SharpBrains

The Cognitive Health and Fitness Market On The Move

Alvaro Fernandez — Fri, 10 Oct 2008 15:36:37 +0000

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 (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. The special report will be available to organizations in our Premium Research Sponsors program.

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The Brain Fitness/ Training Market: An Executive Summary

Alvaro Fernandez — Wed, 08 Oct 2008 05:17:34 +0000

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 from the U.S. to Japan, Israel, and Sweden have been developing brain fitness software products with commercial applications. Since 2005, the market for brain fitness software products has grown significantly. One of the companies that has perhaps done the most to spark the commercial adoption of brain fitness products is Nintendo with its Brain Age and Brain Training games. Nintendo has shipped millions of copies globally since its launch in 2005. Less visible is the growing number of developers that are bringing to market brain fitness products with more solid clinical validation.

- Who is buying these brain fitness software products?

We see four key customer segments purchasing commercialized brain fitness software products in the US: consumers (mostly adults over 50 looking for ways to protect their memory and prevent or delay dementia, as well as some younger adults); healthcare and insurance providers (ranging from hospitals to nursing homes and retirement communities seeking the latest treatments for their patients and members); K12 administrators (interested in applications that can help students with dyslexia and related learning difficulties); and Fortune 1000 companies, the military and sports teams (looking for advancements in productivity).

- Is there science behind the claims made by brain fitness software products? Do these products work?

It depends how “working” is defined. If “working” is defined as quantifiable short-term improvements after a number of weeks of systematic brain training to improve specific cognitive skills, then yes, a number of the brain fitness software programs do seem to work. If, on the other hand, “working” means measurable long-term benefits, such as better overall brain health as we age, or lower incidence of Alzheimer’s symptoms, then the answer is that circumstantial evidence suggests they may work. But, it is still too early to tell.

- What are the public policy implications?

Given the enormous benefits of widespread initiatives to help delay the onset of dementia in the aging US population, both in terms of quality of life for citizens and healthcare cost savings, the US government and healthcare community are watching these trends carefully. For example, the Center for Disease Control recently partnered with the Alzheimer’s Association to develop a comprehensive Cognitive Health roadmap to better guide research efforts and improve public education on the lifestyle habits that every proud owner of a brain could benefit from following.

Open questions

Since this is a new, rapidly growing field, we have many open questions about the industry, which will only be clarified with time:

- Will consumer behavior change to adopt preventive brain exercises that take more time and effort than swallowing a pill? If so, what is the profile of consumers who are most likely to change their lifestyle? Even if brain fitness has no side effects, will users show the commitment required to see results?

- How can consumers and executives assess which cognitive priorities require most attention and track progress due to brain training? Where can they turn for quality information and education to navigate through the emerging research and the overwhelming number of new programs – to separate the hype from the reality? In the absence of clear biomarkers, will cognitive assessments become commonplace as objective baselines?

- What business model and offering will succeed? Software product sales? Online subscriptions? Fun games with unproven brain benefits? Programs that improve the mental skills involved in specific activities, such as driving? Applications that help slow down the progression from Mild Cognitive Impairment to full-blown Alzheimer’s symptoms? Is this content-driven “edutainment”?

- Will therapeutic applications be regulated by the FDA?

- Will large-scale peer-reviewed research support a wider set of consumer applications?

Top three trends to watch: 2007-2015

What are some of the trends that anyone trying to understand this growing market should follow?

Here are some of our predictions that are expanded in Chapter 7:

- Brain fitness goes mainstream. An increased emphasis on brain fitness and maintenance will spread to retirement communities, gyms and health clubs. Will health clubs one day offer brain fitness programs, and perhaps “brain coaches” alongside rowing machines and step-masters? We think so.

- Leveraging better tools. Better and more widely available assessments of cognitive function will enable all of us to establish an objective baseline of how our minds are evolving, identify priorities for “workouts” and lifestyle interventions, and help us measure progress. Just as we find a variety of machines in health clubs today, in the future we can expect different programs tailored to train specific cognitive skills. New and improved computer-based brain fitness tools will come to market, and low tech options will also provide great value. There is more and more research on how meditation and cognitive therapy, to mention two examples, can be effective in literally rewiring parts of the brain.

- A growing ecosystem around those tools, including widespread incentives to use brain fitness products. For example, insurance companies will introduce incentives for members who want to follow brain fitness programs and companies will offer brain fitness training programs to attract and retain mature workers who want access to the best and the latest innovations to keep their minds sharp.

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The State of the Brain Fitness Software Market 2008

-- Published March 11th, 2008 (click Here to learn more and acquire your copy)

This 87-page report is the first to define the brain fitness software market, summarize the science behind brain plasticity and cognitive training, and analyze the size and trends of its four customer segments: consumers, healthcare & insurance providers, K12 school systems, and fortune 1000 companies, military, and sports teams.

