Build­ing Blocks for a Bet­ter Future

The best alter­na­tive for tomor­row should be bet­ter than the best alter­na­tive avail­able today. How do we get there, when “cog­ni­tion” and “brain fit­ness” remain elu­sive con­cepts in pop­u­lar cul­ture? I believe that the lack of pub­lic edu­ca­tion is the major obsta­cle that lim­its the brain fit­ness field’s poten­tial to deliver real-world ben­e­fits, since only informed demand will ensure the ongo­ing devel­op­ment of ratio­nal, struc­tured “rules of the road.” What could be done to address this and other par­tic­u­lar obstacles?

Edu­cate the pub­lic
Ramp up efforts to build pub­lic aware­ness around a cul­ture of brain fit­ness and men­tal cap­i­tal across the lifes­pan, includ­ing estab­lish­ing clear links to daily life and work and the role of cog­ni­tive, emo­tional, and self-regulation fac­tors. Too many peo­ple still view men­tal capac­ity as a kind of uni­fied trait (such as IQ) that is deter­mined by our genes and can only decline with age.

Make it eas­ier to nav­i­gate claims
Easy-to-understand and research-based tax­onomies could help con­sumers and pro­fes­sion­als eval­u­ate prod­uct claims. Per­haps a label­ing sys­tem, sim­i­lar to the Good House­keep­ing Seal of Approval, will emerge at the ini­tia­tive of a reg­u­la­tor or of the industry.

Offer objec­tive cog­ni­tive assess­ment tools
It has been said that “you can’t man­age what you can’t mea­sure.” Reli­able, objec­tive assess­ment tools are crit­i­cal. Ide­ally, assess­ments would be adapted to the par­tic­u­lar cog­ni­tive demands of dif­fer­ent pri­or­i­ties and set­tings such as work­place per­for­mance, func­tional aging, dri­ving, work­ing as a pilot, or clin­i­cal con­di­tions. Per­haps the sin­gle most effec­tive way to bring cog­ni­tive research into the main­stream con­ver­sa­tion would be if peo­ple took an “annual brain check-up” (ASA-MetLife Foun­da­tion, 2006) to under­stand their own oppor­tu­ni­ties for improve­ment and progress, and to sup­port clin­i­cal deci­sion making.

Empha­size brain fit­ness at the pro­fes­sional level
Pro­fes­sional asso­ci­a­tions could beef up their efforts to add a brain fit­ness lens to their exist­ing offer­ings; this could help incor­po­rate an empha­sis on cog­ni­tion, neu­ro­plas­tic­ity, and men­tal well­ness into main­stream activities.

Advo­cate for more and bet­ter research
There are two main pri­or­i­ties for research: to develop widely accepted out­come stan­dards, includ­ing an estab­lished set of “func­tional mark­ers” at dif­fer­ent lev­els (such as brain-based, cog­ni­tive, and behavioral-functional) for dif­fer­ent pop­u­la­tions; and to fund tri­als that test mul­ti­modal inter­ven­tions. Iden­ti­fy­ing the respec­tive and com­ple­men­tary ben­e­fits of dif­fer­ent types of inter­ven­tions can result in bet­ter inte­grated and per­son­al­ized prod­ucts and programs.

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Nav­i­gat­ing the Cog­ni­tive Prod­uct Maze: Ten Things to Consider

1. Tar­get Users. What cohort of the pop­u­la­tion you serve is ready and will­ing to use these pro­grams? What cri­te­ria are most impor­tant to that group?
2. Tar­geted Ben­e­fits. What are the spe­cific cog­ni­tive, emo­tional, or self-regulation skills that the pro­gram aims to enhance or retrain? What is the fre­quency of use (how many hours per week or num­ber of weeks)?
3. Appro­pri­ate Level of Chal­lenge. Do the exer­cises adjust to the individual’s skill level and con­tin­u­ally vary and chal­lenge users at an appro­pri­ate pace?
4. Sci­en­tific Cre­den­tials. Are there sci­en­tists (ide­ally, neu­ropsy­chol­o­gists) behind the pro­gram? Is there a clearly defined and cred­i­ble sci­en­tific advi­sory board? Are there pub­lished, peer-reviewed sci­en­tific papers on the program’s efficacy?
5. Return on Invest­ment. What are your organization’s key busi­ness objec­tives, and can you inde­pen­dently mea­sure pro­gram results to eval­u­ate whether or not the pro­gram will meet those objectives?
6. Total Cost of Own­er­ship. What will the total cost of own­er­ship be over the next three to five years includ­ing up-front fees, ongo­ing fees, hard­ware, soft­ware, train­ing and sup­port fees, cost of addi­tional mod­ules, and staff time? How many users will likely end up using the prod­uct or sys­tem, and what would be the cost of own­er­ship per user?
7. Tech­ni­cal Require­ments. What are the tech­ni­cal require­ments needed to suc­cess­fully deploy and main­tain the pro­gram? Does it require Inter­net access? Are peo­ple expected to install their own CD-ROMs? Who will help solve poten­tial tech­ni­cal main­te­nance glitches?
8. Staff Train­ing. What type of train­ing is required to run the pro­gram and who will pro­vide it?
9. Prod­uct Roadmap. What is the vendor’s prod­uct roadmap? What is the ven­dor devel­op­ing and plan­ning to offer over the next one to three years?
10. Ref­er­ences. What sim­i­lar providers have used this spe­cific pro­gram? What ben­e­fits have they mea­sured directly? Is the use of the pro­gram grow­ing, or is it flat or declining?

