Augmenting Cognitive Training in Older Adults (The ACT Study)

ACT logoThe Augmenting Cognitive Training in Older Adults (ACT Study) is a Phase III definitive multi-site randomized clinical trial with an adaptive design that will establish the benefit of delivering adjunctive transcranial direct current stimulation (tDCS) with cognitive training in older adults to remediate the trajectory of age-related cognitive decline. Cognitive training for speed of processing and working memory demonstrates promise as an intervention to alter the trajectory of cognitive aging and potentially slow the onset of midl cognitive impairment/dementia. tDCS uses a weak electrical current passed across the scalp to stimulate underlying brain tissue and facilitate the neuroplastic response of brain tissue – learning at the neural level. Leveraging the effects of cognitive training, an approach based on neuroplasticity, with the facilitation of neuroplasticity from tDCS, these two non-invasive interventions have a potential for synergistically impacting the overall efficacy of cognitive training on cognitive and functional abilities in older adults. Of note, this trial is first ever Phase III clinical trial for tDCS and will be the largest trial in the field at its completion. The trial measures both trial success and intervention mechanisms using multimodal neuroimaging (T1, FLAIR, fMRI) and magnetic resonance spectroscopy (1H MRS), as well as comprehensive neurocognitive and functional assessment. Dr. Woods leads the Administrative Coordinating Center overseeing all sites as well as the UF study site, which will recruit 240 of the 360 participants in the trial. The Woods Lab developed the trial infrastructure, including: 300 pages of MOPs, 40 hours training videos, trial portal, organizational structure, communication system, and all study procedures. As the first Phase III tDCS, the clinical trial infrastructure developed for the ACT Study in the Woods Lab represents a unique resource for future tDCS trials and is being leveraged across multiple funded studies. Participants in ACT undergo a 3 month intervention where they complete 40 minutes per day of cognitive training 5 days per week paired with either active tDCS or sham tDCS delivered bilaterally to the frontal lobes. tDCS is delivered 5 days per week in the first two weeks of training and once per week thereafter for the remainder of the 3 month intervention. If successful, the ACT intervention will represent a non-invasive method for impacting the ability of older adults to live healthier, longer.


tDCS prep







Funding Source:

National Institute on Aging R01AG050477

Clinical Trial Design Paper:

Woods AJ, Cohen R, Marsiske M, Alexander G, Czaja S, Wu S. 2018. Augmenting cognitive training in older adults (The ACT Study): Design and methods of a Phase III tDCS and cognitive training trial. Contemporary Clinical Trials. 65: 19-32

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