The report tracks developments at over 20 public and private companies offering tools to assess and train brain functions and provides important industry data, insights and analysis to help investors, executives, entrepreneurs, and policy makers navigate the opportunities and risks of this rapidly growing market. The report discusses the implications of cognitive science on healthy aging and a number of disorders such as attention deficits, dyslexia, stroke and traumatic brain injury, schizophrenia, autism, mild cognitive impairment, and Alzheimer’s disease. The report also provides information and frameworks to help institutional buyers make informed purchase decisions about brain fitness programs.

Report Highlights
Table of Contents
List of Figures
Companies Included
End Notes
Endorsements

The companies included in the report are:

Advanced Brain Technologies

Applied Cognitive Engineering

Brain Resource Company

BrainTrain

CNS Vital Signs

Cogmed

CogniFit

Cognitive Drug Research

Cogstate

Dakim

Gemstone

Houghton Mifflin

Lexia Learning

Lumos Labs

MyBrainTrainer

Nintendo

NovaVision

Posit Science

Scientific Brain Training

Scientific Learning

TeachTown

You can click Here to learn more and acquire your copy.

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Teaching is the art of changing the brain

Laurie Bartels — Tue, 07 Oct 2008 03:49:26 +0000

James Zull is a professor of Biology. He is also Director Emeritus of the University Center for Innovation in Teaching and Education at Case Western Reserve University in Ohio. These roles most assuredly coalesced in his 2002 book, The Art of Changing the Brain: Enriching the Practice of Teaching by Exploring the Biology of Learning.

This is a book for both teachers and parents (because parents are also teachers!) Written with the earnestness of first-person experience and reflection, and a lifetime of expertise in biology, Zull makes a well-rounded case for his ideas. He offers those ideas for your perusal, providing much supporting evidence, but he doesn’t try to ram them into your psyche. Rather, he practices what he preaches by engaging you with stories, informing you with fact, and encouraging your thinking by the way he posits his ideas.

I have read a number of books that translate current brain research into practice while providing practical suggestions for teachers to implement. This is the first book I have read that provides a biological, and clearly rational, overview of learning and the brain. Zull provokes you into thinking about his ideas, about your own teaching practice, and ultimately, what it means to learn.

Zull doesn’t lecture here; rather, he discusses his ideas so you can follow their progression. The impetus for his ideas stem from David Kolb’s 1984 book, Experiential Learning. Kolb's model contains four portions:

- engaging in a concrete experience
- following it with reflective observation
- developing an abstract conceptualization based upon the reflection
- actively experimenting based upon the abstract

Kolb's model, like Zull's, is a cycle, and therefore it is possible to jump in at any point in the process. Zull takes Kolb's model and provides the biology.

Zull's conclusion is that:

Teaching is the art of changing the brain.

Zull spends the bulk of the 250 pages exploring the biology and practice behind “creating conditions that lead to change in a learner’s brain.” He provides a list of ten strategies (page 129), based upon the biology of the brain, which can help in making those changes. These strategies apply to parents who are trying to parent, as well as to our own learning process, for ideally we are all life-long learners.

1. Watch for inherent networks (natural talents) and encourage their practice.
2. Repeat, repeat, repeat!
3. Arrange for “firing together.” Associated things should happen together.
4. Focus on sensory input that is “errorless.”
5. Don’t stress mistakes. Don’t reinforce neuronal networks that aren’t useful.
6. Try to understand existing networks and build on them. Nothing is new.
7. Misconnected networks are most often just incomplete. Try to add to them.
8. Be careful about resurrecting old networks; error dies hard.
9. Construct metaphors and insist that your students build their own metaphors.
10. Use analogies and similes, too.

From my own teaching experience, I know these strategies are well worth utilizing. However, implementing them may not always be so easy due to constraints of typical class schedules (insufficient time) or class sizes (too many students), or ingrained habits (for example, viewing mistakes through a negative lens). However, I believe these strategies can aid students in learning about how they learn and engaging in metacognition. In the final analysis, if students understand how they learn, they can take responsibility for their own learning, thus changing their brains through their own efforts.

This is a book that can be read comfortably, and you will progress through the four stages of the learning cycle as you take in the words and ideas (gathering data), reflect on how they can impact yours and your student’s teaching and learning process (reflection), consider how you might alter something about what you do (create an hypotheses), and try out that idea (active testing). Of course, trying out your idea will lead to a new experience, which you will take in and reflect on, perhaps causing you to make a change … And the cycle continues.

For more about James Zull:

- James Zull in his own words – New Horizons for Learning article: What is “The Art of Changing the Brain?”, May 2003
- SharpBrains interview with James Zull: An ape can do this. Can we not?, October 2006

For more about David Kolb:

- Kolb’s faculty page at Case Western

Laurie Bartels writes the Neurons Firing blog to create for herself the "the graduate course I’d love to take if it existed as a program". She is the K-8 Computer Coordinator and Technology Training Coordinator at Rye Country Day School in Rye, New York. She is also the organizer of Digital Wave annual summer professional development, and a frequent attendee of Learning & The Brain conferences.

abstract conceptualization

Case Western Reserve University

David Kolb

Education

experience

Experiential Learning

Brainy Haikus for brain training

Alvaro Fernandez — Sat, 04 Oct 2008 21:57:26 +0000

Thank you to everyone who has written so many fun haikus over the summer (following the post Top 25 Brain and Mind Haikus. Yours?). These are the 10 I have enjoyed the most:

(Also, Can you write a haiku describing anything crossing your mind now? Remember the simple rules: write 3 lines, which don't need to rhyme, containing 5,7, and 5 syllables. You can leave your haiku as a comment below for extra points...)

