Sharp Brains: Brain Fitness and Cognitive Health News

Neuroplasticity, Brain Fitness and Cognitive Health News

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Study: Families’ Perspectives on ADHD and its Treatment

In 2005 the Amer­i­can Acad­emy of Pedi­atrics (AAP) began an ini­tia­tive to pro­mote an approach to care among its mem­bers in which “…the pedi­atric team works in part­ner­ship with a child and a child’s fam­ily to assure that all of the med­ical and non-medical needs of the patient are met.” A crit­i­cally impor­tant focus of this approach is the role of the fam­ily and child — as devel­op­men­tally appro­pri­ate — in the devel­op­ment of an over­all plan of care.

This shared decision-making approach is espe­cially impor­tant for con­di­tions like ADHD where there is not a sin­gle treat­ment that is the most appro­pri­ate and pre­ferred option for all patients. How­ever, Read the rest of this entry »

Cognitive screenings and Alzheimer’s Disease

The Alzheimer’s Foun­da­tion of Amer­ica just released a thought­ful report advo­cat­ing for wide­spread cog­ni­tive screen­ings after the age of 65 (55 given the right conditions).

Accord­ing to the press release,

- “The report shat­ters unsub­stan­ti­ated crit­i­cism and instead empha­sizes the safety and cost-effectiveness of these tools and calls on Con­gress to develop a national demen­tia screen­ing policy.”

- “Lift­ing the bar­ri­ers to early detec­tion is long over­due, Hall said. “Con­ver­sa­tions about brain health are not tak­ing place. We must edu­cate and empower con­sumers to talk openly about mem­ory con­cerns, par­tic­u­larly with pri­mary care providers, so they get the atten­tion and qual­ity of life they deserve.

- “Demand for screen­ings is evi­denced by the suc­cess of AFA’s recent sixth annual National Mem­ory Screen­ing Day held on Novem­ber 18, dur­ing which an esti­mated 50,000 peo­ple were given free con­fi­den­tial mem­ory screen­ings at nearly 2,200 com­mu­nity sites nation­wide. Dur­ing last year’s event, approx­i­mately 16 per­cent of indi­vid­u­als who had a face-to-face screen­ing scored pos­i­tive and were referred to their pri­mary care providers for follow-up. An AFA sur­vey of par­tic­i­pants revealed that fewer than one in four with self-reported mem­ory com­plaints had pre­vi­ously dis­cussed them with their physi­cians despite recent visits.”

Excel­lent report avail­able: here

Please note that the Alzheimer’s Asso­ci­a­tion recently argued in the oppo­site direc­tion (no screen­ings) — which prob­a­bly trig­gered this response.

We see emerg­ing trends that sug­gest the posi­tion in favor of cog­ni­tive assess­ments may in fact gather momen­tum over the next few years: wide­spread com­put­er­ized cog­ni­tive screen­ings in the US Army, insur­ance com­pa­nies like OptumHealth adding such tools to its clin­i­cal decision-making sys­tems, polls such as the Amer­i­can Soci­ety of Aging’s a cou­ple of years ago indi­cat­ing a very strong demand for an “annual men­tal check-up”, the avail­abil­ity of use­ful assess­ment tools and research-based pre­ven­tive advice.

The start­ing point is to under­stand what those assess­ments are NOT: they are not diag­nos­tic tools. When used prop­erly, they can be used as a base­line to track per­for­mance in a vari­ety of cog­ni­tive domains over time, so that both the indi­vid­ual AND the physi­cian are not blinded by a one-time assess­ment, com­par­ing an indi­vid­ual with his or her peers (instead of his or her past per­for­mance) when seri­ous symp­toms have fre­quently already been going on for a while.

Our con­trib­u­tor  Dr. Joshua Sil­ver­man, from Albert Ein­stein Col­lege of Med­i­cine, recently gen­er­ated a nice debate on the topic by ask­ing our read­ers their reac­tion to these 3 ques­tions: Read the rest of this entry »

Grand Rounds 5:12 — Healthcare Reform Q&A

If Dr. Rob can inter­view Santa, why can’t I inter­view a select group of health & med­ical blog­gers? They will have some good ideas to share”.

