Older Adults With Hearing Loss May Have The Most To Gain From Brain-And-Body Training

Walking down a grocery store aisle while mentally running through a shopping list is, for most people, entirely forgettable. But for older adults living with mild cognitive impairment, a condition that sits between normal aging and dementia, juggling a physical and mental task at the same time can be a genuine struggle, one that is linked to a higher risk of falls and faster cognitive decline.

Now, research from a Canadian clinical trial suggests hearing ability may determine whether a combined exercise-and-brain-training program actually helps such older individuals.

Hearing loss affects up to two-thirds of adults over 70 and ranks among the largest potentially preventable risk factors for dementia. Yet few studies have examined whether hearing shapes how much someone benefits from programs designed to sharpen the mind and steady the body. Published in Frontiers in Aging Neuroscience, the findings suggest that people with worse hearing, particularly men and those with lower cognitive scores, may stand to gain the most from a program pairing aerobic and resistance exercise with computerized attention training.

It’s often assumed that people who start out in worse shape are harder to help. Instead, the data point toward a more personalized story: the very people most burdened by sensory and cognitive decline may respond most powerfully to the right intervention.

When You Can’t Hear Well, Can You Walk and Think at the Same Time?

Researchers analyzed data from 75 older adults, average age 74, all diagnosed with mild cognitive impairment and enrolled in the SYNERGIC trial, a multi-site Canadian clinical study. Hearing was assessed two ways: a brief questionnaire about how hearing difficulties affected daily life, and a lab test in which participants identified three-digit number sequences played against background noise.

Over 20 weeks, meeting three times a week in 90-minute sessions, participants were divided into three groups. One received Multi-Domain Training, aerobic and resistance exercise paired with computerized cognitive training targeting divided attention. A second group got the same physical exercise but with a fake cognitive activity, internet browsing and video watching, in place of real brain training. A third group did gentle balance and stretching exercises alongside the same fake cognitive activity.

Before and after the program, everyone completed a walking-while-thinking test. Participants walked along a sensor-embedded mat while simultaneously counting backward by sevens or naming animals. Sensors tracked walking speed, stride consistency, and stability.

Hearing Loss and Walking: A Connection Before Training Even Began

Before any training started, hearing ability was already linked to multitasking performance. Participants who reported more hearing difficulties walked more slowly and showed more unevenness in their gait when their brains were simultaneously occupied with a mental task.

Men showed this pattern most clearly. Male participants with greater hearing complaints had noticeably worse walking performance during multitasking, and the effect deepened when they also scored lower on a standard cognitive screening tool. Women showed no significant relationship between hearing and walking at baseline, consistent with evidence that hearing loss tends to be more common, more severe, and earlier in onset among men.

One additional wrinkle: among participants with relatively good hearing, women performed worse than men on the thinking tasks. Among those with more hearing loss, men trended toward lower accuracy, suggesting hearing loss may place a heavier cognitive burden on men, possibly due to differences in how male and female brains compensate for sensory decline.

Hearing Loss Shaped Who Benefited Most From Combined Training

After 20 weeks, the clearest benefit appeared among participants who reported more hearing complaints. Those in the Multi-Domain Training group showed a reduction in stride time variability during multitasking, a well-established marker of fall risk and brain health. Neither the exercise-only nor the control group showed this benefit.

Breaking results down by sex, women with more hearing difficulties showed improvements in dual-task gait performance across all three groups, suggesting broad responsiveness to any structured activity. Within the Multi-Domain Training group specifically, men with worse objective hearing and women with better hearing showed the greatest gains.

Most notably, participants with poor hearing who also scored lower on cognitive screening improved the most in dual-task gait after Multi-Domain Training. Those same individuals declined after the control program, showing slower walking and greater instability, suggesting that light activity alone may not be enough for the most at-risk group.

Why Hearing Loss May Be a Key to Dementia Prevention Programs

One possible explanation is that hearing loss forces the brain to redirect resources toward processing sound, leaving less capacity for walking steadily or thinking clearly at the same time. A combined exercise-and-brain-training program may strengthen the brain’s backup systems, giving it more bandwidth to handle multiple demands at once, with the greatest potential benefit going to those whose reserves are most depleted.

If larger studies confirm these patterns, clinicians may need to factor a patient’s hearing into decisions about which program to recommend. Hearing ability, sex, and cognitive status all appear to shape who benefits and by how much. For now, these are exploratory findings from a small sample. But they make a strong case that hearing, too often treated as separate from brain health, belongs in any serious conversation about keeping aging minds and bodies strong.

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Disclaimer: This article is intended for informational purposes only and does not constitute medical advice. Consult a qualified healthcare provider before making changes to any exercise, cognitive training, or health management program.

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