(Editor’s Note: given the grow­ing media atten­tion to three appar­ently sep­a­rate worlds –cog­ni­tive enhance­ment via drugs, brain fit­ness train­ing soft­ware, com­put­er­ized neu­rocog­ni­tive assessments-, I found it refresh­ing to see our co-founder Elkhonon Gold­berg intro­duce the topic of cog­notropic drugs with an inte­gra­tive per­spec­tive in the much updated new edi­tion of his clas­sic book, now titled The New Exec­u­tive Brain: Frontal Lobes In A Com­plex World. Below goes an excerpt).

For many neu­ropsy­chol­o­gists, like myself, sci­ence is a labor of love, but see­ing patients is bread and but­ter. Tra­di­tion­ally, the clin­i­cal con­tri­bu­tion of neu­ropsy­chol­ogy has been mostly diag­nos­tic, with pre­cious lit­tle to offer patients by way of treat­ment. Neu­ropsy­chol­ogy is not the only clin­i­cal dis­ci­pline for years con­signed to help­less voyeurism. Every dis­ci­pline con­cerned with cog­ni­tion shares this hum­bling predica­ment. A psy­chi­a­trist treat­ing a schiz­o­phrenic patient or a depressed patient finds him– or her­self in a sim­i­lar posi­tion. There are ample phar­ma­co­log­i­cal tools to treat the patient’s psy­chosis or mood, but very few to treat the patient’s cog­ni­tion. Even though psy­chi­a­trists increas­ingly rec­og­nize that cog­ni­tive impair­ment is often more debil­i­tat­ing in their patients than psy­chosis or mood dis­or­der, tra­di­tion­ally, very lit­tle direct effort has been aimed at improv­ing cognition.

A neu­rol­o­gist treat­ing a patient recov­er­ing from the effects of head injury does not fare much bet­ter. There are ade­quate means to con­trol the patient’s seizures but not his or her cog­ni­tive changes, despite the fact that cog­ni­tive impair­ment is usu­ally far more debil­i­tat­ing than an occa­sional seizure. Soci­ety has been so pre­oc­cu­pied with sav­ing lives, treat­ing hal­lu­ci­na­tions, con­trol­ling seizures, and lift­ing depres­sion that cog­ni­tion (mem­ory, atten­tion, plan­ning, prob­lem solv­ing) has been largely ignored. Granted, var­i­ous neu­rolep­tics, anti­con­vul­sants, anti­de­pres­sants, seda­tives, and stim­u­lants do have an effect on cog­ni­tion, but it is an ancil­lary effect of a drug designed to treat some­thing else.

Alzheimer’s dis­ease and other demen­tias have been society’s wake-up call. Here, in the most afflu­ent coun­try in the most afflu­ent of times, human minds were suc­cumb­ing to decay before human bod­ies, a sharp chal­lenge to the tacit pop­u­lar belief that the “body is frail but soul is for­ever.” This pro­vided an impe­tus for the devel­op­ment of an entirely new class of drugs, which can be termed famil­ially as “cog­notropic.” Their pri­mary and explicit pur­pose is to improve cognition.

Since med­ical and pub­lic pre­oc­cu­pa­tion with demen­tia focuses on mem­ory, most of the phar­ma­co­log­i­cal efforts have been directed at improv­ing mem­ory. At the time of this writ­ing, a hand­ful of drugs known as “Alzheimer’s drugs” or “mem­ory enhancers” have been approved by the U.S. Food and Drug Admin­is­tra­tion (FDA). In real­ity, both des­ig­na­tions are some­what mis­lead­ing. The drugs in ques­tion are Read the rest of this entry »

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 Read the rest of this entry »

Inter­est­ing recent news:

For more on these news, and com­men­tary: Read the rest of this entry »

Dear Mr or Mrs Next US President,

We are glad to wel­come you to our blog car­ni­val. After a short hia­tus, Encephalon is back and gath­er­ing steam. We have pre­pared this “revival” edi­tion just for you, so you can be well informed and impress us all dur­ing the upcom­ing Sci­encede­bate 2008.

With­out fur­ther ado, let’s pro­ceed to the ques­tions posed by 24 blog­gers on neu­ro­science and psy­chol­ogy issues. We hope they pro­vide, at the very least, good men­tal stim­u­la­tion for you and your advisors.

Big Ques­tions

Do I deserve to vote even if I don’t have Free Will? (Marc at Neu­ro­sci­en­tif­i­cally Challenged).

If cul­ture sculpts our brains, what can our brains do to refine our cul­ture first? (Stephanie at Brains On Purpose).

Is God more than a fly­ing brain? (Jes­sica at bioephemera).

Is Your brain really read­ing This? (Pete at Brain Hammer).

A Few Intru­sive Questions

Do you play any musi­cal instru­ment? (Megan at SharpBrains).

Read the rest of this entry »

The New Yorker April 30th issue includes a superb arti­cle on The Way We Age Now: Can med­i­cine serve an aging pop­u­la­tion?. Atul Gawande pro­vides a great (and a bit depress­ing) sur­vey on the geri­atrics field: more and more need for prac­ti­tion­ers, with less and less supply.

now, a cou­ple of quotes and data points that are very rel­e­vant to our efforts around healthy brain aging.

• “for most of our hundred-thousand-year existence—all but the past cou­ple of hun­dred years—the aver­age life span of human beings has been thirty years or less. (Research sug­gests that sub­jects of the Roman Empire had an aver­age life expectancy of twenty-eight years.)”
• “Inher­i­tance has sur­pris­ingly lit­tle influ­ence on longevity. James Vau­pel, of the Max Planck Insti­tute for Demo­graphic Research, in Ros­tock, Ger­many, notes that only six per cent of how long you’ll live, com­pared with the aver­age, is explained by your par­ents’ longevity; by con­trast, up to ninety per cent of how tall you are, com­pared with the aver­age, is explained by your par­ents’ height. Even genet­i­cally iden­ti­cal twins vary widely in life span: the typ­i­cal gap is more than fif­teen years.”

Fas­ci­nat­ing. First, let’s appre­ci­ate our incred­i­ble life expectancy today; we are lit­er­ally push­ing the envelop of how to main­tain healthy brains and bod­ies. By his­tor­i­cal stan­dards, many of us are liv­ing on “bor­rowed” time. Sec­ond, there you have some evi­dence for the impor­tance of our expe­ri­ence and our lifestyle on how long we live. In terms of healthy aging, on aver­age, nur­ture seems to be at least as impor­tant as nature, and the one more in our con­trol to take action today.

You can learn more on the Suc­cess­ful Aging of the Healthy Brain: a beau­ti­ful essay by Mar­ian Dia­mond on how to keep our brains and minds active and fit through­out our lives.

Related blog posts

• What does “nor­mal aging” mean? Do we all age the same way?
• Easy Steps to Improve Your Brain Health Now
• Bill Clin­ton on health care and wellness
• The Upside of Aging-WSJ
• Baby Boomers, Healthy Aging and Job Performance