So did President-elect Obama came to real­ize a few days ago. After his peo­ple kindly con­tacted our peo­ple, we felt com­pelled to grant him open access to our col­lec­tive wis­dom. With­out fur­ther ado, below you have Grand Rounds 5:12 — a Q&A ses­sion led by the incom­ing Pres­i­dent on how to reform (for the bet­ter, we hope) healthcare.

On Health Insurance

Q:  How does the blo­gos­phere per­ceive the prob­lem of hav­ing a sig­nif­i­cant group of peo­ple uninsured?

Health Insur­ance Col­orado: a grow­ing eco­nomic bur­den, which may lead to emer­gency rooms turn­ing peo­ple away if they are unable to pro­vide proof of health insurance.

Dr Rich: well, a recent arti­cle in the Jour­nal of the Amer­i­can Med­ical Asso­ci­a­tion showed how over­crowd­ing in Amer­i­can emer­gency rooms is NOT due to the unin­sured. Rather, it is due to insured Amer­i­cans who can­not get in to see their pri­mary care physi­cians. We may need improved care both for the insured and unin­sured groups.

Insure­Blog: I’d sec­ond that. Lack of health insur­ance is a major prob­lem but is it really our Biggest Problem?

It’s All about Attitude

Q: You may have heard my cam­paign mantra, “Yes We Can”. Can I count on your support?

ButY­ouDont­Look­Sick: Yes. If Leslie Hunt can talk so openly about her chronic ill­ness (Lupus) yet ful­fill her Amer­i­can Idol dreams, we can ful­fill our dreams too.

Notes of an Anes­the­sioboist: you are talk­ing to the group of pro­fes­sion­als will­ing to self-experiment with our own body for the ben­e­fit of sci­ence and our patients.

Med­views: My wife, son, and I signed up to work as med­ical vol­un­teers for your upcom­ing inauguration.

Emergi­Blog: I am on board too. But, please, remem­ber that car­ing is the essence of nurs­ing. And that is why my patients will always be my patients and never my  clients.

Neu­roan­thro­pol­ogy: Mr. President-elect, it seems to me that, despite all our good inten­tions, bal­anc­ing the bud­get and mul­ti­ple com­pet­ing pri­or­i­ties will be a chal­lenge. May I sug­gest you start prac­tic­ing some capoeira for equi­lib­rium training?

Shrink Rap: Happy to help. Now, we will need to pro­tect some time for qual­ity sleep time.

Train­ing

Q: I am encour­aged by your words. How can my team and I bet­ter sup­port you in your daily activities?

Aequa­nim­i­tas: we need more role mod­els for us to “learn to think, observe, and com­pare” and that the patient is our “first, last, and only teacher”.

Mud­phud­der: Couldn’t agree more. We need Read the rest of this entry »

Towards a Healthy Living & Cognitive Health Agenda

Here you have the Novem­ber edi­tion of our monthly newslet­ter cov­er­ing cog­ni­tive health and brain fit­ness top­ics. Please remem­ber that you can sub­scribe to receive this Newslet­ter by email, sim­ply by brain fitness and health newslettersub­mit­ting your email at the top of this page.

Thank you for your inter­est, atten­tion and par­tic­i­pa­tion in our Sharp­Brains com­mu­nity. As always, we appre­ci­ate your com­ments and suggestions.

Sum­mit of the Global Agenda

How can we per­suade busi­ness lead­ers, policy-makers and researchers of the urgency to develop and pro­mote an inte­grated “Healthy Liv­ing” agenda focused on main­tain­ing life­long phys­i­cal and cog­ni­tive health, vs. the usual mind­set focused on deal­ing with spe­cific dis­eases and prob­lems once they arise?

