(Editor’s note: this arti­cle belongs to the excel­lent May 2009 spe­cial issue on Aug­ment­ing Cog­ni­tion of sci­en­tific jour­nal Fron­tiers in Neu­ro­science, Vol­ume 3, Issue 1. You can order this issue, for 50 euros, here. Highly rec­om­mended for sci­en­tists and tech­ni­cal read­ers inter­ested in the sci­ence. This arti­cle, an indus­try overview, is repro­duced here with autho­riza­tion by the Fron­tiers Research Foun­da­tion).

Prepar­ing Soci­ety for the Cog­ni­tive Age

- By Alvaro Fernandez

Ground­break­ing cog­ni­tive neu­ro­science research has occurred over the last 20 years — with­out par­al­lel growth of con­sumer aware­ness and appro­pri­ate pro­fes­sional dis­sem­i­na­tion. “Cog­ni­tion” remains an elu­sive con­cept with unclear impli­ca­tions out­side the research community.

Ear­lier this year, I pre­sented a talk to health care pro­fes­sion­als at the New York Acad­emy of Med­i­cine, titled “Brain Fit­ness Soft­ware: Help­ing Con­sumers Sep­a­rate Hope from Hype”. I explained what com­put­er­ized cog­ni­tive assess­ment and train­ing tools can do (assess/enhance spe­cific cog­ni­tive func­tions), what they can­not do (reduce one’s “brain age”) and the cur­rent uncer­tain­ties about what they can do (i.e., delay Alzheimer’s symp­toms). At the same sym­po­sium, Dr. Gary Kennedy, Direc­tor of Geri­atric Psy­chi­a­try at Mon­te­fiore Med­ical Cen­ter, pro­vided guid­ance on why and how to screen for exec­u­tive func­tion deficits in the con­text of dementia.

I could per­ceive two emerg­ing trends at the event: 1) “Aug­ment­ing Cog­ni­tion” research is most com­monly framed as a health­care, often phar­ma­co­log­i­cal topic, with the tra­di­tional cog­ni­tive bias in med­i­cine of focus­ing on detec­tion and treat­ment of dis­ease, 2) In addi­tion, there is a grow­ing inter­est in non-invasive enhance­ment options and over­all lifestyle issues. Research find­ings in Aug­ment­ing Cog­ni­tion are only just begin­ning to reach the main­stream mar­ket­place, mostly through health­care chan­nels. The oppor­tu­nity is immense, but we will need to ensure the mar­ket­place matures in a ratio­nal and sus­tain­able man­ner, both through health­care and non-healthcare channels.

In Jan­u­ary 2009, we polled the 21,000 sub­scribers of Sharp­Brains’ mar­ket research eNewslet­ter to iden­tify atti­tudes and behav­iors towards the “brain fit­ness” field (a term we chose in 2006 based on a num­ber of con­sumer sur­veys and focus groups to con­nect with a wider audi­ence). Over 2,000 decision-makers and early adopters responded to the survey.

One of the key ques­tions we asked was, “What is the most impor­tant prob­lem you see in the brain fit­ness field and how do you think it can be solved?”. Some exam­ples of the sur­vey free text answers are quoted here, together with my suggestions.

Most impor­tant prob­lems in the brain fit­ness field

Pub­lic aware­ness (39%): “To get peo­ple to under­stand that hered­ity alone does not decide brain func­tion­ing”. We need to ramp up efforts to build pub­lic aware­ness and enthu­si­asm about brain research, includ­ing estab­lish­ing clear links to daily liv­ing. We can col­lab­o­rate with ini­tia­tives such as the Dana Foundation’s Brain Aware­ness Week and use the recent “Neu­ro­science Core Con­cepts” mate­ri­als devel­oped by the Soci­ety for Neu­ro­science to give talks at schools, libraries and workplaces.

Claims (21%): “The lack of stan­dards and clear def­i­n­i­tions is very con­fus­ing, and makes a lot of peo­ple scep­ti­cal”. We need an easy-to under­stand tax­on­omy to help con­sumers and pro­fes­sion­als eval­u­ate claims focus­ing on cog­ni­tive func­tions, not on men­tal health diag­noses. The clas­si­fi­ca­tions should be grounded on a stan­dard­ized research tax­on­omy. How­ever, over time we may have to develop a “label­ing sys­tem” based on the tar­geted cog­ni­tive domain and level of val­i­da­tion. Press releases often only add more con­fu­sion. We should blog study results in depth, become trusted resources to trusted reporters and dif­fer­en­ti­ate new find­ings from pre­vi­ous ones.

