SharpBrains

Stanford Issues Findings from Cognitive and Brain Experts Urging Consumer Caution on Memory Fitness Products (press release)

- "Fear of memory loss, mental impairment and Alzheimer's disease lead many consumers to search for products --- from supplements to software --- that claim to ward off such ailments," Laura L. Carstensen, founding director of the Stanford Center on Longevity, said. "Such products are becoming more prolific, but this burgeoning industry is completely unregulated and the claims can range from reasonable though untested, to blatantly false. It is important for consumers to proceed with caution before buying into many of these product claims. There is no magic bullet solution for cognitive decline."

- The Summit's (Note: held in April 2008) statement points out that "it would be wrong to conclude that nothing can be done to improve mental fitness." But goes on to "strongly encourage research that compares the efficacy and the cost-effectiveness of different approaches to maintaining cognitive fitness."

Here you have the April edition of our monthly newsletter covering cognitive health and brain fitness topics. Please remember that you can subscribe to receive this Newsletter by email, using the box at the top of this page.

We are excited to release our 2009 market report The State of the Brain Fitness Software Market 2009. To be formally released on May 4th but available now for our clients and readers, this report aims to inform decision-makers at healthcare, insurance, research, public policy, investment and technology organizations about important developments in the brain fitness and cognitive health space.

2009 Market Report

The State of the Brain Fitness Software Market 2009: This new 150-page report finds sustained growth in the brain fitness software market (from $225m in 2007 to $265m in 2008) and promising seeds for future growth, combined with increased confusion given aggressive marketing claims and lack of education and standards. The report includes, for the first time, a Market & Research Momentum Matrix to categorize 21 key vendors, 10 Research Executive Briefs written by 12 leading scientists, and the complete results of our market survey with 2,000+ respondents. You can learn more, and acquire the report, Here.

News and Resources

Cognitive Health News April Round-Up: New cognitive track at the Games for Health conference, bilingual brains, poverty's effect on the brain and working memory due to stress, diabetes, neuroenhancing drugs, Kellogg's settlement with the FTC, neurocognitive testing in the military.

Normal Aging vs. Alzheimer's Disease: Dr. Murali Doraiswamy shares his very insightful views on the key question, "How can we help the public at large to distinguish Alzheimer's Disease from normal aging --- so that an interest in early identification doesn't translate into unneeded worries?", based on his recent book The Alzheimer's Action Plan.

Upcoming Guide

(Editor's Note: I recently came across an excellent book and resource, The Alzheimer's Action Plan: The Experts' Guide to the Best Diagnosis and Treatment for Memory Problems, just released in paperback. Dr. Murali Doraiswamy, one of the authors and leading Alzheimer's expert, kindly helped us create a 2-part article series to share with SharpBrains readers advice on a very important question, "How can we help the public at large to distinguish Alzheimer's Disease from normal aging --- so that an interest in early identification doesn't translate into unneeded worries?" What follows is an excerpt from the book, pages 3-8).

---

As it turns out, Jane did not have Alzheimer’s. She consulted a doctor, who, in docspeak, told her that the passage of time (getting older) had taken a slight toll on her once-superquick memory. She was slowing down a little, and if she relaxed, the name or date or other bit of information she needed would come to her soon enough. She was still good at her job and home life. She had simply joined the ranks of the worried well.

Normal brain aging, beginning as early as the forties in some people, may include:

• Taking longer to learn or remember information
• Having difficulty paying attention or concentrating in the midst of distractions
• Forgetting such basics as an anniversary or the names of friends
• Needing more reminders or memory cues, such as prominent appointment calendars, reminder notes, a phone with a wellstocked speed dial

Although they may need some assistance, older people without a mental disorder retain their ability to do their errands, handle money, find their way to familiar areas, and behave appropriately.

How does this compare to a person with Alzheimer’s? When Alzheimer’s slows the brain’s machinery, people begin to lose their ability to Continue Reading »

There's such a flood of very significant research studies, educational resources and articles related to brain health, it's hard to keep track - even for us!

Let me introduce and quote some of the top Brain Health Studies, Articles and Resources published in March:

1) Cognitive Decline Begins In Late 20s, Study Suggests (Science Daily)

- "These patterns suggest that some types of mental flexibility decrease relatively early in adulthood, but that how much knowledge one has, and the effectiveness of integrating it with one's abilities, may increase throughout all of adulthood if there are no pathological diseases," Salthouse said.

- However, Salthouse points out that there is a great deal of variance from person to person

2) Cerebrum 2009: Emerging Ideas in Brain Science - new book by the Dana Foundation that "explores the cutting edge of brain research and its implications in our everyday lives, in language understandable to the general reader."

