Noninvasive Brain Stimulation to Reduce Falls in Older Adults

Numerous interrelated factors on the causal pathway to falls in older adults—from gait and balance decline to cognitive dysfunction, depression, and chronic pain—arise at least in part from ineffective and/or inappropriate activation of brain networks. Transcranial electrical stimulation (tES) and transcranial magnetic stimulation (TMS) are two forms of noninvasive brain stimulation capable of selectively modulating the excitability of brain regions of interest and their connected neural networks. While no studies to date have directly examined the effects of tES or TMS interventions on falls in older adults, mounting evidence suggests that each technology holds promise to enhance gait and balance, improve certain aspects of cognitive function, and combat symptoms associated with depression and chronic pain in both aging and disease. This chapter will thus introduce tES and TMS technologies and their application to clinical research in aging, review available literature with potential relevance to falls prevention, and highlight important areas of future research needed to maximize the potential of noninvasive brain stimulation to alleviate the burden of cognitive–motor decline and falls in older adults.