The AAA Foundation for Traffic Safety just started to recommend a new driver safety program called DriveSharp (see AAA and Posit Release Program to Improve Drivers’ Minds), developed by Posit Science. DriveSharp is a computerized cognitive assessment and training tool based on Karlene Ball’s research on older adults’ cognitive fitness and driving. 

In the press release for the agreement, Peter Kissinger, driver safety research and policy veteran and CEO of the AAA Foundation, says that “Part of making our nation’s roads safer is helping mature drivers who wish to stay active – a quickly growing population – maintain or improve their driving safety.”

We have Peter Kissinger with us to discuss the context for this innovative initiative.

Peter, I appreciate your time. In order to set the context, would you introduce the role and priorities of the AAA Foundation?

Sure. All your readers will know that AAA is the main driver association in North America, with over 50 million members. The AAA Foundation is focused on the research and policy required to improve driver safety and has 4 strategic priorities:
- Introduce a culture of traffic safety. It is an outrage that there is a driving-related death every 13 minutes in the US, and yet, we seem to accept this as status quo
- Improve road safety, especially on rural roads, where almost 60% of the deaths occur,
- Improve safety among teens, one of the highest risk groups
- Improve safety among seniors, another high-risk group.

In terms of driver-centered interventions, are your priorities are teenage and older drivers?

Yes. You have probably seen the U-shaped risk curve (Editor note: see figure at left) that shows how accident risks are very high among teenagers, then decrease and remain stable until our 60s, and then increase again.

We have promoted initiatives such as DriverZED (see www.driverzed.org) to help teenagers better identify and manage the typical sources of risk, so they advance faster through the learning curve. For older drivers we focus on how to balance the privilege of driving with the right of mobility – we know that losing driving independence can bring a variety of negative consequences for the individual.

Given aging population trends, it is clear we need to introduce better systems to balance those two goals you just outlined -safety and mobility. Do you think as a society we are prepared?

I don’t think we are, and I am pessimistic that we will be in the short term. This is a very important problem: official estimates say that the proportion of all drivers who are over 65 years of age will grow from 15% today to 25% in 2025.

Let me give you some background: two years ago we put together a workshop to identify the state of the research and the state of the practice of driver safety among Read the rest of this entry »

The San Francisco Chronicle brings two great pieces today – including an excellent review of our new Book!

Is Your Brain A Couch Potato? (online book review)

“At 165 pages, we’re talking a short, sweet, entertaining read of a complex topic, with timely (written in 1/09) reviews of 21 top technology products, as well as informed and expert predictions of where this burgeoning brain-fitness field is headed. More importantly, after you read it, you’ll have a good, detailed sense of where you, personally, can act to improve your own couch-potato brain – and how to keep it fit and flexible your whole life. The SharpBrains Guide To Brain Fitness reminds of us all why books (and not just googling a topic) can be well worth your time and money. Two Stethoscopes Up – check it out.”

Software designed to make older drivers sharper (article in print version)

- “Allstate is experimenting with the software because it wants its customers who are over 50 to become better drivers so they have fewer accidents and can drive longer, perhaps in return for lower premiums, said Tom Warden, an assistant vice president in Allstate’s research and planning center.”

- “Allstate found Posit after the insurance company’s own scientists, who were working on the physiology and psychology of good drivers, discovered research done by Visual Awareness, a company in Alabama that has worked with State Farm and various state motor vehicle departments on expanding drivers’ fields of view. Posit acquired Visual Awareness last year.”

After many many months of mental stimulation, physical exercise and the certain need for stress management… we have just announced the release of the The State of the Brain Fitness Software Market 2009 report, our second annual comprehensive market analysis of the US market for computerized cognitive assessment and training tools. In this report we estimate the size of the US brain fitness software market at $265M in 2008, up from $225M in 2007 (18% annual growth), and from $100m in 2005. Two segments fuelled the market growth from 2007 to 2008: consumers (grew from $80m to $95m) and healthcare & insurance providers (grew from $65m to $80m).

The 150-page report finds promising research and initiatives to drive significant growth, combined with increased consumer confusion given aggressive marketing claims and lack of education and standards. The report includes:
- The complete results of an exclusive January 2009 Survey with 2,000+ respondents
- A proprietary Market & Research Momentum Matrix to categorize 21 key vendors into four categories
- 10 Research Executive Briefs written by leading scientists at prominent research labs
- An analysis of the level of clinical validation per product and cognitive domain

Top 10 Highlights from the report:

1) Consumers, seniors’ communities and insurance providers drove year on year sustained growth, from $225m in 2007 to $265m in 2008. Revenues may reach between $1 billion to $5 billion by 2015, depending on how important problems (Public Awareness, Navigating Claims, Research, Health Culture, Lack of Assessment) are addressed.