A couple of excellent chapters of direct relevance to everyone's brain health are:
- Chapter 4: A Road Paved by Reason, by Elizabeth Norton Lasley

- Chapter 10: Neural Health: Is It Facilitated by Work Force Participation?, by Denise Park, Ph.D

3) Staying Sharp DVD Program: "Dr. Jordan Grafman, chief of the Cognitive Neuroscience Section at the National Institute of Neurological Disorders and Stroke outside of Washington, DC, and a member of the Dana Alliance for Brain Initiatives, is your guide as we cover what to expect from the aging brain and what we can do to 'stay sharp.'

For a free DVD of this program you can contact stayingsharp@dana.org. (they say free in their website, I don't know if that includes shipping & handling)

4) Drivers to be tested on cognitive ability starting at age 75 (Japan Times)

The outline of a cognitive test that drivers aged 75 or over will be required to take from June when renewing their licenses was released Thursday...The test is intended to reduce the number of traffic accidents involving elderly drivers by measuring their cognitive level.

5) Physical Fitness Improves Spatial Memory, Increases Size Of Brain Structure (Science Daily)

- "Now researchers have found that elderly adults who are more physically fit tend to have bigger hippocampi and better spatial memory than those who are less fit."

6) Brain Trainers: A Workout for the Mind (Scientific American Mind)

"I recently tried out eight of the latest brain fitness programs, training with each for a week. The programs ranged widely in focus, quality and how fun they were to use. “Like physical exercise equipment, a brain exercise program doesn’t do you any good if you don’t use it,” says Andrew J. Carle, director of the Program in Assisted Living/Senior Housing Administration at George Mason University. And people tend not to use boring equipment. “I remember when NordicTrack was the biggest thing out there. Everyone ran out and bought one, and 90 percent of them ended up as a clothes rack in the back of your bedroom.”

The reporter used: Posit Science's Brain Fitness Program Classic, HappyNeuron, Nintendo BrainAge, CogniFit's MindFit/ CogniFit Personal Coach, Lumosity, MyBrainTrainer, BrainTwister, Cogmed Working Memory Training.

7) The Latest in Mental Health: Working Out at the 'Brain Gym' (Wall Street Journal)

- "Marshall Kahn, an 82-year-old family doctor in Fullerton, Calif., says he got such a boost from brain exercises he started doing at a "Nifty after Fifty" club that he decided to start seeing patients again part-time. "Doing all the mental exercise," he says, "I realized I've still got it."

8) Debate Over Drugs For ADHD Reignites (Washington Post)

- "New data from a large federal study have reignited a debate over the effectiveness of long-term drug treatment of children with hyperactivity or attention-deficit disorder, and have drawn accusations that some members of the research team have sought to play down evidence that medications do little good beyond 24 months."

- "The study also indicated that long-term use of the drugs can stunt children's growth."

8) Adaptive training leads to sustained enhancement of poor working memory in children (Developmental Science)

Abstract: Working memory plays a crucial role in supporting learning, with poor progress in reading and mathematics characterizing children with low memory skills. This study investigated whether these problems can be overcome by a training program designed to boost working memory. Children with low working memory skills were assessed on measures of working memory, IQ and academic attainment before and after training on either adaptive or non-adaptive versions of the program. Adaptive training that taxed working memory to its limits was associated with substantial and sustained gains in working memory, with age-appropriate levels achieved by the majority of children. Mathematical ability also improved significantly 6 months following adaptive training. These findings indicate that common impairments in working memory and associated learning difficulties may be overcome with this behavioral treatment.

9) Brain cortex thinning linked to inherited depression (Los Angeles Times)

- "On average, people with a family history of depression appear to have brains that are 28% thinner in the right cortex --- the outermost layer of the brain --- than those with no known family history of the disease. That cortical thinning, said the researchers, is on a scale similar to that seen in patients with Alzheimer's disease or schizophrenia."

If you subscribe to our monthly newsletter, you may remember we ran a survey in January. Well, the response rate and the quality of the responses were nothing short of spectacular, in many dimensions. The responses from over 2,000 participants (out of 21,000 subscribers) reinforce the need for public awareness initiatives and quality information to help evaluate and navigate product claims.

I have been presenting the results from one of the questions (see below), yesterday at the ASA/ NCOA (American Society on Aging) event, today at IHRSA (International Health, Racquet and Sportsclub Association), as part of more comprehensive presentations of what is going on in the brain fitness and cognitive health field.