In The Future of the Aging Soci­ety: Bur­den or Human Cap­i­tal?, I sum­ma­rize some of the key themes dis­cussed at the World Eco­nomic Forum event in Dubai on Novem­ber 7-9th. The world is aging — and in health­ier ways. But our health­care and retire­ment sys­tems are on track to go bank­rupt — their premises are out­dated. The cur­rent disease-based research agenda com­pounds the prob­lem. Solu­tions? 1) Pro­mote Healthy Lifestyles that help Main­tain Phys­i­cal and Cog­ni­tive Func­tional Abil­i­ties, 2) Redesign Envi­ron­ments to Fos­ter Health, Engage­ment and Finan­cial Secu­rity, 3) Develop an Inte­grated Healthy Liv­ing & Aging Research Agenda. Specif­i­cally, we could work with the UN and Global 2000 com­pa­nies to move for­ward a new agenda.

Planet Earth 2.0: A New Oper­at­ing Sys­tem: Imag­ine see­ing a top sheik in Dubai, wrapped in tra­di­tional Arab cloth­ing, exclaim “Yes We Can (a la Obama) in front of the 800 global experts, adding that “we build the future with our own hands. Some of the atten­dants of the World Eco­nomic Forum’s Sum­mit of the Global Agenda urged us to “reboot” the sys­tem. More than a “reboot”, we may have to upgrade to a new global “Yes We Can” oper­at­ing system.

Brain Fit­ness Research

Train­ing Atten­tion and Emo­tional Self-Regulation: Dr. Michael Pos­ner, a promi­nent  cog­ni­tive neu­ro­sci­en­tist and first recip­i­ent of the Dogan Prize, grants us a fas­ci­nat­ing inter­view on what atten­tion, self-regulation, and effort­ful con­trol are, and how to improve them using soft­ware, med­i­ta­tion, and par­ent­ing. In his words, “we have found no ceil­ing for abil­i­ties such as atten­tion, includ­ing among adults. The more train­ing (…) the higher the results.”

Neu­ro­plas­tic­ity and the Brain That Changes Itself: Lau­rie Bar­tels reviews the excel­lent book by Nor­man Doidge, explain­ing that “the neu­ro­science behind Doidge’s book involves neu­ro­plas­tic­ity, which is the brain’s abil­ity to rewire itself. This means that the brain  is our intel­li­gence,  is not some­thing fixed in con­crete but rather a chang­ing, learn­ing entity.”

Can We Pick Your Brain re: Cog­ni­tive Assess­ments?: In our view, a crit­i­cal com­po­nent in the matu­rity of the brain fit­ness mar­ket will be the avail­abil­ity of inex­pen­sive, valid and reli­able objec­tive cog­ni­tive assess­ments,  to help mea­sure how our brain func­tions change over time and iden­tify pri­or­i­ties for tar­geted improve­ments. Dr. Joshua Stein­er­man asks if you would be up for them?

Use It (Prop­erly) or Lose It

Mem­ory Prob­lems? Per­haps you are Multi-tasking: Dr. Bill Klemm tells us that “Multi-tasking vio­lates every­thing we know about how mem­ory works.” He explains that “(multi-tasking) prob­a­bly does make learn­ing less tedious, but it clearly makes learn­ing less effi­cient and less effective.”

Phys­i­cal and men­tal exer­cise to pre­vent cog­ni­tive decline: The Amer­i­can Med­ical News, a weekly news­pa­per for physi­cians pub­lished by the Amer­i­can Med­ical Asso­ci­a­tion, just pub­lished an excel­lent arti­cle on the impor­tance of phys­i­cal and men­tal exer­cise. We are very happy to see efforts like these to train physi­cians and health pro­fes­sion­als in gen­eral,  given that most of them were trained under a very dif­fer­ent under­stand­ing of the brain than the one we have today.

Brain Fit­ness 2: Sight & Sound: PBS recently announced the sec­ond install­ment of their pop­u­lar Brain Fit­ness Pro­gram show, to start air­ing soon.

