# Increased Listening Effort: Is Hearing Training a Solution?—Results of a Pilot Study on Individualized Computer-Based Auditory Training in Subjects Not (Yet) Fitted with Hearing Aids

## TL;DR

This pilot study explores whether computer-based auditory training can improve hearing and cognitive abilities in older adults who haven't yet needed hearing aids.

## Contribution

The study introduces a new approach to measuring the effectiveness of computer-based auditory training on hearing and cognitive dimensions.

## Key findings

- Cognitive dimensions like processing speed and concentration improved significantly after training.
- Subjective hearing handicap decreased significantly, suggesting perceived hearing improvement.
- Listening effort in noise decreased, but speech understanding in noise did not improve significantly.

## Abstract

Background: Hearing and cognition decline with age. Hearing is now considered an independent risk factor for later cognitive impairment. Computerized cognitive auditory training is being discussed as a possible adjunctive therapy approach. Objectives: The aim of this exploratory study is to investigate how the success of a computer-based cognitive auditory training (CCAT) can be measured. For this purpose, the influence of a CCAT on different dimensions of hearing and cognition was determined. Materials and Methods: 23 subjects between 52 and 77 years old were recruited with normacusis to moderate hearing loss. They underwent 40 digital training lessons at home. Before, during, and after completion, concentration ability with the d2-R, memory (VLMT), subjective hearing impairment (HHI), hearing quality (SSQ12), listening effort in noise (ACALES), and speech understanding in noise (GÖSA) were measured. Results and Discussion: In this uncontrolled, non-randomized study, one of the main findings was that cognitive dimensions, namely processing speed, improved by 12.11 ± 16.40 points (p = 0.006), and concentration performance improved by 12.56 ± 13.50 points (p = 0.001), which were not directly trained in CCAT. Learning performance also improved slightly by 4.00 ± 7.00 (p = 0.019). Subjective hearing handicap significantly reduced by 10.70 ± 12.38 (p = 0.001). There were no significant changes in the SSQ-12 (p = 0.979). Hearing effort improved by 1.79 ± 2.13 dB SPL (p = 0.001), 1.75 ± 2.09 (p = 0.001), and 3.32 ± 3.27 dB (p < 0.001), respectively. Speech understanding in noise did not improve significantly. CCAT is likely to improve several dimensions of hearing and cognition. Controlled future studies are needed to investigate its efficacy.