An obvious implication for the survey result reinforces the need for brain-related public awareness campaigns such as the ongoing Brain Awareness Week. Every year, landmark research findings open new opportunities to help maintain lifelong cognitive health and brain fitness. The opportunity is immense - but we will need to ensure the marketplace matures in a rational and sustainable manner, helping consumers and professionals separate hope from hype and make informed decisions.

Robin Klaus, Chairman of Club One Fitness Centers (the company is a client, he is an advisor), just gave us a nice quote saying that "as our population ages the fields of physical fitness and brain fitness will naturally merge and, as this happens, a whole new field of valued added services will emerge for our members. High quality informational resources such as SharpBrains' are crucial to the success of this merger."

The Survey: Results to Key Question 

Asked, "What is the most important problem you see in the brain fitness field and how do you think it can be solved?" respondents identified the following six problems in rank order:

#1: Public Awareness (39%)
- "Getting people to understand that heredity alone does not decide brain functioning."
- "An expectant public will first want to believe that a "miracle" drug is to be soon available (to prevent Alzheimer's Disease)."

#2: Navigating Claims (21%)
- "How to separate marketing hype from stuff that really works?"
- "The lack of standards and clear definitions is very confusing, and makes a lot of people sceptical."

#3: Research (15%)
- "Determining what activities are most beneficial to Continue Reading »

The growing field of cognitive training (one of the tools for brain fitness) can appear very confusing as the media keeps reporting contradictory claims. These claims are often based on press releases, without a deeper evaluation of the scientific evidence.

Let’s take a couple of recent examples, in successive days:

“It doesn’t work!” type of headline:
Reuters (Feb. 10, 2009) — Formal brain exercise won't help healthy seniors: research
“Healthy older people shouldn't bother spending money on computer games and websites promising to ward off mental decline, the author of a review of scientific evidence for the benefits of these "brain exercise" programs says”.

“It works!” type of headline:
ScienceDaily (Feb. 11, 2009) — Computer Exercises Improve Memory And Attention, Study Suggests
“According to the researchers, participants who used the Brain Fitness Program also scored as well as those ten years younger, on average, on memory and attention tests for which they did not train.”

So… does structured brain exercise / cognitive training work or not?

The problem may in fact reside in asking this very question in the first place, as Alvaro pointed out a while ago in his article “Alzheimer's Disease: too serious to play with headlines“.

We need a more nuanced set of questions.

Why? Because:
1. Cognition is made of several different abilities (working memory, attention, executive functions such as decision-making, etc)
2. Available training programs do not all train the same abilities
3. Users of training programs do not all have the same needs or goals
4. We need to differentiate between enhancing cognitive functions and delaying the onset of cognitive deficits such as Alzheimer’s.

Let’s illustrate these points, by Continue Reading »

Study Questions Effectiveness Of $80 Million Per Year 'Brain Exercise Products Industry for Elderly (Science Daily)

- "There is much research on the benefits of cognitive rehabilitation strategies among elderly who already experience mild cognitive impairment (MCI) or Alzheimer's disease, as well as on the positive impact of physical exercise. The researchers, however, wanted to evaluate current research that would focus on the impact of cognitive interventions in the healthy elderly population."

- "...they concluded that there was no evidence indicating that structured cognitive intervention programs had an impact on the progression of dementia in the healthy elderly population"

Comment:  we have not reviewed the analysis yet, so cannot comment in depth. However, just from the press release, we see a few potential problems in how the study was framed, reducing its practical value: Continue Reading »

Dear reader and member of SharpBrains' community,
We want to thank you for your attention and support in 2008, and wish you a Happy, Prosperous, Healthy and Positive 2009!

Below you have the December edition of our monthly newsletter. Enjoy:

Best of 2008

Top 30 Brain Fitness Articles of 2008: We have compiled SharpBrains' 30 most popular articles, written by thirteen Expert Contributors and staff members for you. Have you read them all?

November-December News: No month goes by without significant news in the field of cognitive fitness. Summarized here are 10 recent developments worthy of attention, including an upcoming brain training product for ice hockey players, my lecture at New York Public Library, and more.

Interviews: Videogames, Meditation

Are videogames good for your brain?: A landmark study by Dr. Arthur Kramer and colleagues has shown that playing a strategy videogame can bring a variety of significant mental benefits to older brains. Another recent study, also by Kramer and colleagues, does not show similar benefits to younger brains (despite playing the same game). How can this be? Dr. Kramer, who has kindly agreed to serve on SharpBrains' Scientific Advisory Board, elaborates.

