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)

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?”

8) 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.

How do you know when something is fast moving towards a Gladwellian tipping point? When health insurance companies and public policy makers launch significant initiatives.

For example, the government of Ontario recently announced a $10 million investment with Baycrest Research Centre who will partner with MaRS Venture Group to develop and commercialise brain fitness technologies. The investment was matched by an additional $10 million from private sources.

Another important development was the $18 million agreement between the Australian-based Brain Resource Company (ASX:BRC) and OptumHealth in the US. This will allow for the provision of web-based cognitive assessments as part of a clinician’s decision support systems.

These are some initiatives covered in a webinar Top Ten Cognitive Fitness Events of 2008 presented in December for SharpBrains' clients. Alvaro Fernandez described the state of play and main drivers behind the growth of the burgeoning brain fitness market - which I will try and summarize here.

The key drivers seem to be Continue Reading »

We have just announced an upcoming webinar to provide a market update:  Top 10 Cognitive Fitness Events of 2008 - A Market Update.

When: Thursday December 11th, from 12:00 to 1:00 pm Pacific Time. The same webinar will be repeated on Thursday December 18th, from 9:00 to 10:00 pm Pacific Time.

The Top 10 Cognitive Fitness Events that will be discussed include:

1) February: Dakim secures a $10.6m investment from Galen Partners. Jack LaLanne becomes spokesperson.
2) April: The Government of Ontario, Canada, invests $10m in Baycrest to develop and commercialize cognitive fitness technologies.
3) April: University of Michigan researchers reveal in the Proceedings of the National Academy of Sciences how computerized working memory training can generalize and improve fluid intelligence in healthy adults.
4) May: Humana unveils Games for Health initiatives, not renewing its agreement with Posit Science.
5) June: The US Army launches a new policy requiring cognitive screenings of all soldiers before deployment (in order to Continue Reading »

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.

Over the next weeks we are going to be sharing the Executive Summary of our market report The State of the Brain Fitness Software Market 2008 with members and clients of several partner organizations (the British Columbia Seniors Living Association, where I will be speaking this Thursday, Neurotech Reports, where I will speak on October 24th, and the Health 2.0 conference, where we are sponsoring a panel on gaming for health), so it is only fair that we first share it with our own readers.

Executive Summary

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, increasing prevalence of Alzheimer’s rates, and soaring health care costs in the US that place more emphasis than ever on prevention and lifestyle changes.

US brain fitness market: significant and growing

We estimate the size of the US brain fitness market was $225m in 2007 – more than double what it was in 2005. Whereas K12 school systems were the largest buyers in 2005, consumers were responsible for most of the growth from 2005 to 2007. We estimate that the consumer segment grew from a few million in 2005 to $80m in 2007, and foresee significant market growth driven not only by consumers but also by healthcare and insurance providers.

Market dynamics

As we speak to diverse audiences about this emerging field around the country we are frequently asked the following questions:

- Why are we talking about the brain fitness field at all?

Over the past decade, teams backed by neuroscientists around the world Continue Reading »

I have fallen behind on answering a few excellent recent comments -on cognitive training overall, Posit Science and Alzheimer's Australia, gerontology and the brain, the value of videogames-, so let me address them here:

1) Nicks says (Brain Fitness Programs For Seniors Housing, Healthcare and Insurance Providers: Evaluation Checklist)

"This report is interesting and it addresses many very important questions that cognitive neuropsychologists, such as myself have. I feel that many of the products on the market now make claims which are generally unsubstantiated.

I find it concerning that many of these programmes have been marketed to target older adults in particular without making any specific statement on whether the activities are beneficial and have been supported with empirical research.

i have recently conducted a cognitive intervention study which used a large array of outcome measures which focus on Continue Reading »

During the research phase before the publication of the special report Brain Fitness Centers in Seniors Housing - A Field in the Making, published by the American Seniors Housing Association (ASHA), we realized that there were equal amounts of interest and confusion among executives and professionals thinking about adding computer-based cognitive exercise products to their mix of health & wellness activities, so we included the Evaluation Checklist that follows.

The real-life experiences at leading organizations such as Senior Star Living, Belmont Village Senior Living, Erickson Retirement Communities and others were instrumental in the development of the Checklist. We hope it is useful.

