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Cognitive decline is a growing concern in ageing populations, prompting researchers to explore non-pharmacological strategies. Transcranial direct current stimulation — a non-invasive technique that delivers low-level electrical current to the brain — has shown some promise for cognitive enhancement, and there is interest in whether pairing it with physical exercise might amplify benefits in older adults.
This systematic review and meta-analysis followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, searching multiple international databases for randomised controlled trials examining the combined effect of exercise and transcranial direct current stimulation on cognition in older adults. Effect sizes were pooled using a random-effects model and reported as standardised mean differences.
The combined intervention produced a statistically significant improvement in overall cognitive function. Executive function and general cognitive ability both showed significant gains, while memory improvement did not reach statistical significance. Effects were observed across both shorter and longer intervention durations, though shorter programmes yielded larger effect sizes. Cognitively healthy individuals showed slightly larger effects than those with existing cognitive impairment. Among exercise types, Tai Chi paired with transcranial direct current stimulation produced the smallest effect size but also the most consistent results across studies, with no measurable heterogeneity — suggesting it may be the most reliable, if modest, combination. Longer transcranial direct current stimulation sessions were associated with greater cognitive benefit, while longer overall programmes and longer individual exercise sessions were associated with smaller effects.
Conclusion: Combining exercise with transcranial direct current stimulation appears to offer meaningful cognitive benefits for older adults, though outcomes vary by cognitive domain, baseline ability, and programme design, and the evidence base remains limited.
Source: Hu S, Yang Y, Li X Frontiers in neuroscience (2026). View on PubMed (PMID 42182054) · doi:10.3389/fnagi.2022.981002