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Top 10 Brainy Haikus - enjoy!

- Amit:

Love, college, career.
A new world of transitions.
Will I survive? Yes.

- Kathy:

My release technique,
Forgive, forget, love all,
Meditate on that!

- Alan:

Through the microscope,
slice of brain stains pink and blue,
the wonder of thought.

- Justin:

Justin the genieus
Must spell check the word genius
to post this Haiku

- Tim:

writing quick haiku
seems so very difficult
can i pull it off

- Mercury:

Seeking brain fitness.
Am I haiku-focusing,
or just distracted?

- Kalsang:

My fingers tapping,
I chant out five, seven, five.
Is this new music?

- LW:

body aching now,
yoga isn't so easy,
good for you they say?

- Emma:

You think yoga's bad?
Try Aikido my good friend.
Knackers your shoulders.

- CJ:

Rain Stormy Boomer
Sewer Backing To My Door
Is Insurance Paid?

-----

In case you want to read more, below you have many more haikus contributed during the year:

- Techne, the philosopher, wonders:

Solve the big questions:
How do I know when I know?
Who knows the knower?

- Steve, the environmentalist, requests:

Neuroplastic good.
Plastic, though lasts forever.
Always recycle!

- GTB, the skeptic, says

Haiku's are easy
But sometimes they don't make sense
Refrigerator

- Millie, spiritual, suggests:

Playing music feeds
my soul while reading music
nurtures my old brain.

- Mark, the optimist, reflects:

I thought I did well
Then I reviewed my answers
I am retard

- jolovli, the boomer, tries again:

improving function
smoked too much weed in college
it's never too late

- Lloyd, the stressed-out, volunteers:

I thought so damn Hard.
My brain built lots of pressure.
I farted out loud.

- Terry says:

New information
Synthesizing my knowledge
A forward movement

- Frank says:

Painfully easy
Significantly harder
Mental stimulus

- Chuck says:

This was fun, and no,
I don't intend to haiku.
Thanks for posting it

- Sarah says:

finding your teasers
added fun to my morning,
helped wake my brain up

- Lorraine says:

teaching math is fun
when you find great resources
sharp brains is the place

- Psalm says

As my mind expands,
it grasps new ideas...oh look
there's something shiny!!

- anon writes

the noon hour portends
a burrito with salsa
brightening my tongue

- Mike says

See I think I see
Here now, not so - really real?
Wounded, mind leaves me

- Lisa

new thoughts activate
frontal lobe work hard, harder
no senility

- Karen

Brain training others
Like watching the Earth open
One thought at a time

- Bruce

My brain stem works hard,
But the tests are much harder,
Need more grey matter

- Alvaro

Can perform better,
Learning, training, and practice
Body, brain and mind

- terri

strokes take speech away
someone should find a quick fix
everyone needs to speak

- qt

Aha, a challenge
for the brain to endeavour
sooner than later

- Stacy

Brain hurts so badly
Working night shift: not so fun
Need to get some sleep

- campercourt

It is morning now
The sun rose very early
Goodmorning to you

- kestrel

first white is purple

or it was red I think

now haiku, what next?

- Stacey

I thought is was fun.
Then it got a lot harder.
Wow i suck at this.

- anon

oh boy I wonder
will my teeny little ears
still hear loud thunder

of course it is true
the aforementioned thunder
came out of the blue

from the blue you say
I think perhaps you are wrong
but it's still okay

- Steve:

Accountant's cull.
Farewell to long-time work-mates.
Too real for haiku!

- Gail:

Old women gather
Seeking change is the power/
Thanks to grandmothers

- Robert:

My brain is just fried.
I used it too much this week.
I need some Spongebob.

- Shelley:

An infinite mind
Expansive, conscious, knowing
Alert and aware

- Jet:

Haiku to you too
Now is forever, now is
Now is now to you

- Jack:

Cool death match: face off
Wernicke's area and
Broca's Region.

Yours, please?

(Remember the simple rules: write 3 lines, which don't need to rhyme, containing 5, 7, and 5 syllables. You can leave your haiku as a comment below for extra points...).

aikido, brain, brain exercise, Brain exercises, Brain games, Brain teasers, distracted, genius, haiku, haikus, meditation, mind, mind teasers, online brain training, poetry, thought, wonder, write haiku, write haikus, yoga

Your comments on cognitive training, Posit Science, Alzheimer's Australia, gerontology, games

Alvaro Fernandez — Fri, 03 Oct 2008 22:46:04 +0000

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 a number of different cognitive functions. The measures investigated both objective and subjective behaviours. The results confirmed that attempting cryptic crosswords for one hour per day increased subjective awareness of older adults own memory. However there was no evidence of a tangible increase in episodic, verbal memory with both recall and recognition. There was also no evidence of increases in metacognition. It is important to note that the intervention period was only six weeks. However this demonstrates that there is a need for products to be clear on what functions the activity will promote and whether it is affected by any confounding variables. For example we found that the beneficial effects were more apparent in individuals with a lower number of years in education. This is important because it is likely that people who purchase such intervention products will tend to have a higher socio-economic status and significantly more developed educational background.

