Hearing loss moderates cognitive‐motor dual‐tasking before and after combined exercise and cognitive training in older adults with mild cognitive impairment: Findings from the SYNERGIC and COMPASS‐ND studies

Abstract

AbstractBackgroundAge‐related hearing loss is associated with poor cognitive‐motor dual‐task performance and is a risk factor for dementia and mild cognitive impairment (MCI). Although different interventions have shown to improve dual‐task performance in older adults, it is currently unclear whether hearing ability affects training efficacy in individuals with MCI.MethodsSecondary data analyses of 75 participants with MCI (Mage = 73.66 ± 6.67) who completed the Canadian Consortium on Neurodegeneration and Aging SYNERGIC and COMPASS‐ND studies. We investigated how hearing ability (normal hearing (n = 56), hearing loss (n = 19)) moderated the efficacy of a 20‐week intervention (combined exercise and cognitive training (n = 32), exercise training alone (n = 31), control (n = 12)) on single‐ and dual‐task working memory performance (serial one or seven subtractions, semantic fluency) and spatio‐temporal gait characteristics.ResultsAt baseline, participants with hearing loss had slower gait speed and higher step time variability while concurrently completing the semantic fluency task, compared to participants with normal hearing. Participants with hearing loss also had higher accuracy on the semantic fluency and serial seven subtractions tasks while dual‐tasking, compared to participants with normal hearing. Single‐ and dual‐task gait speed increased significantly following combined exercise and cognitive training, with greater improvements observed in participants with hearing loss compared to those with normal hearing. However, older adults with hearing loss showed a significant decrease in dual‐task serial seven subtractions and semantic fluency following combined exercise and cognitive training.ConclusionThese findings help clarify the relationship between hearing loss, cognition, and mobility in old age and inform training recommendations for persons with MCI based on hearing ability. Combined exercise and cognitive training appears to have increased attentional and physical resources, allowing participants with hearing loss to shift postural prioritization strategies while dual‐tasking from a posture‐second strategy to a posture‐first strategy. Thus, combined exercise and cognitive training may be particularly beneficial for older adults with both MCI and hearing loss, in order to improve safe walking behaviours while multi‐tasking and mitigate further decline.