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Sum­mary: Work Toward Accord

The grow­ing inter­est in the sci­ence, prac­tice, and busi­ness of brain fit­ness presents a sig­nif­i­cant oppor­tu­nity to build men­tal cap­i­tal, enhance men­tal well­ness, and delay symp­toms of brain-based decline and dis­ease. To best cap­i­tal­ize on this oppor­tu­nity, stake­hold­ers must agree on a mean­ing­ful and appro­pri­ate capacity-based framework—one that sup­ports both con­sumers and pro­fes­sion­als in mak­ing informed deci­sions, and that allows for person-centered and cross sec­tor inno­va­tion. Such accord can mean that in five to ten years, we may find our­selves in a much bet­ter place. Where to start? By devel­op­ing a cul­ture of brain fit­ness and men­tal cap­i­tal that spans from cra­dle to grave: I pro­pose that this is the real business—and guid­ing ethic—of the brain fit­ness field.

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Alvaro Fer­nan­dez, M.B.A., M.A., is CEO of SharpBrains.com.

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.

Credit for pic: Big­Stock­Photo.

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
• The Busi­ness and Ethics of the Brain Fit­ness Boom — Part 3: The Real Need

Ref­er­ences

Agency for Health­care Research and Qual­ity (AHRQ). 2010. Alzheimer’s Dis­ease and Cog­ni­tive Decline, Struc­tured Abstract.April 2010. Agency for Health­care Research and Qual­ity, Rockville, Md. www.ahrq.gov/clinic/tp/alzcogtp.htm. Retrieved April 11,2010.

ASA-MetLife Foun­da­tion. 2006.Attitudes and Aware­ness of Brain Health Poll. San Fran­cisco, Calif.: Amer­i­can Soci­ety on Aging.

Bar­ret, L. 2008. Healthy@Home Sur­vey (research com­mis­sioned and funded by Blue Shield of Cal­i­for­nia Foun­da­tion to AARP Foun­da­tion). Wash­ing­ton, D.C.: AARP Foundation.

Dinger, E. 2010. Lis­ten­ing to the Mem­ber: The 2010 AARP Mem­ber Opin­ion Sur­vey. AARP Research & Strate­gic Analy­sis. Washington,D.C.: AARP.

Fer­nan­dez, A. 2010. Trans­form­ing Brain Health with Dig­i­tal Tools to Assess, Enhance and Repair Cog­ni­tion Across the Lifes­pan. 2010 “State-of-the-market” Report. San Fran­cisco, Calif.: SharpBrains.

Fer­nan­dez, A., and Gold­berg, E. 2009. The Sharp­Brains Guide to Brain Fit­ness: 18 Inter­views with Sci­en­tists, Prac­ti­cal Advice, and Prod­uct Reviews to Keep Your Brain Sharp. San Fran­cisco, Calif.: SharpBrains.

Olshan­sky, J., et al. 2011. “The Global Agenda Coun­cil on the Age­ing Soci­ety: Pol­icy Prin­ci­ples.” Global Pol­icy 2: 97–105.

Sharp­Brains. 2011. “2011 Sharp-Brains Sum­mit: Retool­ing Brain Health for the 21st Cen­tury.” www.sharpbrains.com/summit/agenda/. Retrieved April 21, 2011.

The Gov­ern­ment Office for Sci­ence. 2008. Fore­sight Men­tal Cap­i­tal and Well­be­ing Project: Final Project Report (Exec­u­tive Sum­mary). Lon­don, U.K.: The Gov­ern­ment Office for Science.

Valen­zuela, M., and Sachdev, P. 2009. “Can Cog­ni­tive Exer­cise Pre­vent the Onset of Demen­tia? A Sys­tem­atic Review of Clin­i­cal Tri­als with Lon­gi­tu­di­nal Fol­low Up.” Amer­i­can Jour­nal of Geri­atric Psy­chi­a­try 17: 179−87.

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