Overall, there is a need in psychology for an overhaul of how we measure cognitive interventions. We also need to ensure that we use the correct methodology (i.e. within subjects designs) and that we used the sorrect sample population. Unfortunatly many of the previous research which the cognitive reserve hypothesis and use-it-or-lose-it theory are based on have not done so."

My comment: Nick, I mostly agree. I will send you an email to learn more about your research. I find it concerning that people buy things without understanding what they are buying. But I also find concerning the number of people who have already done one million crossword puzzles and think that the single most important thing they can do next for their cognitive health and memory is...one more crossword puzzle. I find it even more concerning that, when I recently asked a group of around 200 assisted living professionals how many of them did offer menntally stimulating activities other than playing bingo and social receptions to their residents, less than a third of them raised their hands.

We only learn by trying things. Clinical trials are a superb way of learning. Initiatives like Alzheimer Australia's (promoting a particular cognitive training program) can also be very useful, if they use independent measures of cognition and quality of life. We also see many seniors housing facilities conducting pilot studies that will never be published as scientific research but help them find what tools may be helpful in their particular environments.

I could not agree more that a critical part of the puzzle, now largely missing, is the availability of inexpensive and high-quality cognitive assessments. And that will facilitate a more informed use of the growing array of options. Fortunately, we see very interesting signs that this may change sooner than many people think.

2) David says (Posit Science Program Classic and InSight: Alzheimer's Australia):

"Alzheimer's Australia WA enlisted Curtin University Centre for Research on Ageing to conduct a literature and provider review into neuroplasticity and memory enhancement in older people. The result of a two year process of investigation and review by our organisation identified Posit Science as the only provider who had a significant body of clinical trial evidence to support the efficacy of their products.

Alzheimer's Australia supports the Posit Science programs as one way of staying mentally active (a dementia risk reduction strategy that we clearly support) that also provides proven individual benefit to memory and cognitive function in people experiencing age-related memory loss.

The organisation does not promote these programs to people with dementia, nor on the basis that using them will delay or prevent dementia. Very preliminary pilot study evidence indicates they may have some therapeutic benefit for people with early dementia or MCI, and Alzheimer's Australia WA is currently engaged with Curtin and Edith Cowan Universities here in Australia to undertake pilot studies to explore this further.

We are also undertaking an 18-month government-funded demonstration project to trial the use of these programs in residential communities, senior's fitness groups and the workplace, and evaluation of both individual benefit and the sustainability of each group model will be undertaken as part of this process."

My comment: David, great to read about the research initiatives you mention at the end of your comment. That is exactly what is needed-but my advice would be to compare more than one computer-based cognitive training method. It makes little sense to compare a computer-based training program with watching TV as the control group, for example. You may want to compare Posit science's 2 programs (which focus on clearly separate and narrow sensory-focused cognitive domains) with wider interventions (such as MindFit and Dakim mPower), and perhaps even with Nintendo Brain Age. From an delay of Alzheimer's symptoms, and even cognitive decline, point of view, continued and frequent use in the real world are likely to be very important based on the available evidence, and it is far from clear than the Posit Science programs' strengths lie there.

People in Australia may find it a bit confusing that something actively endorsed and sold by an Alzheimer's Association brings the disclaimer "The organisation does not promote these programs to people with dementia, nor on the basis that using them will delay or prevent dementia". I'd assume that is what people think they are buying from you. Which is why I said in my post that, first, I think it is a great initiative to offer a mentally stimulating activity but, second, given the limited amount of long-term research, it would be a superb opportunity to add an independent cognitive assessment component, to measure the potential impact of one (or several) interventions and to start explaining to people how the brain works, what cognitive functions are, and how different lifestyle factors, such as physical exercise, contribute to cognitive health.

You are endorsing two products by Posit Science, one of which (Classic) has one published study behind, the other one (InSight) with, objectively, no direct clinical validation behind (InSight is a fundamentally new product, launched in March 2008 with 6 exercises: five are brand new, and one had been tested before on a variety of situations with very impressive results. There has been no correlation study done to date, to our knowledge, to validate whether X hours devoted to InSight produces same, better, or worse results as X hours devoted to that one tested exercise). Posit Science Classic program (for auditory processing training) has been used in many more studies (including IMPACT), but those results remain to be published.
Facing a similar situation, Susan Greenfield, Director of the Royal Institution in the UK and Alzheimer's expert, chose to endorse MindFit last year. A number of agencies and communities in the US are choosing Dakim's system. I also hope you are aware of a number of working memory training programs that can be of much value to older adults.

A couple of days ago I published an interview with an executive from Allstate: they are using Posit Science Insight program as a research study first, to measure its effectiveness on improving driving safety of older adults, which makes for a beautiful initiative.