MetaCar­ni­val #1: a con­ver­sa­tion across the blo­gos­phere: We often insist on “Nov­elty, Vari­ety and Chal­lenge” as key ingre­di­ents for good “brain exer­cise”. There are many ways to mix those ingre­di­ents — you may enjoy this one, the first inter­dis­ci­pli­nary gath­er­ing of blogs and blog car­ni­vals cov­er­ing health, sci­ence, anthro­pol­ogy, gen­eral advice and more.

Brain Teasers

Top 15 Brain Teasers and Games for Men­tal Exer­cise: Over the last 2 years we have pub­lished close to 100 puz­zles, teasers, rid­dles, and every kind of men­tal exer­cise (with­out count­ing our in-depth inter­views with top neu­ro­sci­en­tists). Which ones have proven most stim­u­lat­ing for you. Let us know. Here is a selec­tion of our Top 15 teasers.

Final Details

That’s all for now. Next month, we will be offer­ing another great selec­tion of arti­cles: Dr. Andrew New­berg will dis­cuss the brain value of med­i­ta­tion,  Dr. David Rabiner will review a recent study on how neu­ro­feed­back may assist in the diag­nos­tic of atten­tion deficits, and much more.

Please share this newslet­ter with your friends and col­leagues if you haven’t done so already.

Have a Happy Thanksgiving!

Physical and mental exercise to prevent cognitive decline

We offered some Brain Fit­ness Pre­dic­tions in our Mar­ket Report , including…

7. Doc­tors and phar­ma­cists will help patients nav­i­gate through the over­whelm­ing range of avail­able prod­ucts and inter­pret the results of cog­ni­tive assess­ments. This will require sig­nif­i­cant pro­fes­sional devel­op­ment efforts, given that most doc­tors today were trained under a very dif­fer­ent under­stand­ing of the brain than the one we have today.”

The Amer­i­can Med­ical News, a weekly news­pa­per for physi­cians pub­lished by the Amer­i­can Med­ical Asso­ci­a­tion, just pub­lished an excel­lent arti­cle along those lines:

Steps to a nim­ble mind: Phys­i­cal and men­tal exer­cise help keep the brain fit
– Neu­ro­science is uncov­er­ing tech­niques to pre­vent cog­ni­tive decline.

A few quotes:

- It’s an exam­ple that high­lights a wave of new think­ing about the impor­tance of brain fitness.

- Until recently, con­ven­tional wis­dom held that our brains were intractable, hard-wired com­put­ers. What we were born with was all we got. Age wore down mem­ory and the abil­ity to under­stand, and few inter­ven­tions could reverse this process. But increas­ingly, evi­dence sug­gests that phys­i­cal and men­tal exer­cise can alter spe­cific brain regions, mak­ing rad­i­cal improve­ments in cog­ni­tive function.

- With nearly 72 mil­lion Amer­i­cans turn­ing 65 over the next two decades, physi­cians need the tools to han­dle grow­ing patient con­cerns about how to best main­tain brain health. Armed with this new brand of sci­ence, front­line physi­cians will be bet­ter equipped to address the needs of aging baby boomers, already in the throes of the brain fit­ness revolution.

- “Encour­age them to exer­cise the brain in novel and com­plex ways,” he says.

Full arti­cle: here

One of the physi­cians quoted in the arti­cle is Gary J. Kennedy, MD, Direc­tor of the Divi­sion of Geri­atric Psy­chi­a­try at Mon­te­fiore Med­ical Cen­ter in NYC and a pro­fes­sor in the Dept. of Psy­chi­a­try and Behav­ioral Sci­ences at Albert Ein­stein Col­lege of Medicine.

To put the AMA arti­cle in bet­ter per­spec­tive for Sharp­Brains read­ers, we asked Dr. Kennedy a few follow-up ques­tions. Below you have his questions.

Alvaro Fer­nan­dez (AF): Can you sum­ma­rize how cog­ni­tive func­tions tend to evolve as we age?

Gary Kennedy (GK): As we age cog­ni­tive func­tions that rely on Read the rest of this entry »

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