SharpBrains

Think about this: How can anyone take care of his or her brain when every week brings a new barrage of articles and studies which seem to contradict each other?

Do supplements improve memory? Do you need both physical and mental exercise –or is one of them enough? Which brain training approach, if any, is worth one's time and money?

We tried to address these questions, and many others, in our recent book, The SharpBrains Guide to Brain Fitness (182 pages, $24.95), that we presented at Games for Health Conference last week. The book is the result of over two years of extensive research including more than a hundred interviews with scientists, professionals and consumers, and a deep review of the scientific literature, led by neuropsychologist Elkhonon Goldberg and myself with the help of cognitive scientist Pascale Michelon. As we wrote in the Introduction, what we wanted to do first of all was to debunks these 10 myths on brain health and brain training:

Myth 1. Genes determine the fate of our brains.
Facts: Lifelong neuroplasticity allows our lifestyles and actions to play a meaningful role in how our brains physically evolve, especially given longer life expectancy.

Myth 2. Aging means automatic decline.
Facts: There is nothing inherently fixed in the precise trajectory of how brain functions evolve as we age.

Myth 3. Medication is the main hope for cognitive enhancement.
Facts: Non-invasive interventions can have comparable and more durable effects, side effect-free.

Myth 4. We will soon have a Magic Pill or General Solution to solve all our cognitive challenges.
Facts: A multi-pronged approach is recommended, centered around nutrition, stress management, and both physical and mental exercise.

Myth 5. There is only one “it” in “Use It or Lose it”.
Facts: The brain is composed of a number of specialized units. Our life and productivity depend on a variety of brain functions, not just one.

Myth 6. All brain activities or exercises are equal.
Facts: Varied and targeted exercises are the necessary ingredients in brain training so that a wide range of brain functions can be stimulated.

Myth 7. There is only one way to train your brain.
Facts: Brain functions can be impacted in a number of ways: through meditation, cognitive therapy, cognitive training.

Myth 8. We all have something called “Brain Age”.
Facts: Brain age is a fiction. No two individuals have the same brain or expression of brain functions.

Myth 9. That “brain age” can be reversed by 10, 20, 30 years.
Facts: Brain training can improve specific brain functions, but, with research available today, cannot be said to roll back one’s “brain age” by a number of years.

Myth 10. All human brains need the same brain training.
Facts: As in physical fitness, users must ask themselves: What functions do I need to improve on? In what timeframe? What is my budget?

Do you have other myths in mind you would like  us to address?

We have started to receive great feedback from the healthcare community, such as this email from a neurosurgeon in Texas:

"I really like the book, it is comprehensive without being too technical. I have recommended it to several patients. There are some other books that I expected would be greeted with enthusiasm, but were too complex for most of my patients. I think this book is right in the sweet spot".

And this great book review by an Internist Physician and Robert Wood Johnson Foundation Fellow, titled Is Your Brain A Couch Potato?:

“…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. life."

—Doc Gurley, book review for SFGate.com (06/08/09)

The book:  The SharpBrains Guide to Brain Fitness (available via Amazon.com Here, review copies available upon request).

Description: While most of us have heard the phrase “use it or lose it,” very few understand what “it” means, or how to properly “use it” in order to maintain brain function and fitness. The SharpBrains Guide to Brain Fitness is an invaluable guide that helps readers navigate growing brain research and identify the lifestyle factors and products that contribute to brain health and fitness. By gathering insights from eighteen of the world’s top scientists and offering tools and detailed descriptions of over twenty products, this book is an essential guide to the field of brain fitness, neuroplasticity and cognitive health. An accessible and thought-provoking read, The SharpBrains Guide to Brain Fitness educates lifelong learners and professionals in healthcare, education, business, etc., on emerging trends and forecasts of what the future will hold.

