearing loss displayed the most marked impairments in dual-task gait but also experienced the most significant gains from combined physical and cognitive training. Females exhibited a different pattern wherein self-reported hearing loss was a stronger predictor of training benefit, suggesting nuanced perception and reporting disparities between sexes regarding hearing abilities.

The dual-task performance was quantified by measuring gait speed, stability, and variability while subjects performed cognitively demanding tasks such as backward counting and animal naming. Those with poorer hearing showed slower walking speeds and increased gait irregularities, reflecting diminished neuromotor integration. Crucially, these deficits were amplified in subjects with lower baseline cognitive scores, emphasizing the compounded risk arising from the confluence of sensory and cognitive decline.

Lead researcher Dr. Rachel Downey emphasized the novel aspect of this work: “Our findings are among the first to systematically demonstrate how hearing loss interacts with cognitive impairment in males to affect gait during multitasking. This has far-reaching implications for fall risk and long-term independence in aging populations.” Complementing this, Dr. Karen Li, director of the Laboratory for Adult Development and Cognitive Aging, remarked on the importance of these results for pre-dementia intervention strategies, underscoring the plasticity of the aging brain even amidst sensory and cognitive challenges.

The intervention groups were stratified into three distinct categories: a combined exercise and cognitive training group; a physical exercise with sham cognitive training control; and a placebo group engaging in toning and stretching with sham cognitive exercises. The multi-domain approach permitted isolation of the synergistic effects of aerobic-resistance training and targeted cognitive tasks on dual-task gait performance.

Remarkably, only participants undergoing both exercise and cognitive training exhibited significant improvements in gait stability while performing cognitive tasks. This synergy harnesses neuroplastic mechanisms, where physical exercise promotes cardiovascular and neuromuscular health, concurrently amplified by cognitive drills that challenge executive function and attentional resources necessary for dual-tasking.

These improvements were not uniformly distributed. Male participants with higher degrees of objectively verified hearing loss saw the most pronounced benefits, indicating that neurorehabilitation can counteract impairments resulting from sensory decline. In contrast, female participants’ improvements aligned more closely with subjective experiences of hearing loss, suggesting psychological or perceptual factors modulate the training’s efficacy.

Beyond the scientific revelations, the practical healthcare implications are profound. As Dr. Li explains, the escalating risk of falls associated with aging is exacerbated by combined sensory and cognitive impairments. Interventions that are non-pharmacological, scalable, and home-based, such as those tested in this trial, offer promising avenues to mitigate this risk, potentially delaying or preventing transition to dependency and dementia.

The study was peer-reviewed and published in Frontiers in Aging Neuroscience in early 2026, contributing valuable empirical evidence to a growing field examining multisensory integration and cognitive-motor coupling in aging. Notably, the rigorous methodology employed in this trial provides a replicable model for future research exploring personalized intervention strategies.

Funding acknowledgments denote robust support from prominent Canadian research entities, including the Canadian Institutes of Health Research and the Ontario Ministry of Research and Innovation, reflecting the study’s strong scientific merit and societal relevance. Additionally, the research team declares no commercial conflicts of interest, with transparency reinforcing the integrity of the reported findings.

Taken together, this investigation underscores the critical role of hearing health in maintaining complex motor-cognitive functions and highlights sex-specific pathways influencing rehabilitation outcomes. It suggests a paradigm shift towards multifaceted intervention models integrating sensory health and cognitive training to foster aging well.

In sum, older adults with MCI are not beyond hope; their brains exhibit significant plasticity allowing meaningful improvements via combined physical and cognitive training, even when challenged by sensory decline. This study paves the way for more targeted, effective strategies to sustain mobility, cognitive function, and ultimately quality of life during aging.

News Publication Date: 29-Jan-2026

Web References:
SYNERGIC clinical trial
Frontiers in Aging Neuroscience article

References:
Downey, R., Li, K., Petersen, B., 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, 10.3389/fnagi.2025.1716733. https://doi.org/10.3389/fnagi.2025.1716733