Meditation on the Brain: Dr. Andrew Newberg provides an excellent overview of the brain benefits of practices such as meditation. He recommends, "look for something simple, easy to try first, ensuring the practice is compatible with one's beliefs and goals. You need to match practice with need: understand the specific goals you have in mind, your schedule and lifestyle, and find something practical."

The Need for Objective Assessments

Cognitive screenings and Alzheimer's Disease: The Alzheimer's Foundation of America just released a thoughtful report advocating for widespread cognitive screenings after the age of 65 (55 given the right conditions). SharpBrains readers, probed by Dr. Joshua Steinerman, seem to agree.

Quantitative EEG for ADHD diagnosis: Dr. David Rabiner reports on the findings from a recent study that documents the utility of Quantitative EEG as an objective test to assist in the diagnosis of ADHD. If this procedure were to become more widely used, he suggests, the number of children and adolescents who are inappropriately diagnosed and treated for the disorder would diminish substantially.

Shall we question the brand new book of human troubles?: The fights over the new version of the psychiatric diagnostic manual, the DSM-V, are starting to come to light. Dr. Vaughan Bell wonders why the public debate avoids the key question of whether diagnosis itself is useful for mental health and why psychometrics are simply ignored.

Resources for Lifelong Learning

Education builds Cognitive Reserve for Alzheimers Disease Protection: Dr. Pascale Michelon reviews a recent study that supports the Cognitive Reserve hypothesis - mentally stimulating experiences throughout life, such as formal education, help build a reserve in our brains that contributes to a lower probability of developing Alzheimer's symptoms.

5 Tips on Lifelong Learning & the Adult Brain: Laurie Bartels asks us to please please 1) challenge ourselves with new learning, 2) remember that neuroplasticity and neurogenesis are hallmarks of our brains, 3) check for mis-learning on an ongoing basis, 4) more visuals, less text, 5) move it, move it - start today!

Learning & the Brain is a conference that gets marked on my calendar annually because I always return home having either been exposed to new information, or with a new perspective on an old topic. Last month’s conference in Cambridge, MA, themed Using Emotions Research to Enhance Learning & Achievement, was no exception. As with previous conferences, in addition to the many keynote sessions, I focused on the adult learning strand, since so much of my time is spent providing professional development for, and collaborating with adults. Here are five conference cues as they relate to education.

1. CHALLENGE YOURSELF WITH NEW LEARNING

Aaron Nelson stated that our memory starts to decline between ages twenty-five and thirty, or to phrase it a bit more positively, Sam Wang says our memory peaks around age thirty. On the other end of the age spectrum, according to Ken Kosik, there is unequivocal evidence that education protects against Alzheimer's. Both Nelson and Kosik mentioned the theory of cognitive reserve, which translates roughly to the more we learn, the more connections we create, and therefore the greater the neuronal buffer we have to draw upon as we age.

Elkhonon Goldberg, at last April's conference, stated that “as one ages, the domain of the novel shrinks, and the domain of what is known grows". He cautioned the audience to beware of being on mental autopilot. Thus, the goal is not to simply get better at doing more of the same. The type of learning that makes a difference consists specifically of new, novel challenges. The result of such engagement is that Continue Reading »

Given the growing media coverage mentioning the terms Cognitive Reserve and Brain Reserve, you may be asking yourself, "What exactly is my Cognitive (or Brain) Reserve?"

The cognitive reserve hypothesis, tested in multiple studies, states that individuals with more cognitive reserve can experience more Alzheimer’s disease pathology in the brain (more plaques and tangles) without developing Alzheimer’s disease symptoms.

How does that work? Scientists are not sure but two possibilities are considered.
1. One is that more cognitive reserve means more brain reserve, that is more neurons and connections (synapses) between neurons. Individuals with more synapses would then have more synapses to lose before the critical threshold for Alzheimer’s Disease is reached.
2. Another possibility is that more cognitive reserve means more compensatory processes. The brain of individuals with more cognitive reserve would use more alternative networks to compensate for the damages caused by the pathology in previously used networks.

In a newly published study, Roe and colleagues from Washington University in St. Louis, used the number of years of education as a measure of cognitive reserve. Why years of education? Because previous studies have shown that people who have more education also exhibit a greater resistance to Alzheimer’s symptoms, even while pathological changes are occurring in the brain (see Bennett el al., 2003 or Roe, Xiong, et al., 2008).

Roe and her colleagues studied 198 individuals whose mean age was 67. Out of these 198 individuals, 161 were nondemented and 37 were diagnosed with Alzheimer’s Disease.

All the participants in the study took a Continue Reading »