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NCT Number: NCT07730775

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

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.

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Key information

Conditions

Auditory-cognitive Dual-task Training

Age range

60 year and older

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

Ethnic Chinese aged 60 years and above, who speak Cantonese or Putonghua;
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;
Not using hearing aids;
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

Previously took part in a training intervention study;
Diagnosed with a major neurocognitive disorder;
A history of symptomatic stroke or other disease of the central nervous system; speech/ language disorders;
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.

Treatment and study plan

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

Behavioral

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.

Control

Behavioral

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.

Primary outcomes

Hearing Handicap Inventory for the Elderly

Time frame: 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 outcomes

The Cantonese Hearing in Noise Test

Time frame: 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

Time frame: 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

Time frame: 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

Time frame: 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.

Study contacts

Contact information is provided by the study sponsor or research team.

Ivy Yan Zhao

CONTACT

[email protected]

+8527664550

Sponsors and collaborators

Lead sponsor

The Hong Kong Polytechnic University

Other

Registry information

Important dates

Study start: 2026
Primary completion: 2029
Study completion: 2029
First posted: Jul 28, 2026
Registry last updated: Jul 28, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.