2) Increased interest and confusion: 61% of respondents Strongly Agree with the statement “Addressing cognitive and brain health should be a healthcare priority.” But, 65% Agree/Strongly Agree “I don’t really know what to expect from products making brain claims.”

3) Investment in R&D seeds future growth: Landmark investments by insurance providers and government-funded research institutes testing new brain fitness applications planted new seeds for future growth.

4) Becoming standard in residential facilities: Over 700 residential facilities – mostly Independent and Assisted Living facilities and CCRCs – have installed computerized cognitive training programs.

5) Customer satisfaction: Consumers seem more satisfied with computer-based products than paper-based options. But, satisfaction differs by product. When asked “I got real value for my money”, results were as follows: Lumosity.com (65% Agree), Puzzle Books (60%), Posit Science (52%), Nintendo (51%) agreed. Posit Science (53% Agree) and Lumosity.com (51%) do better than Puzzle Books (39%) and Nintendo (38%) at “I have seen the results I wanted.”

6) Assessments: Increasing adoption of computer-based cognitive assessments to baseline and track cognitive functions over time in military, sports, and clinical contexts. The Alzheimer’s Foundation of America now advocates for widespread cognitive screenings after 65-75.

7) Specific computerized cognitive training and videogames have been shown to improve brain functions, but the key questions are, “Which ones”, and “Who needs what when?”

Aggressive marketing claims are creating confusion and skepticism, resulting in a distracting controversy between two misleading extremes: (a) “buying product XYZ can rejuvenate your brain Y years” or (b) “those products don’t work; just do one more crossword puzzle.” The upcoming book The SharpBrains Guide to Brain Fitness aims to help consumers navigate these claims.

9) Developers can be classified into four groups, based on a proprietary Market and Research Momentum Matrix: SharpBrains finds 4 Leaders, 8 High Potentials, 3 Crosswords 2.0, and 6 Wait & See companies.

10) Increased differentiation: Leading companies are better defining their value proposition and distribution channels to reach specific segments such as retirement communities, schools, or healthcare providers.

Leading researchers prepared 10 Research Executive Briefs:
- Dr. Joshua Steinerman (Einstein-Montefiore): Neuroprotection via cognitive activities
- Dr. Jerri Edwards (South Florida): Assessments of driving fitness
- Dr. Susanne Jaeggi and Dr. Martin Buschkuehl (Bern, Michigan): Working memory training and fluid intelligence
- Dr. Torkel Klingberg (Karolinska): Working memory training, dopamine, and math
- Dr. Liz Zelinski (UC Davis): Auditory processing training
- Dr. David Vance (UAB): Speed-of-processing training
- Dr. Jerri Edwards (South Florida): Cognitive training for healthy aging
- Dr. Daphne Bavelier & Dr. Shawn Green (Rochester): Action videogames and attentional skills
- Dr. Arthur Kramer (Illinois): Strategy videogames and executive functions
- Dr. Yaakov Stern (Columbia): The cognitive reserve and neuroimaging
- Dr. David Rabiner (Duke): Objective assessments for ADHD

Table of Contents

Editorial
Executive Summary
Chapter 1. Bird’s-Eye View of the Growing Field
Chapter 2. Market Survey on Beliefs, Attitudes, Purchase Habits
Chapter 3. The Emerging Competitive Landscape
Chapter 4. The Science for Brain Fitness and Cognitive Health
Chapter 5. Consumers – Adopting Crosswords 2.0?
Chapter 6: Healthcare and Insurance Providers – A Culture of Cognitive Health
Chapter 7: K12 School Systems- Ready for Change?
Chapter 8: Military, Sports Teams, Companies – Brain-Performance Link
Chapter 9: Future Directions – Projections and Bottlenecks

Companies profiled include: Advanced Brain Technologies, Applied Cognitive Engineering, Brain Center America, Brain Resource, CNS Vital Signs, Cogmed, Cogstate, CogniFit, Cognitive Drug Research, Dakim, Houghton Mifflin, Learning Enhancement Corporation, LearningRx, Lumos Labs, Marbles: The Brain Store, Nintendo, NovaVision, Posit Science, Scientific Brain Training, Scientific Learning, TransAnalytics, vibrantBrains, Vigorous Mind, Vivity Labs.

More on the report by clicking on The State of the Brain Fitness Software Market 2009.