In short: at this point it is a judgment call, informed but not fully determined by the existing evidence, what program may benefit people most, Which is why 1) the most independent cognitive assessments we use to establish baselines and measure progress, the better, 2) informing consumers and professionals about the value and limitations of different approaches may be, in my view, what is really needed. Especially if it comes from an Alzheimer association, and with the kind of disclaimer you offered in your comment, 3) research initiatives like the one you outline are really needed, and I commend your association for taking the lead there.

The easy way out would have been "because research is not perfect, we opt to do nothing or little". Given what we know, it is good to try-and measure.

3) Dr. Thibeault writes (Brain Training and Cognitive Health: September News)

- "#3 above as it relates to gerontology. Come visit MENTAL GYMNASTIC classes in Oxnard, Camarillo, and Thousand Oaks, Calfornia. With more than 220 "students' there is widespread interest."

My comment: I know there is a lot of interest in mental fitness related classes among lifelong learners, in fact I do teach such classes at several San Francisco Bay Area universities...but that was not really the point. The problem we identified was that many gerontology masters programs (this is, the training ground for the gerontologists of tomorrow) didn't seem to offer any brain/ cognitive-related classes, in a n obvious disconnect with one of the main areas of concern for people over 50. Btw, I hope to visit one your classes soon!

4) Charlie asks (Playing the Blame Game: Video Games Pros and Cons)

"Could you direct me to a link which has the Olson/Kutner study? I'm doing a paper for grad school and would love to include a reference to this work. Thanks for a very helpful and enlightening article. ck "

My comment: Olson & Kutner maintain a good website including research references. See grand theft childhood.

5) Jean writes (same post)

"I am still firmly on the fence and more than a little distressed about the time taken away from reading.
However, I must admit that when we played cowboys and indians or police and thief, the gun (toys, supplied by some adult) played a large part. Our movies were westerns, which by todays standards would have been heavily rated for violence and cultural inappropriateness. Yet most of us turned out okay. So I suppose given the right parenting environment, these children will be okay too."

My comment: You raise a good point... I appreciate the fact that the first thing that the researchers mentioned in the article did was to immerse themselves in several games, in order to analyze reality, not preconceived notions. I also agree that "most of us turned out okay"!

Enjoy the weekend!

Alzheimers, Alzheimers Australia, Assisted Living, brain, cognitive, cognitive assessments, Cognitive Training, crossword puzzle, Dakim, Dakim mPower, Games for Health, gerontology and brain, heathcare, insurance, MCI, memory enhancement, mental gymnastic, mild cognitive impairment, MindFit, neuroplasticity, neuropsychologists, Posit Science, Posit Science Insight, Posit Science Program Classic, Prevent Alzheimers, Serious Games, Susan Greenfield, videogames

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

Alvaro Fernandez — Wed, 01 Oct 2008 16:29:15 +0000

Insurance company Allstate and brain fitness software developer Posit Science just announced (see press release Protecting Pennsylvania Drivers, One Brain at a Time) a very intelligent initiative:

Video exercises aid driving skills (Chicago Tribune)

-"Allstate, which called the Posit program "potentially the next big breakthrough in automobile safety," said it expects its software exercises to reduce risky driving maneuvers by up to 40 percent and improve stopping distance by an average of 22 feet when traveling at 55 miles per hour."

-"We'll look to see whether over the next six to nine months there will be a reduction in" the number of accidents between the group participating in the video exercises and those sitting out, said Tom Warden, assistant vice president of Allstate's research and planning center.

I am fortunate to interview Tom Warden, Assistant Vice President and Leader of Allstate’s Research and Planning Center, based in Menlo Park, California.

Alvaro Fernandez: Tom, thank you for your time. Can you please explain the context behind this new initiative that you just announced?

Tom Warden: Our research center is constantly looking for new ideas to improve the driving behavior of drivers of all ages. Recently we have paid extra emphasis on ways to improve the safety of older drivers.

Let me provide some background here. Allstate, as a company, has always been one of the pioneers in helping to introduce new safety measures. For example, we were among the pioneers in the 60s to advocate for mandatory use of seating belts, given research studies on the benefits for drivers and passengers alike. More recently, we helped lobby for wider adoption of airbags, an effective but expensive way of protection that only became mainstream when manufacturers were required to include them.

Let's talk now about your agreement with Posit Science. What will happen over the next months?

The first thing we are doing is to conduct a research study to analyze the real-life impact of Posit Science InSight, a computer-based cognitive training program, on accident rates. We know that as drivers get older, especially in their 70s and beyond, a number of cognitive problems can get in the way of safe driving. We want to see if there is a way to reduce this effect.

We are offering the InSight program for free to over 100,000 auto policy-holders in Pennsylvania aged 50-75, and to some potential clients. We recommend participants to devote at least 10 hours to the training exercises, but of course the more they can devote the better. We will compare the results with a control group.

How will you measure success, and by when will you know if your expectations are met?

