Personalized tDCS in Elderly Fallers Study

Study Summary

The objective of this study is to determine if a four-week, 20-session intervention of personalized transcranial direct current stimulation (tDCS), as compared to sham intervention, improves dual task standing and walking performance (Aim 1), as well as other physical (Aim 2) and cognitive (Aim 3) factors on the causal pathway to falls, in older adults who report two or more falls within the past year and fear of falling again in the future, yet who do not have any acute or over neurological or musculoskeletal condition. Primary endpoints will include the "dual task" costs to gait speed when walking and postural sway speed when standing, as induced by performing a serial subtraction cognitive task (i.e., \[(speeddual task - speedsingle task) / speedsingle task) X 100\] (Aim 1), the Short Physical Performance Battery (Aim 2), and the Trail Making Test (Part B minus Part A) (AIM 3). Secondary endpoints will include the dual task cost to serial subtraction performance, additional gait and balance outcomes derived from the dual task paradigm, the Timed Up-and-Go, fear of falling, habitual physical activity, and performance within a battery of neuropsychological tests focused on global cognitive function, attention, verbal fluency and memory.

Primary Outcome

This metric will assess the change from baseline in the degree to which performing a secondary cognitive task diminishes gait speed. The dual-task cost (DTC) to gait speed is calculated by (dual-task gait speed-single-task gait speed)/single-task gait speed \*100. Greater reduction in DTC to gait speed from baseline to post intervention indicates better performance.

Interventions

• OTHER Active-Sham
• OTHER Personalized tDCS