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.
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Change from baseline in the dual task cost to gait speed
Timeframe: 3-day follow-up; 3-month follow-up; 6-month follow-up
Change from baseline in the dual task cost to standing postural sway speed
Timeframe: 3-day follow-up; 3-month follow-up; 6-month follow-up
Change from baseline in Short Physical Performance Battery (SPPB)
Timeframe: 3-day follow-up; 3-month follow-up; 6-month follow-up
Change from baseline in Montreal Cognitive Assessment (MoCA) total score
Timeframe: 3-day follow-up; 3-month follow-up; 6-month follow-up