Round-up of recent news with a variety of angles, from the effects of gaming to cognitive training for driving skills and brain fitness classes.

Seniors use brain training software to sharpen their minds (Dallas Morning News)

- “Allstate Insurance has invited some policyholders and other older drivers to try InSight so researchers can evaluate whether the software reduces accidents.”

- “Depending on the results, the auto insurer says it may expand the pilot project and offer premium discounts to drivers who take the brain training.”

- “Today, only one in seven licensed drivers is 65 or older. But by 2030, when the last of the boomers turn 65, the proportion will be one in four. “

Brain games (Palo Alto Weekly)

- “There is research that justifies the belief that games can aid the brain’s health, according to Dr. Walter Bortz II, a Stanford University School of Medicine associate professor and expert on longevity and robust aging. Studies show that stimulating the brain by learning new tasks increases blood factors in the brain that act like steroids, making it possible for the brain to grow even in old age

- “Called “brain plasticity,” such growth is the foundation of brain-fitness software research.”

Brain Fitness Classes Keep Seniors Mentally And Socially Active (Washington Post)

- “More options for exercising the brain are on the way. Last year, the Ontario government pledged about $8 million to develop a brain fitness center in Toronto. In San Francisco, Jan Zivic, a former executive search consultant, opened a center, vibrantBrains, that offers memory improvement classes and workshops. Zivic was inspired by help she got from brain fitness games she played after being injured in an automobile accident.”

The 15 Clearest Benefits of Gaming (Edge Magazine)

-”But Fernandez warns that the gamer generation isn’t automatically guaranteed to have better cognitive health than their grandparents. “Cognitive fitness (having the mental abilities required to thrive in cognitively more complex environments) seems to depend on four major pillars: nutrition, physical exercise, stress management and mental exercise. All these factors have physical effects on our brains (for example, physical exercise contributes to the creation of new neurons, while stress and anxiety prevents and/or reduces the creation of new neurons). The bad news is that we have growing obesity rates and anxiety among young people. So, games are great for mental exercise, but we shouldn’t forget the other ‘ingredients’ for cognitive fitness.”

- “Fernandez muses, “Indeed ‘fun’ can be seen as a goal in itself … The problem is that we confuse gaming as a vehicle with gaming as content. Gaming as vehicle is arguably great—it allows for interactivity, engagement. Gaming as content, well, it depends. It is not the same to play a bloody shooter game as it is to Tetris or Rise of Nations, so the field should do a better job at explaining to mainstream society the diversity of games and dispel some myths.”

More Brain Fitness and Cognitive Health News

Good article in the New York Times today:
An Epidemic of Crashes Among the Aging? Unlikely, Study Says

- “The (Insurance Institute for Highway Driving) insurance institute is conducting further research to determine why the risks appear to be going down for older drivers. It may be that today’s older drivers are simply in better physical and mental shape than their counterparts a decade ago, so they are not only less likely to make a driving mistake, but also less frail and better able to survive injuries.”

There is no doubt that, as a group, older persons of any given age are in better physical and mental shape today than their counterparts years ago. For context, worldwide life expectancy has increased more than 20 years in less than 6o years – so you can imagine how a person in his or her early 70s today is in better shape than someone in his or her mid-60s a few decades back.

Still, as the number of people over the age of 60 starts to grow exponentially given the influx of baby boomers, society at large will probably benefit from starting to think through 1) what are the types of programs, whether introduced and managed by the AARP, DMV or car insurance companies, that can help older adults drive safely for as long as they want and need, 2) what are the mechanisms to prevent having drivers in our roads who don’t possess the minimum perceptual and cognitive abilities required to drive “safely” (and what “safely” really means).

And, yes, we should probably have a similar conversation regarding teenage driving.
For related reading, you may enjoy these 2 articles:

- Allstate: Can we improve Driver Safety using Posit Science InSight?

- Improving Driving Skills and Brain Functioning- Interview with ACTIVE’s Jerri Edwards

With three years still left until publication, the fights over the new version of the psychiatric diagnostic manual, the DSM-V, are hotting up and The New York Times has a concise article that covers most of the main point of contention.

- “What you have in the end,” Mr. Shorter said, “is this process of sorting the deck of symptoms into syndromes, and the outcome all depends on how the cards fall.”

- Psychiatrists involved in preparing the new manual contend that it is too early to say for sure which cards will be added and which dropped.

Although I doubt the DSM committee are using that exact metaphor, it certainly illustrates the point that the process requires a certain degree of value-judgement.