Given that we have already started recruiting participants and training may start as soon as next week, we may have some interesting results by the end of March 2009 or perhaps during the summer. In order to have statistically meaningful numbers, we will have to see how many people enroll in the study and the size of the observed impact.
We will analyze the program compliance rates since this type of intervention needs to be engaging enough for people to devote a number of hours to at home. But, at the end of the day, what we want to see is whether using the program will translate into lower accident rates and better safety.

Assuming those goals are met, what would be the next steps?

In that case we will have to figure out ways to roll out the program nationwide, perhaps even offering discounts to policy-holders who commit to using the program. We would also engage in public advocacy, share the results, partner with the DMV and other agencies.

But, we have not really contemplated this yet, we need to see the results first.

The InSight program is a pretty specialized program. It does not train all main cognitive skills involved in driving, such as say working memory or divided attention, but focuses mostly on visual processing. Are you conducting some type of independent cognitive assessment to identify who may benefit from that program vs. other options?

No, we are not. We became interested in talking to Posit Science after they acquired Visual Awareness, the company that had developed the Useful Field of View (UFOV) technology. We felt Karlene Ball and her team brought the kind of research that stood up to our standards and held the most promise to meet our needs.

What was the main business case to embark on a pioneering initiative like this?

As I said earlier, Allstate has a long tradition of introducing safety-related measures, and this initiative reflects that commitment. In this case, our objective goes even beyond driver safety: we want to help our clients. We want to contribute to their overall quality of life and protection. We believe that programs like InSight can contribute to better daily functioning and quality of life. We want our clients to have positive feelings towards Allstate and to know we care about them.

A potential concern we have heard in similar cases, where an insurance company offered a computer-based assessment or training program, is Privacy. How can users of InSight who are also Allstate policy holders know that whatever information the program gathers cannot be used against them, for example to deny coverage or increase premiums?

That's a great question. We are aware of that potential concern, and we are putting processes in place so that Allstate doesn't get access to any cognitive information on a particular individual. The Posit Science program is gathering the information, and Posit Science will only share data with us at an aggregated level, for overall research purposes. Allstate will be completely blind as to who uses the program.

A couple of final questions on related innovation areas. One: given that medications can contribute to the cognitive impairments in older drivers that you are trying to address, are there initiatives underway to better measure and explain those to seniors -and their doctors? Second: Allstate has been aggressively promoting a Parent-Teen Driving Contract to contribute to the safety of teenage drivers. Another cognitive training program, called DriveFit, is being used by hundreds of driving schools in Canada and Europe. Are you considering a similar research study to reduce accident rates among teenagers?

On the first question, that is indeed a major problem. Medication can impair cognitive functioning, and of course as we get older we usually get more of them, which can contribute to driving problems. Unfortunately, I am not aware of any major initiative to deal with that problem from a comprehensive perspective.

On the second one, it is clear that teenagers face specific challenges when starting to drive, before they get the needed experience and abilities to process information and to manage risks. We are always looking for ways to increase the safety in our roads, so that type of project would certainly fall within the scope of our interests, but for now we chose to focus on helping older drivers drive more safely and improve their quality of life. Given demographic realities, we really need to explore options there as soon as we can.

Any final remarks for our readers to understand the significance of your agreement?

We believe this program has the potential to lower accident rates and improve the quality of life of millions of adults. We are excited to be able to offer it to our policy-holders, to show our commitment to innovation and to their overall protection and well-being. We are hopeful that, if the results are as positive as we believe they can be, interventions like this can become a major new safety benefit, and that it may positively reflect on AllState's brand and public perception.

Tom, thank you very much for your time. We will be very interested in learning more about the ongoing progress of this initiative.

Thank you.

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Note: the interview above has been edited for clarity and readability purposes. It is not a verbatim transcript.

If you want to learn more about the topic, you will enjoy these related articles:

- Improving Driving Skills and Brain Functioning- Interview with ACTIVE's Jerri Edwards
- DriveFit (by CogniFit); Brain Fitness Program for Driving

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Newsletter: Navigating Games for Health and Education

Alvaro Fernandez — Tue, 30 Sep 2008 23:56:29 +0000

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.

Quick, Are videogames good or bad?

That's an impossible question. Good or bad for what? What specific games are we talking about? More importantly, what are they substituting for, given time is a limited resource? Contributor Jeremy Adam Smith, managing director of Greater Good magazine, offers an in-depth review on the trade-offs videogames present in: Playing the Blame Game.

News Round-Up

Math Innovation in UK Schools: a recent (and unpublished) study seems to support the potential role for "Serious Games" in education. Learning and Teaching Scotland reports significant improvements in pupils' concentration and behavior, on top of math skills, after using Nintendo Brain Training game.

Alzheimer's Australia endorses Posit Science programs: this announcement brings to surface a genuine public health dilemma - do you, as an association, promote programs before they have been shown to have long-term effects on Alzheimer's progression and prevalence, or do you wait until you have "perfect" research, and then perhaps lose 10-20-30 years or useful contribution to thousands/ millions of brain's Cognitive Reserves? In our judgment, it may well be worth offering options today, as long as they are accompanied by independent measurement of the cognitive benefits.

