Engag­ing peo­ple where they are in the life-course

Eighty per­cent of the 38,000 adults over age 50 who were respon­ders in the 2010 AARP Mem­ber Opin­ion Sur­vey indi­cated “stay­ing men­tally sharp” was their top ranked inter­est and con­cern (Dinger, 2010). What exactly does this phrase mean? And what role can tech­nol­ogy play in “stay­ing men­tally sharp”? Intel CEO Paul Otellini has said, “You have to start by think­ing about what peo­ple want to do… and work backward.”

The grow­ing inter­est in brain fit­ness presents a sig­nif­i­cant oppor­tu­nity to build men­tal cap­i­tal, enhance men­tal well­ness, and delay symp­toms of brain-based decline and disease.

In March 2008, AARP ran their Healthy@Home Sur­vey (Bar­ret, 2008) ask­ing just under 1,000 respon­ders, ages 65 and over (mean age of 74 years), and their care­givers about their per­cep­tions of suc­cess­ful aging and tech­nolo­gies for suc­cess­ful aging. In a nut­shell, the survey’s main find­ings were that older adults pri­or­i­tize health and inde­pen­dence, that their obsta­cles have a strong cog­ni­tive or per­cep­tual com­po­nent, and that they are open to dig­i­tal health technology.

In other words, the top pri­or­ity for older adults is not anti-aging—it is about main­tain­ing capac­i­ties to func­tion inde­pen­dently. This is where recent cog­ni­tive sci­ence and dig­i­tal tools can add more value: man­ag­ing and enhanc­ing “brain fit­ness” in the present and the near future—not just pre­vent­ing or treat­ing Alzheimer’s Dis­ease thirty years from now.

What are some of the areas where peo­ple want more help with brain fit­ness? To answer this ques­tion, Sharp­Brains (www.sharpbrains.com) con­ducted a sur­vey in March 2010 of our monthly newslet­ter sub­scribers (a group not rep­re­sen­ta­tive of the pop­u­la­tion at large, but indica­tive of early adopters and deci­sion mak­ers). We received nearly 1,700 responses from respon­dents who were ages 40 and older.

When asked what were the most impor­tant brain func­tions nec­es­sary to thrive per­son­ally and pro­fes­sion­ally in the twenty-first cen­tury, respon­dents’ pri­or­i­ties cov­ered a range of cog­ni­tive, emo­tional, and self-regulation func­tions, sug­gest­ing that brain fit­ness solu­tions will need to inte­grate all these domains—or at least be able to link their spe­cific func­tional ben­e­fits to spe­cific user pri­or­i­ties. It was inter­est­ing to con­trast the top two ranked func­tions (“abil­ity to man­age stress­ful sit­u­a­tions”; “con­cen­tra­tion power to avoid dis­trac­tions”) with the bot­tom two (“abil­ity to mul­ti­task”; remem­ber­ing faces and names”), which may debunk many myths about our assump­tions of what peo­ple actu­ally want and need. When asked for their beliefs about the effec­tive­ness of cer­tain habits and tools, respon­dents named intel­lec­tual chal­lenges, aer­o­bic exer­cise, and read­ing books as most effec­tive, closely fol­lowed by meditation.

Sim­ply stated: what peo­ple seem to want is help to enhance and pro­long their func­tional men­tal capac­ity. The next step is to deter­mine how older adults can best nav­i­gate through the brain fit­ness marketplace.

Empow­er­ing Pro­fes­sion­als to Empower Consumers

Insti­tu­tions and pro­fes­sion­als in the field of aging have the daily task of help­ing con­sumers, patients, and care­givers nav­i­gate the avail­able non-invasive options. Per­son­al­ized assess­ments and advice are crit­i­cal, since improve­ments expe­ri­enced in ther­apy and train­ing pro­grams seem more likely to trans­fer to real life when a per­son tar­gets the brain function(s) that are specif­i­cally rel­e­vant to their unique con­text and its bot­tle­necks or deficits (Sharp­Brains, 2011).

Peo­ple have dif­fer­ent needs and pri­or­i­ties, have vary­ing lifestyles, and reside in par­tic­u­lar cog­ni­tive envi­ron­ments: one size does not fit all.

I pro­pose that insti­tu­tions and pro­fes­sion­als who must tra­verse this still-emerging, com­plex land­scape first iden­tify an individual’s par­tic­u­lar bot­tle­necks or deficits, then seek the level of clin­i­cal val­i­da­tion for options (technology-based or not) that tar­get those spe­cific cog­ni­tive, emo­tional, or self-regulation func­tions. (See the list on page 68 that can help pro­fes­sion­als eval­u­ate brain fit­ness options.)

The other role pro­fes­sion­als play is in edu­cat­ing and empow­er­ing con­sumers, patients, and care­givers to enhance their self-efficacy by mak­ing their own deci­sions. (Our Sharp­Brains 2009 con­sumer guide included a pro­gram eval­u­a­tion check­list, excerpted in the box on this page; the full check­list is avail­able at www.SharpBrains.com.)

In the absence of per­fect answers—and we won’t have per­fect answers for a while, if ever—today’s best course is to pro­vide edu­ca­tion and resources that facil­i­tate informed deci­sion mak­ing. Pro­fes­sion­als in the field of aging are in a unique posi­tion to help parse the offer­ings in the rapidly evolv­ing field of brain fitness.

How to Eval­u­ate Brain Fit­ness Pro­grams: A Con­sumer Checklist

Are there sci­en­tists and neu­ropsy­chol­o­gists, and a sci­en­tific advi­sory board behind the program?

• Are there pub­lished, peer-reviewed sci­en­tific papers in main­stream sci­en­tific and pro­fes­sional jour­nals writ­ten by those sci­en­tists? How many?
• Does the pro­gram tell me what part of my brain or which cog­ni­tive skill I am exercising?
• Is there an inde­pen­dent assess­ment tool to mea­sure my progress?
• Is it a struc­tured pro­gram, with guid­ance on how many hours per week and days per week to use it?
• Do the exer­cises vary and teach me some­thing new?
• Does the pro­gram chal­lenge and moti­vate me, or does it feel like it would become easy once I learned it?
• Does the pro­gram fit my per­sonal goals?
• Does the pro­gram fit my lifestyle?
• Am I ready and will­ing to do the pro­gram, or would it be too stressful?

To Be Continued…

• Tomor­row, Jan­u­ary 10th: Part 4 — The Future

You can track and dis­cuss each part as it becomes avail­able via my Twit­ter account, our Face­book page, LinkedIn group, and RSS feed. Enjoy, and please add your 2 cents!

Note: This is an excerpt from the Gen­er­a­tions arti­cle  The Busi­ness and Ethics of the Brain Fit­ness Boom, by Alvaro Fer­nan­dez. Copy­right © 2011 Amer­i­can Soci­ety on Aging; all rights reserved. This arti­cle may not be dupli­cated, reprinted or dis­trib­uted in any form with­out writ­ten per­mis­sion from the pub­lisher: Amer­i­can Soci­ety on Aging, 71 Steven­son St., Suite 1450, San Francisco,CA 94105–2938; e-mail: info@asaging.org.

Read pre­vi­ous arti­cles here:

• The Busi­ness and Ethics of the Brain Fit­ness Boom — Part 1: The Business
• The Busi­ness and Ethics of the Brain Fit­ness Boom — Part 2: The Ethics

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