It’s interesting, however, that the public debate is currently focused on whether certain diagnoses should be included or not, rather than whether diagnosis itself is useful for psychiatry.

We’ve had psychometrics for a good 100 years that allow us to measure dimensions of human experience and performance with a much greater degree of accuracy than Read the rest of this entry »

“If Dr. Rob can interview Santa, why can’t I interview a select group of health & medical bloggers? They will have some good ideas to share”.

So did President-elect Obama came to realize a few days ago. After his people kindly contacted our people, we felt compelled to grant him open access to our collective wisdom. Without further ado, below you have Grand Rounds 5:12 – a Q&A session led by the incoming President on how to reform (for the better, we hope) healthcare.

On Health Insurance

Q:  How does the blogosphere perceive the problem of having a significant group of people uninsured?

Health Insurance Colorado: a growing economic burden, which may lead to emergency rooms turning people away if they are unable to provide proof of health insurance.

Dr Rich: well, a recent article in the Journal of the American Medical Association showed how overcrowding in American emergency rooms is NOT due to the uninsured. Rather, it is due to insured Americans who cannot get in to see their primary care physicians. We may need improved care both for the insured and uninsured groups.

InsureBlog: I’d second that. Lack of health insurance is a major problem but is it really our Biggest Problem?

It’s All about Attitude

Q: You may have heard my campaign mantra, “Yes We Can”. Can I count on your support?

ButYouDontLookSick: Yes. If Leslie Hunt can talk so openly about her chronic illness (Lupus) yet fulfill her American Idol dreams, we can fulfill our dreams too.

Notes of an Anesthesioboist: you are talking to the group of professionals willing to self-experiment with our own body for the benefit of science and our patients.

Medviews: My wife, son, and I signed up to work as medical volunteers for your upcoming inauguration.

EmergiBlog: I am on board too. But, please, remember that caring is the essence of nursing. And that is why my patients will always be my “patients” and never my “clients”.

Neuroanthropology: Mr. President-elect, it seems to me that, despite all our good intentions, balancing the budget and multiple competing priorities will be a challenge. May I suggest you start practicing some capoeira for equilibrium training?

Shrink Rap: Happy to help. Now, we will need to protect some time for quality sleep time.

Training

Q: I am encouraged by your words. How can my team and I better support you in your daily activities?

Aequanimitas: we need more role models for us to “learn to think, observe, and compare” and that the patient is our “first, last, and only teacher”.

Mudphudder: Couldn’t agree more. We need Read the rest of this entry »

(Please note that this is my personal take at the discussions that took place in Dubai as part of the Global Agenda Council on the Challenges of Gerontology put together by the World Economic Forum, and builds on the work of my colleagues, but it does not represent a formal document or statement of position. Simply put, we would like to engage your brain in defining the challenges and outlining/ executing the solutions).

Context: The Challenges of the Aging Society

The world is aging. This is occurring in two ways: through shifts in the age structure that will eventually lead to many more people reaching older ages than ever before, and through continued success in extending life. Less than 100 years ago, life expectancy was between 30 to 40 years. Today, close to 800 million citizens are 60 and over.

And aging in healthier ways. Aging has incorrectly been associated with decline and decay, when in fact many people live healthy into older ages. There has been a synchronous extension in life expectancy and quality of life – the average 65-year-old today is much healthier, physically and mentally, than the average 50-year-old of 100-150 years ago – when most existing institutions were envisioned and created.

Healthy life can be further extended with existing knowledge. The fact is the onset and progression of fatal and disabling diseases, disorders, and disability can be postponed using well-researched basic measures of public health, environmental and behavioural changes, and medical technology interventions. The same methods may be used to improve or maintain mental and physical functioning.

Our healthcare and retirement systems are on bankruptcy track – their premises are outdated. Existing institutions, policies and attitudes do not reflect the points outlined above, having been developed for a society that no longer exists. We need to get on the right track: Read the rest of this entry »

Here you have the twice-a-month newsletter with our most popular blog posts. Please remember that you can subscribe to receive this Newsletter by email, simply by submitting your email at the top of this page.

Have you ever wondered how we can maintain SharpBrains’ website, blog and newsletter without selling any products and with only limited advertising? The answer is, we offer market research to organizations such as healthcare providers, research centers, technology developers, venture capital firms, consulting and training companies, and more.

Our new Premium Research Sponsors program will allow pioneering organizations to collaborate with us to shape the future of the brain fitness and cognitive health field, by sponsoring and accessing the most up-to-date information on the science and best practices to assess and improve cognitive functioning across the lifespan. You can learn more about the Premium Research Sponsors program Here.

