Summary: Can targeted exercise and computerized brain training slow the decline that leads to falls and dementia? A new analysis of data from the SYNERGIC clinical trial suggests they can—though hearing ability and biological sex significantly influence outcomes.
Researchers tracked 75 older adults with mild cognitive impairment (MCI) through a 20-week program combining physical exercise and cognitive training. The study found that hearing loss strongly impairs “dual-task” performance—the ability to walk while doing a mental task—yet the aging brain retains substantial plasticity. Participants, even those with pronounced hearing or cognitive problems, showed measurable gains in walking speed and stability after the intervention.
Key Facts
- Dual-task vulnerability: People with hearing loss walked more slowly and showed less stable gait when asked to perform mental tasks while walking—an important indicator of fall risk.
- Evidence of plasticity: Combined physical and cognitive training produced the largest improvements in dual-task gait, even among participants with both hearing loss and MCI.
- Sex differences: Response patterns differed by sex. Men with objectively measured hearing loss experienced the greatest gains after combined training, while women who reported hearing problems improved most when their own perception of hearing loss was considered.
- Non-pharmacological approach: The 20-week program increased aerobic and resistance training intensity and paired it with computerized cognitive exercises—an adaptable, home-friendly intervention.
Source: Concordia University
Overview
This Concordia-led analysis used data from the SYNERGIC clinical trial, a multi-site project that tested how exercise and cognitive training affect cognition, mobility and fall risk in older adults. The team studied 75 participants aged 60 to 85 with mild cognitive impairment, assessing them before and after a 20-week intervention that combined physical and cognitive training in different ways.
The investigators focused on dual-task performance—walking while doing mental tasks such as counting backward or naming animals—and on how hearing status affected those abilities. Hearing was recorded both by self-report and by an objective hearing-acuity test.
At baseline, poorer hearing correlated with worse dual-task performance: participants with hearing loss walked slower, had less stable gait patterns, and struggled more when asked to combine walking and thinking. These deficits were most pronounced in participants who both reported hearing problems and scored lower on cognitive tests.
Lead author Rachel Downey observed that males tend to develop hearing impairment earlier and more severely than females, and this study is one of the first to document how that hearing decline relates to dual-task gait in men with MCI. Karen Li, supervising author and director of the Laboratory for Adult Development and Cognitive Aging, underscored the novelty of studying these relationships specifically in people with pre-dementia cognitive impairment.
Intervention design and differences by sex
Participants were randomized to one of three interventions:
- Aerobic and resistance exercise combined with sham cognitive activities (watching videos, simple online searches)
- Multi-domain training: aerobic-resistance exercise plus computerized cognitive training
- Placebo-style program: balance and toning exercises with sham cognitive activities
Exercise intensity increased every four weeks, so the program emphasized progressive physical challenge rather than mere maintenance. After 20 weeks, those in the multi-domain group—combined exercise and cognitive training—showed the biggest improvements in gait stability while performing cognitive tasks. The most notable gains in this group were observed among men with poorer measured hearing and among women who reported hearing complaints.
The study highlighted a sex-specific pattern: men’s self-reported hearing closely matched objective measures, while women’s self-reports did not align as strongly with test results. This suggests women may be more sensitive to early hearing changes or may interpret and report hearing difficulties differently, and that their perception influenced how they benefited from training.
Participants in the placebo group showed little improvement and in some cases declined, reinforcing the importance of targeted, progressive interventions.
Treatable risks and practical implications
The main takeaway is encouraging: even with hearing loss and cognitive impairment, older adults can gain functional benefits from structured exercise and cognitive training. Brain plasticity persists into the pre-dementia stage, and dual-task abilities that predict fall risk can improve with non-drug interventions that are feasible to deliver in community or home settings.
Given that hearing loss is a modifiable risk factor for dementia and that mobility challenges raise fall risk, these findings support integrated, personalized programs that address physical fitness, cognition, and sensory health together—especially for those at higher risk due to hearing impairment or lower cognitive scores.
Frequently asked questions
A: Hearing loss increases cognitive load. The brain must dedicate more processing power to understanding sounds, leaving fewer resources for balance and gait control. Adding a mental task can overwhelm these resources, slowing movement or increasing the risk of stumbles.
A: Yes. The study reports significant improvements in walking stability after 20 weeks of combined training, even among participants with hearing loss and lower cognitive scores, indicating retained brain plasticity.
A: Men’s self-reported hearing tended to match objective tests, while women’s reports diverged more from measured hearing. Women’s heightened awareness or concern about hearing changes may influence both their reporting and how they respond to interventions.
Editorial notes
- Edited by a Neuroscience News editor.
- Journal paper reviewed in full and summarized for clarity.
- Additional context added by the reporting team without changing study findings.
About this research
Author: Patrick Lejtenyi
Source: Concordia University
Contact: Patrick Lejtenyi, Concordia University
Image credit: Neuroscience News
Original research: 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. DOI: 10.3389/fnagi.2025.1716733. Clinical trial registration: NCT02808676.
Abstract (summary)
Hearing loss is a modifiable risk factor for dementia and is associated with poorer cognitive-motor dual-task performance. Exercise and cognitive training may improve these abilities, but it was unclear how hearing status and sex influence such gains in people with MCI. Secondary analysis of 75 SYNERGIC participants (mean age ≈ 73.7) showed that poorer hearing predicted worse dual-task performance at baseline, especially in men. Multi-domain training produced significant improvements in dual-task gait variability, particularly for those reporting more hearing complaints. Sex-stratified analyses revealed distinct response patterns: females with more hearing complaints improved across interventions, while males with poorer objective hearing benefited most from combined training. In participants with poorer hearing, lower cognitive scores predicted greater improvements after multi-domain training but declines after placebo training. These findings suggest hearing ability, sex, and cognitive status interact to shape training effects and support tailored interventions to preserve mobility and reduce fall and dementia risk in older adults with MCI.