Brain Fitness Programs For Seniors Housing, Healthcare and Insurance Providers: Evaluation Checklist

Over the next several years, it is likely that many seniors housing operators will begin to carefully evaluate a growing number of options to include “brain fitness centers” in their communities.

Some options will require purchasing a device, such as Nintendo products, or the Dakim touch-screen system. Others will require installing software in PCs in existing or new computer labs, such as Posit Science, Cogmed or CogniFit’s programs. Others will be fully available online, such as those offered by Lumos Labs, Happy Neuron and My Vigorous Mind. And still others may be technology-free, promising engaging combinations of interactive, group-based, activities with pen-and-paper exercises.

Creating a solid business case will help communities navigate through this growing array of options. We suggest communities consider this SharpBrains Checklist for Brain Fitness Centers:

1. Early Users: Who among our residents is ready and willing to do the program? How are they reacting to the pilot testing of the program?

2. Cognitive benefits: What are the specific benefits claimed for using this program? Under what scenario of use (how many hours/week, how many weeks)? What specific cognitive skill(s) does the program train? How will we measure progress? Continue Reading »

The American Seniors Housing Association (ASHA) has just released an Special Issue Brief, titled Brain Fitness Centers in Senior Housing - A Field in the Making. We prepared it for their members, and it is now available for purchase (You can click here for purchase and download. $25.)

It was a pleasure to learn more about emerging trends there and discuss best practices and implications with some of the pioneers at Senior Star Living, Belmont Village, Erickson, and more, who have been leading innovative initiatives and conducting their own pilot studies. I hope you enjoy the report.

This 15-page Special Report describes Continue Reading »

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.

Major Implications from Brain Research

Should Social-Emotional Learning Be Part of Academic Curriculum?: It is clear by now that our brains are more than cognitive machines. For example, emotions can either enhance or inhibit our ability to learn. Daniel Goleman explores the implications of "new studies that reveal how teaching kids to be emotionally and socially competent boost their academic achievement." Brought to you in partnership with Greater Good Magazine.

Retain older workers beyond retirement: BusinessWeek covers a best practice in a topic of growing importance: how large companies, such as American Express, can retain older workers in productive ways beyond a set arbitrary retirement age. As Dr. Art Kramer told us recently, "as a society, it is a massive waste of talent not to ensure older adults remain active and productive."

BrainTech and Sustainable Brains: Building on a recent quote by John Doerr about clean technology trends, we wonder... "If Energy is the mother of all markets...who would be the father of all markets?" The Human Brain, perhaps?

Health and Research

What You Can do to Improve Memory (and Why It Deteriorates in Old Age): Is there anything we can do besides "exercise like crazy, eat healthy foods that you don't like all that much, pop your statin pills, and take up yoga?" Yes: focus, focus, focus, suggests Dr. Bill Klemm.

News and Events

Cognitive Health News August 2008: This is a roundup of recent brain health news and our commentary, including the growing adoption of Dakim and Nintendo products, the cognitive impact of videogames, and the cognitive dimension of the obesity crisis.

Exercise your brain at these events: Alvaro will present the main findings from our market research at multiple conferences in the US, Canada and Dubai during the rest of  the year.

Where does the "Feeling of Knowing" comes from?: Dr. Ginger Campbell shares some insights from her recent interview with neurologist Robert Burton (author of On Being Certain: Believing You Are Right Even When You're Not)."While it might be true that one can learn to become more aware of the emotional signals coming from one’s body, Dr. Burton argues that “gut feelings” or intuition should not be assumed to be true without testing."

Resources for Brain Health Across the Lifespan: Laurie Bartels shares a list of interviews, video, articles, and books that go hand-in-hand with the brain-related topics we cover.

Brain teaser

Can you use mental self rotation to read a map?: please check out this teaser by Dr. Pascale Michelon, one of our favorites so far.

We hope you have enjoyed this newsletter. We encourage you to stay tuned for our September editions, since great content is coming. We will soon publish an interview with Lee Woodruff, co-author of the book In An Instant: A Family's Journey of Love and Healing, and discuss the spectacular cognitive recovery of her husband, ABC reporter Bob Woodruff, who experienced a traumatic brain injury in Iraq in 2006. We will also interview Dr. Mike Posner, eminent cognitive neuroscientist, to explore recent findings on attention and attention training and their implications.