A systematic review and meta-analysis of transcranial direct current stimulation to remediate age-related cognitive decline in healthy older adults
Open accessAbstract
BACKGROUND: Transcranial direct current stimulation (tDCS) has been proposed as a possible method for remediating age-associated cognitive decline in the older adult population. While tDCS has shown potential for improving cognitive functions in healthy older adults, stimulation outcomes on various cognitive domains have been mixed. METHODS: A systematic search was performed in four databases: PubMed, EMBASE, Web of Science, and PsychInfo. Search results were then screened for eligibility based on inclusion/exclusion criteria to only include studies where tDCS was applied to improve cognition in healthy older adults 65 years and above. Eligible studies were reviewed and demographic characteristics, tDCS dose parameters, study procedures, and cognitive outcomes were extracted. Reported effect sizes for active compared to sham group in representative cognitive domain were converted to Hedges' g. MAIN RESULTS: A total of thirteen studies involving healthy older adults (n=532, mean age=71.2+5.3 years) were included in the meta-analysis. The majority of included studies (94%) targeted the prefrontal cortex with stimulation intensity 1-2 mA using various electrode placements with anodes near the frontal region. Across all studies, we found Hedges' g values ranged from -0.31 to 1.85 as reported group effect sizes of active stimulation compared to sham. CONCLUSION: While observed outcomes varied, overall findings indicated promising effects of tDCS to remediate cognitive aging and thus deserves further exploration. Future characterization of inter-individual variability in tDCS dose response and applications in larger cohorts are warranted to further validate benefits of tDCS for cognition in healthy older adults.
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Prior evidence shows enhanced cognitive performance in domains of working memory and episodic memory and evidence of transfer effects following active stimulation with cognitive training in older adults.
“This is surprising given prior evidence of enhanced cognitive performance in domains of working memory and episodic memory and evidence of transfer effects following active stimulation with cognitive training in older adults [33–36, 46, 47].”
From Primary outcome from the augmenting cognitive training in older adults study (ACT): A tDCS and cognitive training randomized clinical trial (2023) · cites this paper as [47]
The Discussion (page unavailable) reports improved working-memory performance in three of four studies pairing tDCS with extended cognitive training. The Results table (page unavailable) also reports a significant effect on a far-transfer task in a study paired with cognitive training. The review reports an episodic-memory benefit from active versus sham stimulation, but does not establish that this benefit followed stimulation paired with cognitive training. (LLM, conf=0.86)
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- Authors
- Indahlastari, A., Hardcastle, C., Albizu, A., Alvarez-Alvarado, S., Boutzoukas, E. M., Evangelista, N. D., Hausman, H. K., Kraft, J., Langer, K., & Woods, A. J.
- Affiliations
- University of Florida Health (US)
- University of Florida (US)
- Corresponding author
- Indahlastari, Aprinda
- ORCID
- Venue
- Neuropsychiatric Disease and Treatment
- Publisher
- Informa UK Limited
- Published
- 2021-03
- Volume
- Volume 17
- Pages
- 971-990
- ISSN
- 1176-6328 (ISSN-L)
- 1178-2021
- PMC
- PMC8018377
- OpenAlex
- W3148929485
- Cited by
- 64
- References
- 123
- Citations by year
- 2026: 10 · 2025: 8 · 2024: 13 · 2023: 17 · 2022: 9 · 2021: 7
- FWCI
- 1.34
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- Neuropsychiatric Disease and Treatment (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Dove Medical Press (Taylor and Francis Group) (submittedVersion, cc-by-nc)
- Funders
- Brain Research Foundation
- McKnight Foundation
- Evelyn F. McKnight Brain Research Foundation
- University of Florida (T32HL134621, UL1 TR001427)
- National Institutes of Health (UL1TR001427)
- Clinical and Translational Science Institute, University of Florida (UL1TR001427)
- National Institute on Aging (R01AG054077, T32AG020499, K01AG050707, T32AG061892)
- National Heart, Lung, and Blood Institute (T32HL134621)
- National Center for Advancing Translational Sciences
- Topics
- Life Sciences › Neuroscience › Neurology › Transcranial Magnetic Stimulation Studies
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Cognitive Functions and Memory
- Life Sciences › Neuroscience › Cognitive Neuroscience › Neuroethics, Human Enhancement, Biomedical Innovations
- Keywords
- transcranial direct current stimulation, age-related cognitive decline, cognitive aging, older adults, prefrontal cortex stimulation, sham stimulation, cognitive enhancement, electrode placement
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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