More September News: September has brought a wealth of additional worldwide media coverage on cognitive health and brain fitness topics, including the role of schools in nurturing student's executive functions, the importance of baseline neuropsychological testing in sports, the need for gerontology as a discipline to incorporate brain research, how walking can enhance brain function, and the value of brain fitness programs for long-term care operators.

Resources for Brain Fitness Navigation

Wellness Coaching for Brain Health and Fitness: will Wellness Coaches expand their role and become "Brain coaches"? We have partnered with Sutter Health Partners, the pioneering coaching group of a major health system, to train their wellness coaches on the implications of emerging brain research for their work: focus on the 4 pillars of brain health -balanced nutrition, physical exercise, stress management and mental exercise.

Evaluation Checklist for Organizations: many healthcare and education organizations are already making purchase decisions which involve evaluating different programs that make "brain training" or "cognitive health" claims. Here we present our 10-Question SharpBrains Checklist to help organizations make informed decisions.

Evaluation Checklist for Consumers: if you are an individual interested in programs for yourself and/ or a loved one, you can use this checklist. The starting point is to recognize that no program is a "magic pill" or "general solution", but a tool to be used in the appropriate context.

Learning to Lead, and To Think

Roundtable on Human Resources and Leadership: several bloggers discuss latest news around leadership, social intelligence, applications of brain research, and more.

Helping Young and Old Fish Learn How To Think: David Foster Wallace gave a masterful commencement speech on Life and Work to the 2005 graduating class at Kenyon College. Worth reading, with full attention.

Brain Teasers

Seven Brain teasers for Job Interviews: A recent CNN article explains why a growing number of technnology and consulting companies use brain teasers and logic puzzles of a type called “guesstimations” during job interviews. What are they looking for? Good executive functions. Here you have a few typical questions.

Enjoy!

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Wellness Coaching for Brain Health and Fitness

Alvaro Fernandez — Tue, 30 Sep 2008 18:18:33 +0000

We just received this quote of how a major health system is using our Brain Fitness Market Report:

"At Sutter Health Partners we recognize the importance of brain health and how much the health of the brain and the body are interdependent. The market report helped us further target our coaching efforts to integrate brain fitness and upgrade our entire coaching platform. It is easy to read and gives you the industry perspective in a thorough yet concise manner. I highly recommend it!"

-- Margaret Sabin, CEO of Sutter Health Partners and VP, New Product Development, at Sutter Health.

You may wonder, "what is the link between wellness coaching and brain fitness"?

In practice, good health and wellness coaches provide excellent brain health advice, given that the areas they focus on (nutrition, physical exercise, stress management) do play an important role in maintaining our brains in top shape.

Additionally, pioneers such as Sutter Health Partners are adding a Brain "lens" to their work. How?

First, by better understanding and explaining the brain benefits of what they already do, in order to provide additional motivation to stick with healthy behaviors. For example, most people will be able to recite multiple benefits of moderate cardiovascular exercise. But how many know that it can also contribute to neurogenesis -the creation of new neurons - in adult brains?

Second, by starting to offer brain fitness guidelines to clients who want too go beyond crossword puzzles and sudoku.

I had a great training session with a number of Sutter Health coaches last week - let me summarize some of the main points we covered.

What is Brain Fitness?

The general state of feeling alert, in control, productive, especially as the result of mental and physical exercise and proper nutrition. Having the mental abilities required to function in society, in our occupations, in our communities. It is not about “IQ”. It is about skills such as attention, memory, emotional self-regulation, planning, managing distractions…

Can Brain Fitness be measured today?

Yes, but, today, only by neuropsychologists and medical professionals. We expect to see cheaper and widely available assessments (perhaps via a 30-40 minute set of online assessments) over the next few years, thanks to the work underway to make quality computer-based assessments available to a growing number of clinicians, insurance companies, sports teams and the military.

What is the research background that explains the emergence of the brain fitness field?

1- New paradigm in brain research: today it is clear that the brain retains a lifelong capacity to change responding to experience (neuroplasticity), paving the way for lifestyle-based interventions.
2- Neuroimaging tools such as fMRI enable, for the first time i history, the scientific exploration of the live brain.
3- The brain has a core set of brain functions-or “mental muscles”. Our vocabulary must expand beyond "memory" and "intelligence" if we are to help move "Use It or Lose It" from theory to practice.
4. Some brain functions improve as we age – others typically decline. And there is major variability among groups of individuals.
5- The four “pillars” of brain health: balanced nutrition, physical exercise, stress management and brain exercise.
6- Cross-training the brain builds up the Brain Reserve.
7. Well-directed mental exercise (meditation, cognitive therapy, software-based programs) can be effective to train specific skills and provide needed mental stimulation.
8. Cognitive assessments will become critical to identify bottlenecks and measure progress.
9. The earlier we start, the better. But it is never too late to start.
10. This is still an emerging field: much more research needs to be done.

One of the top 10 predictions on the brain fitness/ brain training market we included in our our Brain Fitness Market Report said that:

"10. Brain training will be added to corporate wellness and leadership initiatives. Large employers with existing corporate wellness and leadership programs will introduce brain fitness specific programs aimed not only at improved health outcomes but also at increased productivity and cognitive performance in the workplace."