Products Reviewed (we reviewed scientific studies published before January 2009, when the manuscript text was closed):

- Overall brain maintenance: Brain Age series (Nintendo), BrainWare Safari (Learning Enhancement Corporation), FitBrains.com (Vivity Labs), Happy-Neuron.com (Scientific Brain Training), Lumosity.com (Lumos Labs), MindFit (CogniFit), (m)Power (Dakim)

- Targeted brain workout: Classic and InSight (Posit Science), Working Memory Training JM and RM (Cogmed), DriveFit (CogniFit), Earobics (Houghton Mifflin), Fast ForWord (Scientific Learning), IntelliGym (Applied Cognitive Engineering), Vision Restpration Therapy (NovaVision)

- Emotional self-regulation: emWave PC and Personal Stress Reliever (HeartMath), Journey to the Wild Divine (Wild Divine), RESPeRATE (InterCure), StressEraser (Helicor)

Given the whole distracting "controversy" of whether Nintendo Brain Age "works" or not, I have started to use the following "brain teasers" in my talks in order to help the audience gain a more useful perspective of what is going on. They worked great both in the Medicare Readmissions Summit in DC a few weeks ago, and at the Games for Heath Conference last week.

Q: How many soldiers in the US Army have gone through computerized cognitive testing before being deployed, and why?
A: Over 150,000, in order to establish an objective starting baseline and identify potential PTSD and TBI problems upon their return

Q: How big is the ongoing investment by OptumHealth, a division of UnitedHealth Group (UNH), in developing computerized cognitive assessments to inform clinical decision-making?
A: over $6m

Q: How many Allstate policy-holders over the age of 50 are now using a computerized cognitive training program to measure the potential improvements in driving safety derived from the training?
A: Over 8,000, in the state of Pennsylvania

Q: How many residential communities are offering computerized cognitive training programs to their residents?
A: Over 700, in the US alone, covering independent and assisted living

Q: How much money has the Government of Ontario invested in setting up a new Centre for Brain Fitness as part of Baycrest research center in order to develop and commercialize technologies to assess and enhance cognitive functions?
A: $10m, matched with another 10m from local investors

For more on our Cognitive Health Track at Games for Health Conference last week, see this USA Today article:

More doctor's prescriptions may include brain games to improve mental acuity

(pretty good overall, but please note that SharpBrains didn't organize the whole conference, "only" the cognitive health track, which was a lot of stimulating fun. Ben Sawyer and team did overall conference).

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."

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

Cognitive training (or structured mental exercise) definitely seems to work - as long as we define properly what "work" means, don't expect magic cures, and help navigate options. Please keep reading...

Interview: Baycrest

Interview with Baycrest's CEO Dr. William Reichman: Discussing the recent Centre for Brain Fitness at Baycrest, Dr. Reichman suggests that "we have an opportunity to make major progress in Brain Health in the XXI century, similar to what happened with Cardiovascular Health in the XXth, and technology will play a crucial role." A major obstacle? We need a consensus on "widely accepted standards for outcome measures".

Does It Work?

Does cognitive training work? (For Whom? For What?): 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 understanding of the scientific evidence. Dr. Pascale Michelon, SharpBrains' Research Manager for Educational Initiatives, analyzes a couple of recent studies, clarifying what they mean - and what they don't mean.

It Works, and It Doesn't Work: the IMPACT study (a major, multi-site study on the Posit Science auditory program) will be published at the Journal of the American Geriatrics Society in April. Results support that cognitive training works - but doesn't support the grandiose "brain age" claims we see too often.

Cognitive Training can Influence Brain Biochemistry: Dr. David Rabiner discusses a recent scientific study that "shows that brain biochemistry can be modified by experience", and that computerized cognitive training (Cogmed working memory training) can provide that experience.

The Big Picture

Making Healthy Choices - Primare Care and Prevention: a panel at the recent World Economic Forum explored why "New markets and industries are arising – “silver industries” such as financial services, health, housing and hospitality geared to senior citizens. Longevity needs to be linked to health – including cognitive health – and lifestyle choices play a major role in health."

Enrich your environment now and benefit your future offspring: Dr. Robert Sylwester reports that "all sorts of long held-beliefs about our brain and cognition are being re- examined by cognitive neuroscientists" because of fascinating studies such as the one  he reviews (with mice): "The study's findings seemed to suggest that acquired characteristics can be genetically transmitted...long-term benefits accrue from a stimulating early environment that encourages curiosity and exploration."

