1. A systematic review and meta-analysis of the impact of transcranial direct current stimulation on cognitive function in older adults with cognitive impairments: the influence of dosage parameters.
- Author
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Prathum T, Chantanachai T, Vimolratana O, Laksanaphuk C, Apiworajirawit I, Aneksan B, Latthirun K, Yang CT, and Klomjai W
- Subjects
- Humans, Aged, Randomized Controlled Trials as Topic, Transcranial Direct Current Stimulation methods, Cognitive Dysfunction therapy, Cognitive Dysfunction etiology, Cognition physiology
- Abstract
Introduction: Numerous studies have demonstrated the effects of transcranial direct current stimulation (tDCS) on cognitive function in the older people. This study further explores the impact of tDCS and its dosage parameters on cognitive enhancement in older people with cognitive impairments., Methods: Randomized controlled trials (RCTs) published through November 2023 were retrieved from databases including PubMed, Scopus, EMBASE, EBSCO, and the Cochrane Library. Participants were older adults with cognitive impairments, including Alzheimer's disease (AD), mild cognitive impairment (MCI), and dementia. AD was diagnosed based on the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), or the National Institute of Neurological and Communicative Disorders and Stroke - Alzheimer' Disease and Related Disorders Association (NINCDS-ADRDA) criteria. Dementia was diagnosed using the DSM-V or NINCDS-ADRDA criteria, while MCI was diagnosed using the DSM-V, the Petersen criteria, or assessments such as Montreal Cognitive Assessment (MoCA) and Clinical Dementia Rating (CDR). Standardized mean difference (SMD) values were analyzed to assess the effects., Results: A total of 19 RCTs were included. tDCS significantly improved the Mini-Mental State Examination score both immediately post-intervention (SMD = 0.51, p = 0.005) and at follow-up (SMD = 2.29, p = 0.0003). Significant effects were observed when tDCS was used alone (SMD = 0.39, p = 0.04), at current densities ≤ 0.06 mA/cm
2 (SMD = 0.25, p = 0.04), session durations exceeding 20 min (SMD = 0.89, p = 0.01), up to 15 sessions (SMD = 0.28, p = 0.009), and when an active electrode was placed over the temporal area (SMD = 0.33, p = 0.02). People with AD showed greater improvements compared to those with MCI or dementia (SMD = 0.91, p = 0.02). However, tDCS did not significantly improve memory or executive function., Conclusion: tDCS demonstrated efficacy in enhancing global cognition in older people with cognitive impairments, providing insight into optimal parameters for clinical application. However, no improvement were observed in memory or executive function., Competing Interests: Declarations. Ethics approval and consent to participate: Ethical approval was noted for all published papers included in the review. No further ethics approval was sought for this review of existing literature. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests., (© 2025. The Author(s).)- Published
- 2025
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