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Preparing Society for the Cognitive Age (Frontiers in Neuroscience article)

Frontiers in Neuroscience Augmenting Cognition(Edi­tor’s note: this arti­cle belongs to the excel­lent May 2009 spe­cial issue on Aug­ment­ing Cog­ni­tion at sci­en­tif­ic jour­nal Fron­tiers in Neu­ro­science. The 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 (, 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.

Sharp­Brains offers a range of pub­li­ca­tions to under­stand emerg­ing cog­ni­tive health research, tech­nol­o­gy and trends, and pre­pare for them:

- Book: The Sharp­Brains Guide to Brain Fit­ness

- Indus­try reports:

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As seen in The New York Times, The Wall Street Journal, BBC News, CNN, Reuters,  SharpBrains is an independent market research firm tracking how brain science can improve our health and our lives.

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