Market News

The Cognitive Health and Fitness Market On The Move: As you have probably seen, the Cognitive Health and Brain Fitness field is rapidly evolving. Here we highlight some of the main developments affecting the field over the last 6-months: public policy initiatives in Canada and the US, the growing role of computerized assessments, several venture capital rounds, major initiatives by insurance companies, and significant research findings.

 The Big Picture

Executive Summary of the Brain Fitness Market: Let’s step back and ask ourselves, “Why is the field evolving in such a fast way? What is hope, what is hype, what is reality?” A spate of recent global news coverage on brain fitness and brain training reflects a growing interest in natural, non drug-based interventions to keep our brains sharp as we age. This interest is very timely, given an aging population, the increased prevalence of Alzheimer’s rates, and soaring health care costs in the US that place more emphasis than ever on prevention and lifestyle changes. This article summarizes the main market dynamics, open questions, and top trends to watch for.

Nourishing Our Brains and Minds

Philosophy as the Missing Link in School Curricula: Kimberly Wickham answers provides some good answers to the question, “Why would anyone want to teach philosophy to pre-adolescent children?” that will engage your critical thinking skills.

A User’s Guide to Lifelong Brain Health: Drs Simon Evans and Paul Burghardt hope (as we do) that the emerging emphasis on cognitive exercise and fitness helps complement -not substitute- other lifestyle factors important for the “physical health of the brain and all the systems it communicates with”. Think: nutrition, exercise, sleep.

Excellent Reader Comments: Our last newsletter generated a round of excellent  comments by readers on cognitive training, Posit Science and Alzheimer’s Australia, gerontology and the brain, and the value of videogames. Come enjoy this collective wisdom and participate as you wish.

Brainy Haikus:
river with haikus
flowing in since the summer
keeping  us afloat

The Challenges of Gerontology?: The World Economic Forum has asked me, as one of the 16 members of the Global Agenda Council on the Challenges of Gerontology, for “an 800 word summary of your most compelling actionable idea on the challenges of gerontology.” Feel free to help me out by offering your own actionable ideas, either related to the discipline of gerontology itself or on ways to best engage the growing number of brains over the age of 60 in our planet.

Enjoy!

As you have probably seen, the Cognitive Health and Brain Fitness field is rapidly evolving, so let me highlight some of the main recent developments affecting the field:

1) Public policy initiatives:
- The Government of Ontario, Canada, announced a $10m investment in Baycrest Research Center to help develop and commercialize brain fitness technologies. This $10m investment was matched with an additional $10m by local investors.
- In the US, The Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 was signed into law, included in the recently-approved economic bailout bill. The passage of this law has significant implications for healthcare providers and technology vendors alike.

2) Computerized Cognitive Assessments Used by the US Military:
The US Army launched a new policy requiring cognitive screenings of all soldiers before deployment (in order to better diagnose potential problems such as PTSD and TBI upon return). ANAM was the selected computerized battery of tests.

3) Venture & Angel Fundraising for Cognitive Training companies:
A number of developers have raised money. CogniFit received $5m (from Milk Capital), Lumos Labs $3m (FirstMark Capital -previously called Pequot Ventures-, Norwest Venture Partners), Scientific Brain Training $1.5m (issued shares), Vivity Labs $1m (undisclosed angel investors), This is, of course, on top of the February $10.6 investment in Dakim (Galen Partners) that we already included in our market report.

4) Major Initiatives by Insurance Companies:
- Allstate launched a large-scale research project to measure impact of Posit Science InSight (visual processing training) on driver safety for adults over 50.
- OptumHealth announced a 3-year, $18m agreement with Brain Resource to offer web-based cognitive assessments as part of clinicians’ decision support systems.
- Humana decided not to renew its agreement with Posit Science to offer Posit’s auditory processing training program to Medicare members.

5) New Research:
- In a significant new study, a team from the University of Michigan published a high-quality paper in the Proceedings of the National Academy of Sciences showing how computerized working memory training can generalize and improve fluid intelligence (one of the domains that tends to decline with age).
- Learning and Teaching Scotland released an internal study showing how Nintendo Brain Training can help children’s math and concentration skills. The study gained significant media attention, despite the fact it hasn’t been published in a respected journal.

Note: This is an excerpt from the 6-Month Market Update we will  release later this month, covering the many important developments that have occurred since we launched the inaugural Brain Fitness Market Report in March this year. This special report will be available exclusively for our Premium Research Sponsors.