Falls are major enemies of the elderly. If they slip or collapse, the result could be a hip fracture that requires immediate replacement with an artificial joint, and in many cases, blood clots kill many victims within a year.

But there is help on the way. Researchers at Tel Aviv University (TAU) have discovered that mild, non-invasive stimulation of a specific aea in the brain of older adults improves their ability to maintain their balance and walk safely while carrying out other cognitively demanding tasks.  

The researchers declared that “the therapy is safe, and we hope that, in time, patients will be capable of using it to treat themselves at home.” 

Led by Prof. Jeffrey Hausdorff of TAU’s Sackler Faculty of Medicine, the Sagol School of Neuroscience and the Tel Aviv Sourasky Medical Center, along with Dr. Brad Manor at Harvard Medical School, studied the effects of gentle electrical brain stimulation on the capability of older adults to walk or stand while simultaneously carrying out a cognitive task, a common dual-task situation that can determine their overall functionality. A hospital in Spain was also involved in the study.

The researchers stimulated the dorsal lateral pre-frontal cortex (DLPFC), a cognitive brain area responsible for dividing attention and executive functions. They found that this stimulation significantly reduced the immediate, negative impact of a dual-task on standing and walking performance. 

“We hope that a series of treatments will lead to similar positive results over a more extended period. This therapy method is entirely safe, and we hope that, in time, patients will be capable of treating themselves in their own homes,” said Hausdorff.

The study was published under the title “Targeted tDCS Mitigates Dual-Task Costs to Gait and Balance in Older Adults” in the Annals of Neurology, the journal of the American Neurological Association. The research was funded by a grant from the US-Israel Binational Science Foundation.

Dual tasking that involves walking while simultaneously carrying out a cognitive task, like talking on a cellphone or with a companion, occurs frequently throughout the day, added Hausdorff. “The concurrent performance of two tasks requires the ability to split attention. We know that among older people, difficulties performing another task while walking or standing reflect an existing and/or a potential problem concerning both functions, as well as an increased risk of falling. A fall can have many severe and undesirable consequences for older adults. We sought to examine the benefits of very low intensity, non-invasive electrical stimulation of various parts of the brain, hoping that this might improve their ability to perform both tasks simultaneously in a safer manner.”

The team studied 57 subjects over the age of 70. Each of them was tested by four different treatments: sham, designed not to have any influence at all, but to rule out any placebo effects; stimulation of a cognitive area of the brain (DLPFC) that is responsible for dividing attention; stimulation of a sensory-motor area of the brain that contributes to the regulation of walking; and simultaneous stimulation of both areas – motor and cognitive – together.  

Each treatment included non-invasive stimulation using a very low-intensity electric current for 20 minutes. Immediately upon the conclusion of the treatment, the walking and standing sway of each subject were evaluated, with and without the request to also perform a cognitive task. 

The study showed that stimulation of the cognitive area, whether alone or together with the stimulation of the motor area, cut the negative effects of the cognitive task on walking and standing stability by about half. On the other hand, stimulation of the sensory-motor area alone and sham stimulation did not improve the subjects’ performance. 

The researchers explained that since the stimulation is a gentle one, it does not activate brain neurons but only increases their excitability; in other words, it facilitates the ability of the patient to activate those neurons in the brain.

“In our study, we demonstrated that low-level ‘gentle‘ stimulation of a specific cognitive area of the brain can improve the performance of older adults when they carry out the double task of walking or standing in place while at the same time performing a cognitive task, at least within the immediate time range.  

Healthy young adults frequently walk while doing many other things; but for older people, this may place them in an unsafe situation and increase their risk of falling, said the professor. “We hope that a series of treatments will lead to similar positive results over a more protracted period to improve standing stability and walking capability, diminish the risks of falling and perhaps also enhance cognitive function among the elderly population.”

The team also foresee the possibility of combining this type of therapy with exercise and other modes of intervention that can improve walking, enhance thinking and reduce the risk of falls. “There is evidence that combined therapy could prove to be the most effective solution, but further research is required to examine this,” he concluded.