Coaches will play a major role in helping clients navigate this field, as initiatives such as Sutter Health's indicate. Stay tuned!

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Brain Training and Cognitive Health: September News

Alvaro Fernandez — Sun, 28 Sep 2008 22:47:35 +0000

A round-up of interested news during the month:

1) Training Young Brains to Behave (New York Times)

2) Head Games (OpEd in New York Times)

3) Will Gerontology recognize the Brain? (American Society on Aging event)

4) Brain function gets a boost from walking (Los Angeles Times)

5) An idea whose time has (finally) come (McKnight's Long Term Care News)

6) Train your brain (Financial Times Germany)

7) Toman auge ejercicios que adiestran la mente (Milenio, Mexico)

8) Trois nouvelles études IDATE : Serious Games (Publi-News, France)

Links and commentary below.

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1) Training Young Brains to Behave (New York Times)

- "But just as biology shapes behavior, so behavior can accelerate biology. And a small group of educational and cognitive scientists now say that mental exercises of a certain kind can teach children to become more self-possessed at earlier ages, reducing stress levels at home and improving their experience in school. Researchers can test this ability, which they call executive function, and they say it is more strongly associated with school success than I.Q."

Comment: we are happy to see the growing number of articles on the importance of executive functions and the role of schools in helping children "accelerate biology". In the next couple of weeks we will be publishing a fascinating interview with researcher Mike Posner precisely on this topic.

2) Head Games (OpEd in New York Times)

- "CHILDREN aged 5 to 18 suffer at least 96,000 sports-related concussions every year in the United States, the Centers for Disease Control and Prevention estimates. Even more troubling, as many as 20 percent of all high school football players sustain concussions annually, studies show."

- "The only way to know for sure whether a concussion victim’s brain has returned to normal is to compare the results of neuropsychological tests conducted before and after the injury. That requires preparing athletes for the season by putting them through baseline testing."

Comment: Great OpEd, raising awareness of a problem with growing importance - not only in terms of sports concussions, but also car accidents, strokes, and a variety of life-events that may provoke brain damage - and introducing readers to the need for cognitive baselines for specific individuals.

Now, we will probably need to go further than the author of the OpEd suggests. There are simply not enough neuropsychologists in the whole planet to test one-person at a time for 4-hours each, and the cost of trying so would be astronomical.

The more realistic route is to combine a) fully-automated computer-based assessments as a baseline, b) the involvement of a neuropsychologist when needed, probably both to supervise the whole assessment program for a sports team, for example, and then to supervise the post-damage rehabilitation process.

3) Will Gerontology recognize the Brain? (American Society on Aging event)

A few weeks ago, during the American Society on Aging's Brain Health day, a participant made a comment along the lines, "I just completed my Masters in Gerontology at University XYZ. Despite my best efforts, I could not find a single brain-related class to attend as part of my studies. Which is why I decided to come to a conference like this".

Comment: Incredible that this happens in 2008, a decade after the "Decade of the Brain". Healthcare and cognitive science seem to have inhabited different universes for too long. I hope we start to see more active cross-pollination between both fields. Gerontology would be a great place to start, given the growing demand for preventive programs to contribute to the cognitive health of an aging population.

4) Brain function gets a boost from walking (Los Angeles Times):

Comment: A couple of recent studies have reinforced the lifelong potential for brain plasticity (the ability of the brain to rewire itself through experience) and the importance of physical exercise for cognitive vitality. One study focused on 1) adults over 50 with mild cognitive impairment, the other one on 2) stroke survivors. The press release for the second study contains this quote:"This is great news for stroke survivors because results clearly demonstrate that long-term stroke damage is not immutable and that with exercise it's never too late for the brain and body to recover," says Daniel Hanley, M.D., professor of neurology at the Johns Hopkins University School of Medicine

Indeed, there is no reason why the process of physical and cognitive rehabilitation (or "enhancement") should ever stop, either as part of formal therapy or as a lifestyle modification.

5) An idea whose time has (finally) come (McKnight's Long Term Care News):

"Like many revolutions, long-term care's recent embrace of technology-based brain fitness tools began quietly. Then it exploded."

Comment: Indeed. We see more and more seniors housing and long-term care operators evaluate options to help maintain residents' cognitive health.

And, now, in case you want to use your language skills, you may also enjoy these recent articles:

6) Train your brain (Financial Times Germany):

"Ob Gehirntraining etwas nützt ist nicht bewiesen. Aber in den USA boomt der Markt, Hersteller kooperieren mit Krankenkassen und Seniorenheimen. In Deutschland fassen die Spiele gerade erst Fuß."

7) Toman auge ejercicios que adiestran la mente (Milenio, Mexico):

"La clave está en encontrar actividades que estimulen más nuestra memoria."

8) Trois nouvelles études IDATE : Serious Games (Publi-News, France):

"A travers une analyse détaillée des caractéristiques, des usages et des différentes familles de serious games, cette étude met en évidence les enjeux associés aux phases de conception, de développement et de diffusion des différents types de serious games."

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