Auditory-cognitive Dual-task Training
Conditions
Brief summary
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.
Interventions
BEHAVIORALWeb-based gamified auditory-cognitive sequential dual-task training system
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.
BEHAVIORALControl
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.
Sponsors
The Hong Kong Polytechnic University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
SUPPORTIVE_CARE
Masking
DOUBLE (Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
60 Years to No maximum
Healthy volunteers
No
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.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Hearing Handicap Inventory for the Elderly | at week 6, immediately post-intervention (week 12), and week 24 | 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. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| The Cantonese Hearing in Noise Test | at week 6, immediately post-intervention (week 12), and week 24 | a standardized Cantonese sentence speech-intelligibility test, assesses speech reception thresholds for sentences in quiet and in spatially simulated noise presented from the front, right, or left. It has demonstrated low within-list response variability and high inter-list reliability, with normative results comparable to those of the English Hearing in Noise Test. |
| The Chinese Auditory Verbal Learning Test | at week 6, immediately post-intervention (week 12), and week 24 | The Chinese Auditory Verbal Learning Test (AVLT), which assesses multiple cognitive domains including immediate recall, learning efficiency, delayed recall, retention rate, and recognition memory, and has demonstrated high test-retest reliability (ICC=0.79-0.82) and 78% sensitivity; |
| The Chinese Trial Making Test Part A& B | at week 6, immediately post-intervention (week 12), and week 24 | The Chinese Trial Making Test Part A\& B (TMT A\&B), which measures visual attention, processing speed, and executive function, and has shown strong discriminant validity (d=1.2 for vascular dementia) |
| Dual task of listening and working memory | at week 6, immediately post-intervention (week 12), and week 24 | complex span working memory (trained): Participants are shown a string of five digits for 5 seconds to memorize for later recall. They then hear a list of five AB isophonemic monosyllabic CVC words (e.g., ship, rug, rail) in ICRA 6-talker babble at a 0 dB signal-to-noise ratio and must repeat each word immediately. After each word list, they recall the five digits. |
Contacts
CONTACTIvy Yan Zhao
Outcome results
None listed