Research (15%): “Deter­min­ing what activ­i­ties are most ben­e­fi­cial to the user with the min­i­mum level of effort or most over­lap of already exist­ing effort”. A high pri­or­ity would be to ensure widely-accepted out­put stan­dards (either com­mer­cial or fol­low­ing con­sen­sus processes such as the schiz­o­phre­nia MATRICS Cog­ni­tive Bat­tery) with a trans­par­ent archi­tec­ture of out­comes and rela­tion­ships cov­er­ing the impact (brain-based, cog­ni­tive, behav­ioral per­for­mance) by age groups and by healthy vs. spe­cific disorders.

Cul­ture (14%): “Inte­gra­tion within exist­ing health­care infra­struc­ture will require research, edu­ca­tion and cul­tural change. If brain fit­ness remains a niche alter­na­tive approach for the well-healed, we will have failed”. We need to improve the part­ner­ship with clin­i­cians and their pro­fes­sional associations.

Assess­ment (6%): “Devel­op­ment of stan­dard­ized and eas­ily acces­si­ble assess­ments of cog­ni­tive sta­tus that could be used by indi­vid­u­als and orga­ni­za­tions to test the effi­cacy of cog­ni­tive improve­ment meth­ods”. Per­haps the sin­gle most effec­tive way to bring cog­ni­tive research into the main­stream con­ver­sa­tion would be if peo­ple took an “annual brain check-up” serv­ing as a cog­ni­tive base­line (as objec­tive, func­tional infor­ma­tion to track changes and to inform about inter­ven­tions and diag­noses). Com­put­er­ized assess­ments are already being used in a vari­ety of con­texts, from sports neu­ropsy­chol­ogy to mil­i­tary Trau­matic Brain Injury (TBI) detec­tion. A recent report by the Alzheimer’s Foun­da­tion of Amer­ica advo­cat­ing for wide­spread cog­ni­tive screen­ings after the age of 75 or even 65 may open up a very inter­est­ing pub­lic pol­icy debate.

Expo­sure (5%): “Get infor­ma­tion and prod­ucts out to all the peo­ple, per­haps a drive to get them into pub­lic libraries”. We have a major oppor­tu­nity now to help pre­pare soci­ety to thrive in this cog­ni­tive age. We need to improve research and focus on pub­lic aware­ness and stan­dards for this oppor­tu­nity to come to fruition.

Dr. Bill Reich­man, CEO of Bay­crest, puts it this way, “We have an oppor­tu­nity to make major progress in Brain Health in the 21st cen­tury, sim­i­lar to what hap­pened with Car­dio­vas­cu­lar Health in the 20th, and tech­nol­ogy will play a cru­cial role”. For that pre­dic­tion to come true, research on aug­ment­ing cog­ni­tion will need to become main­stream. Neu­ro­sci­en­tist Torkel Kling­berg is opti­mistic, “In the future we may be as aware of cog­ni­tive func­tion as we now are obsessed with calo­ries, diets, glycemic index and car­dio­vas­cu­lar training”.

The process in under way.

– Alvaro Fer­nan­dez is the Chief Exec­u­tive Offi­cer of Sharp­Brains (www.sharpbrains.com), a mar­ket research and edu­ca­tional firm that cov­ers appli­ca­tions of cog­ni­tive neu­ro­science. Alvaro is a mem­ber of the World Eco­nomic Forum’s Coun­cil on The Future of the Aging Soci­ety, and teaches at UC-Berkeley Life­long Learn­ing Insti­tute. He has an M.B.A. and an M.A. in Edu­ca­tion from Stan­ford University.

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Sharp­Brains offers two pub­li­ca­tions to bet­ter under­stand emerg­ing cog­ni­tive health research, tech­nol­ogy and trends, and pre­pare for them:

- Book: The Sharp­Brains Guide to Brain Fit­ness ($24.95 book, $9.99 Kin­dle version)

- Indus­try report: The State of the Brain Fit­ness Soft­ware Mar­ket 2009 ($1,295, includes exec­u­tive webi­nar and access to Net­work for Brain Fit­ness Innovation)

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