Managing Emotions

From Distress to De-Stress: helping anxious, worried kids: In a detailed 2-part article, (Part 1, Part 2), Dr. Jerome Schultz provides great tips on how to help children learn to self-regulate emotions, adding that "Teachers, occupational therapists, physical education teachers and parents need to actually teach children (of all ages) how to get themselves into a physical state of being relaxed. This doesn’t happen automatically. If it did, there wouldn’t be so many adult yoga classes!"

Lie to Me, Paul Ekman and Biofeedback: You may have watched the new series Lie To Me, with Tim Roth, based on the work of Paul Ekman. The introduction to the second episode shows why what are called "lie detectors" are nothing but biofeedback systems that measure physiological anxiety.

News

Brain Games for Baby Boomers: round-up of other recent news, covering the effects of gaming, cognitive training for driving skills, and brain fitness classes.

Neurocognitive assessments and sports concussions: a new study and a new resource to understand and address the 1.6 to 3.8 million cases of sports-related concussions that occur annually in the United States.

Brain Teaser

How will you, your organization, your neighbors, participate in Brain Awareness Week, March 16th-22nd, organized by the Dana Foundation with the participation of thousands of outreach partners, including SharpBrains? You can find event ideas, excellent resources (yes, including puzzles), and a calendar of events, Here.

Have a great month of March!

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

Bird's Eye View

Brain fitness heads towards its tipping point: How do you know when something is moving towards a Gladwellian tipping point? When health insurance companies and public policy makers launch significant initiatives. Dr. Gerard Finnemore provides a market overview, based on SharpBrains' client webinar held last December.

Ten Reflections on Cognitive Health and Assessments: Here are 10 highlights from several stimulating January events:  Symposium on Adaptive Technology for the Aging (by Arizona State University), Health Bloggers' Summit (by Consumer Reports), Traumatic Brain Injury (by Veteran Affairs in Palo Alto), and a new Alzheimer's/ Dementia Expert Panel organized by the city of San Francisco.

News and Events

Nintendo Brain Age vs. Crossword Puzzles: we need much public education in order to help consumers separate reality from hope from hype. Nintendo is not helping, neither is media reporting.

Collection of recent news: including training for senior fitness trainers, reports on the importance of purpose,  on older driver safety, and more.

Upcoming events: I will be speaking soon at the New York Academy of Medicine, the American Society on Aging/ NCOA conference, and the Silvering Workforce Summit at the University of North Carolina. Let me know if you are attending any.

Education and Learning

Learning about Learning: an Interview with Joshua Waitzkin: Scott Barry Kaufman interviews "child prodigy" Joshua Waitzkin on The Art of Learning. Many fascinating insights, including "I think losing my first National Chess Championship was the greatest thing that ever happened to me, because it helped me avoid many of the psychological traps...(associated with being called a "child prodigy")".

Resources to help students build emotional intelligence: Daniel Goleman introduces educators and parents to a new book that "adds an important tool to the emotional intelligence kit: mindfulness, a moment-by-moment awareness of one's internal state and external environment."

Resources

Top 10 Cognitive Health and Brain Fitness Books: Here you have The 10 Most Popular Brain Fitness & Cognitive Health Books, based on book purchases by SharpBrains' readers during 2008.

10-Question Program Evaluation Checklist: To help consumers and professionals navigate through the growing number of programs making "brain fitness" or "brain training" claims, we published last year this Evaluation Checklist. Now we are making the Checklist available as a Bookmark given recent requests by universities and conference organizers.

Brain Teaser

Brain Teaser to Exercise your Memory and Reasoning Skills: Dr. Pascale Michelon offers a stimulating teaser that not only helps exercise our brain but also educates us on how and why the same activity may exercise different brains differently - depending on where we are from.

Nintendo brain-trainer 'no better than pencil and paper' (The Times):
"The survey of ten-year-old children found no evidence to support claims in Nintendo's advertising campaign, featuring Nicole Kidman, that users can test and rejuvenate their grey cells. “The Nintendo DS is a technological jewel. As a game it's fine,” said Alain Lieury, professor of cognitive psychology at the University of Rennes, Brittany, who conducted the survey. “But it is charlatanism to claim that it is a scientific test.”

