SharpBrains

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 »

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

My apologies for not having blogged in a few days. I landed back in San Francisco today after speaking and participating in a very stimulating event put together by the Arizona State University's Adaptive Neural Systems Center with funding from the National Science Foundation.

The 2-day symposium was titled Co-Adaptive Learning: Adaptive Technology for the Aging (link opens a PDF with the agenda), featured impressive speakers and a highly qualified audience, and covered a wide array of current and future healthcare and aging applications of neuroscience. The one aspect that was very meaningful for me to observe how often we discussed cognitive abilities, cognitive deficits, cognitive assessments, cognitive enhancement tools (both invasive and non-invasive) in a variety of healthy aging and clinical contexts.

I will share more about the event in the next few days, including links to the fascinating work presented by speakers, but let me know simply thank the two gracious organizers and hosts of the event by quoting the goal of their center and work:

- Jimmy Abbas, PhD: "One of the hallmarks of biological systems is the ability to adapt. In our work, we mimic neurobiological systems in order to endow technology with the ability to adapt, and we use technology to maximize adaptations in neurobiological systems. With these approaches, we aim to promote functional adaptation after disability."

- Ranu Jung, PhD: "Our goal is to improve the quality of life of individuals with disabilities by designing techniques to investigate, replace and repair damaged neural systems to enhance mobility and functionality. Whether a person has spinal cord injury, limb loss or Parkinson's disease, mobility and functionality mean independence."

Links:

Center: Adaptive Neural Systems Center.

Agenda (PDF): Co-Adaptive Learning: Adaptive Technology for the Aging

We have tracked for several years the scientific studies published by Torkel Klingberg and colleagues, often wondering aloud, "when will educators, health professionals, executives and mainstream society come to appreciate the potential we have in front of  us to enhance our brains and improve our cognitive functions?"

Dr. Klingberg has just published a very stimulating popular science book, The Overflowing Brain, that should help in precisely that direction. Given the importance of the topic, and the quality of the book, we have named  The Overflowing Brain: Information Overload and the Limits of Working Memory  The SharpBrains Most Important Book of 2008, and asked Dr. Klingberg to write a brief article to introduce his research and book to you. Below you have. Enjoy!

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Research and Tools to Thrive in the Cognitive Age

By Dr. Torkel Klingberg

Do we all have attention deficits?

The information age has provided us with high technology which fills our days with an ever increasing amount of information and distraction. We are constantly flooded with on-the-go emails, phone calls, advertisements and text-messages and we try to cope with the increasing pace by multi tasking. A survey of workplaces in the United States found that the personnel were interrupted and distracted roughly every three minutes and that people working on a computer had on average eight windows open at the same time. There is no tendency for this to slow down; the amount and complexity of information continually increases

The most pressing concerns with this environment are: how do we deal with the daily influx of information that our inundated mental capacities are faced with? At what point does our stone-age brain become insufficient? Will we be able to train our brains effectively to increase brain capacity in order to Continue Reading »

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).

According to the press release,

- "The report shatters unsubstantiated criticism and instead emphasizes the safety and cost-effectiveness of these tools and calls on Congress to develop a national dementia screening policy."

- “Lifting the barriers to early detection is long overdue,” Hall said. “Conversations about brain health are not taking place. We must educate and empower consumers to talk openly about memory concerns, particularly with primary care providers, so they get the attention and quality of life they deserve.”

- "Demand for screenings is evidenced by the success of AFA’s recent sixth annual National Memory Screening Day held on November 18, during which an estimated 50,000 people were given free confidential memory screenings at nearly 2,200 community sites nationwide. During last year’s event, approximately 16 percent of individuals who had a face-to-face screening scored positive and were referred to their primary care providers for follow-up. An AFA survey of participants revealed that fewer than one in four with self-reported memory complaints had previously discussed them with their physicians despite recent visits."

Excellent report available: here

Please note that the Alzheimer's Association recently argued in the opposite direction (no screenings) - which probably triggered this response.

We see emerging trends that suggest the position in favor of cognitive assessments may in fact gather momentum over the next few years: widespread computerized cognitive screenings in the US Army, insurance companies like OptumHealth adding such tools to its clinical decision-making systems, polls such as the American Society of Aging's a couple of years ago indicating a very strong demand for an "annual mental check-up", the availability of useful assessment tools and research-based preventive advice.

The starting point is to understand what those assessments are NOT: they are not diagnostic tools. When used properly, they can be used as a baseline to track performance in a variety of cognitive domains over time, so that both the individual AND the physician are not blinded by a one-time assessment, comparing an individual with his or her peers (instead of his or her past performance) when serious symptoms have frequently already been going on for a while.

Our contributor  Dr. Joshua Silverman, from Albert Einstein College of Medicine, recently generated a nice debate on the topic by asking our readers their reaction to these 3 questions: Continue Reading »

If you could, you would. You can, but prefer not to know it?

More than any other organ, your brain is up to you. You are what you think, not just what you eat. Here's some food for thought:

Design your Mind

Setting cognitive and behavioral goals raises challenging and worthy questions: What do you want from your brain? Will you know it when you achieve it?

To attain the brain of our choosing, we must understand our selves and current abilities. Introspection and curiosity are helpful if they trigger and sustain the effort to enrich the mind. However, objective information which leads to informed assessment of brain function is often lacking.

Mind your Brain

Honesty. Openness. Self-awareness.

Irrefutable virtues, but in practice most people fall short. Few regularly appraise their brain skills; even so, the ability to accurately judge one's own mental performance is not guaranteed. I believe the first step to minding the brain is shedding hang-ups while offering and soliciting frank feedback from family and close confidants. In the clinical setting, routine cognitive screening and "mental check ups" are not currently practiced, in part due to time constraints and limited utility of traditional paper-and-pencil tests. From a public health perspective, the U.S. Preventative Task Force reviewed 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 »

The Wall Street Journal had a very interesting article yesterday, titled To Be Young and Anxiety-Free, focused on the value of cognitive behavioral therapy to help children with high levels of anxiety learn how too cope better and prevent the snowball scenario, when that anxiety grows and spirals out of control resulting in depression and similar

- "...new research showing that treating kids for anxiety when they are young may help prevent the development of more serious mental illnesses, including depression and more debilitating anxiety disorders."

- "Of course, most kids have fears without having a full-blown anxiety disorder. And some anxiety is healthy: It makes sense, for example, to be a little nervous before a big test. Doctors and psychologists do caution that the increased focus on childhood anxiety could lead to an overdiagnosis of the problem. What makes anxiety a true illness is when it interferes with normal functioning or causes serious emotional and physical distress."

- "But the use of antidepressants in children has come under fire because Continue Reading »

A few colleagues and I just had an interesting exchange on the recent article at The Atlantic, Is Google Making Us Stupid?, which basically blamed Google for literally rewiring our brains into more stupid brains (not being able to pay attention, read deep books...) based on a number of personal anecdotes and a little research. 

My 2 cents: this is a complex topic and we'd first need to clarify the question, before looking for answers to support or refute it. I found the Atlantic article superficial for a meaningful conversation, with its title and main premise making little sense: Google can not makes us stupid, in the same way that guns don't make us violent or pens don't make us good writers.

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