HEaring and LIstening eXperience (HELIX): Evaluation of a co-designed serious game for auditory-cognitive training

In the dementia field, a number of applications are being developed aimed at boosting functional abilities. There is an interesting gap as to how utilising serious games can further the knowledge on the potential relationship between hearing and cognitive health in mid-life. The aim of this study was to evaluate the auditory-cognitive training application HELIX, against outcome measures for speech-in-noise, cognitive tasks, communication confidence, quality of life, and usability. A randomised-controlled trial was completed for 43 participants with subjective hearing loss and/or cognitive impairment, over a play period of 4 weeks and a follow-up period of another 4 weeks. Outcome measures included a new online implementation of the Digit-Triplet-Test, a battery of online cognitive tests, and quality of life questionnaires. Paired semi-structured interviews and usability measures were completed to assess HELIX's impact on quality of life and usability. An improvement in the performance of the Digit-Triplet-Test, measured 4 and 8 weeks after the baseline, was found within the training group; however, this improvement was not significant between the training and control groups. No significant improvements were found in any other outcome measures. Thematic analysis suggested HELIX prompted the realisation of difficulties and actions required, improved listening, and positive behaviour change. Employing a participatory design approach has ensured HELIX is relevant and useful for participants who may be at risk of developing age-related hearing loss and cognitive decline. Although an improvement in the Digit-Triplet-Test was seen, it is not possible to conclude whether this was as a result of playing HELIX.