Comments: as we have said before, Nintendo Brain Age and Brain Training should be seen as what they are: a game. And the construct of one's having a  "brain age" makes no sense.

Having said that, the researcher quoted then offers, out of the blue, a highly inaccurate statement:

"The study tested Nintendo's claims on 67 ten-year-olds. "That's the age where you have the best chance of improvement," Professor Lieury said. "If it doesn't work on children, it won't work on adults."

That assertion (that something won't "work" on adults because it won't "work" on kids) makes even less sense than having a "brain age". The Cognitive Reserve research shows the need for lifelong mental stimulation - and the reality is that kids are more exposed to novelty and challenge all the time, whereas older adults may not be. Further, that claim (something that doesn't "work" on kids won't "work" on adults) has already been tested and proven wrong:

In a couple of recent trials, discussed here, the same strategy game (Rise of Nations, a complex challenge for executive functions), played for the same number of hours (23)  showed quite impressive (untrained) cognitive benefits in people over 60 - and no benefits in people in their 20s.

How can this be? Well, we often say that our brains need novelty, variety and challenge - and it should be obvious that those ingredients depend on who we are Continue Reading »

Here you have SharpBrains' 30 most popular articles, ranked by the number of people who have read each article in 2008.

Please note that, since the first article already includes most of our most popular brain teasers, we have excluded teasers from the rest of the ranking. (If those 50 are not enough for you, you can also try these brain teasers).

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Continue Reading »

(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: Continue Reading »

Just saw a very interesting press release regarding computer-based neurocognitive assessments - a critical part of the brain fitness puzzle. How long will it take before consumers can have access to a reliable and credible annual "mental check-up"/ cognitive baseline?

HeadMinder Cognitive Stability Index: Computerized Neurocognitive ... (Press release)

- "The HeadMinder web-based Cognitive Stability Index (CSI) has proven more useful for blast-concussion detection than the ANAM computerized test battery the DoD currently employs. The CSI provides an immediate solution to clear the backlog of 400,000 IED-exposed service members in less than two years."

- "The CSI is a 30-minute, Internet-based, computerized test that provides automated, objective measures of attention, memory, response speed, and processing speed for initial evaluation of cognitive functioning. The CSI produces standardized reports that enable triage and decision-making appropriate to a user's qualifications - from medic to neuropsychologist to neurologist and other treatment team members."

We covered this emerging type of assessments in the article Computerized Cognitive Assessments: opportunities and concerns

- "In fact, one of the Continue Reading »

The August issue of Venture Capital Journal brings a very good piece on the emerging brain fitness software  (also called "neurosoftware") category: 

-- Mind Games (subscription required)

-- Dakim, Lumos Labs, Posit Science and other “brain fitness” startups are starting to gain mind share — and capital — from venture firms.

The reporter and I spoke as Lumos Labs received its $3m round, and we discussed other fundable start-ups, featuring CogniFit. Which, as mentioned over the weekend, just raised $5m.

If case you are a new SharpBrains reader, perhaps visiting us after reading this VCJ article, let me provide a quick overview of the category and our Market Report (which is annual, not quarterly as the article states):

A) Report Highlights

We estimate the size of the US brain fitness software market at $225M in 2007, up from $100m in 2005 (50% CAGR), analyzing the size and trends of four customer segments: consumers, healthcare & insurance providers, K12 school systems, and fortune 1000 companies, military, and sports teams. Two segments fueled the market growth from 2005 to 2007: consumers (grew from $5m to $80m, 300% CAGR) and healthcare & insurance providers (grew from $36m to $65m, 35% CAGR).

Ten Specific Highlights from The State of the Brain Fitness Software Market 2008 report include:

1) 2007 was a seminal year for the US Brain Fitness software market, which reached $225 million in revenues – up from an estimated $100 million in 2005.

2) Over 20 companies are offering tools to assess and train cognitive skills to four customer segments: consumers; healthcare and insurance providers; K12 school systems; and Fortune 1000 companies, the military, and sports teams.

Continue Reading »