Transcript: Alvaro Fernandez on Brain Health and Non-invasive Cognitive Enhancement

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Below you can find the full tran­script of our engag­ing Q&A ses­sion yes­ter­day on life­long cog­ni­tive fit­ness, “men­tal cap­i­tal­ism”, and more,  with Alvaro Fer­nan­dez, co-author of The Sharp­Brains Guide to Brain Fit­ness, mod­er­at­ed by Har­ry Moody, Direc­tor of Aca­d­e­m­ic Affairs at AARP.

Full Tran­script of Live Q&A held on Novem­ber 15th, 2–3pm ET

2:12
Com­ment From Rick Moody
Wel­come to every­one from Rick Moody at AARP

2:13
AlvaroF: Please ask your questions!

2:13
AlvaroF: Rick and I will mod­er­ate them.

2:13
AlvaroF: We had a fun ses­sion with Dr. Gary Small last time, and look for­ward to anoth­er good ses­sion today.

2:14
Com­ment From Steve
What are the prod­ucts that you have reviewed, and what are their differences?

2:14
AlvaroF: Good ques­tion, but we need to start before prod­ucts. The ques­tion is, what type of inter­ven­tions pro­duce what kind of results?

2:15
AlvaroF: We also track lifestyle options such as aer­o­bic exer­cise, non-prod­ucts such as med­i­ta­tion and cog­ni­tive ther­a­py, tech­nolo­gies such as biofeedback.

2:16
AlvaroF: So, the start­ing point we dis­cuss in The Sharp­Brains Guide to Brain Fit­ness, is that every­one needs to under­stand how our brains work and what and why we need to enhance. Only then we can make informed deci­sions about what prod­uct, if any, makes sense.

(Edi­tor’s Note: Alvaro did­n’t have time to answer the ques­tion of what spe­cif­ic prod­ucts were ana­lyzed. The answer is: twen­ty one prod­ucts devel­oped by Nin­ten­do, Learn­ing Enhance­ment Cor­po­ra­tion, Viv­i­ty Labs, Sci­en­tif­ic Brain Train­ing, Lumos Labs, Cog­niFit, Dakim, Posit Sci­ence, Cogmed, Houghton Mif­flin, Sci­en­tif­ic Learn­ing, Applied Cog­ni­tive Engi­neer­ing, NovaV­i­sion, Heart­Math, Wild Divine, Inter­Cure, Helicor.)

2:17
Com­ment From Rick Moody
There will be no sound; this is text-only interchange.

2:17
Com­ment From Rick Moody
I think this ques­tion is the big one, the one from con­sumers. It’s of great impor­tance to us at AARP: how to give guid­ance to consumers?

2:18
AlvaroF: key is to engage and inter­est con­sumers in the fact that we all have brains and cog­ni­tions that deserve our atten­tion. How to enhance then, how to main­tain them…in the same way we take care of our bod­ies and even of our cars.

2:18
AlvaroF: Brain main­te­nance, anyone?

2:19
AlvaroF: Then, once con­sumers and engaged, they need to learn about what is pos­si­ble and what not, and what tools are becom­ing avail­able and how to best use them.

2:20
AlvaroF: The field is not about “mag­ic pills” or gen­er­al solu­tions, but options in our men­tal fit­ness toolkit.

2:20
AlvaroF: Inter­ven­tions and prod­ucts can “work” but we need to have real­is­tic expec­ta­tions about what “works” means

2:20
Com­ment From Peter Whitehouse
Please address the issue of gen­er­al­iz­abil­i­ty of improve­ments from “pro­grams” into dai­ly life.

2:21
AlvaroF: Great ques­tion, Peter. The ulti­mate objec­tive in my view is not to gen­er­al­ize but to trans­fer to real life outcomes.

2:22
AlvaroF: That’s why the ques­tions needs to be, what life out­comes do I need to improve on, and then work back­wards to fig­ure out what intervention/s may make more sense.

2:22
Com­ment From Nas­rin Lakhani
Are there any stud­ies on brain func­tion improve­ment with biofeed­back intervention

2:23
AlvaroF: Let me link this to Peter’s pre­vi­ous question

2:23
AlvaroF: Biofeed­back-based train­ing may not “gen­er­al­ize” to over­all intel­li­gence, but cer­tain­ly it can help to learn how to rec­og­nize and reg­u­late stress and emo­tions bet­ter, which is a crit­i­cal out­come in itself.

2:25
AlvaroF: We men­tion one prod­uct in the book, Res­per­ate, which is basi­cal­ly a biofeed­back-based tool to low­er blood pres­sure via self-reg­u­la­tion. Iit is FDA ‑approved, which is very inter­est­ing in itself

2:25
Com­ment From Kate
How soon should we start try­ing to main­tain our brain health, and is it ever too late to try?

2:25
AlvaroF: Nev­er too ear­ly, and nev­er too late

2:26
AlvaroF: The UK gov­ern­ment run a major research project a few years ago and main take-away was that every­one should invest in their own Men­tal Cap­i­tal as ear­ly as possible

2:27
AlvaroF: because the objec­tive here is not only the delay of disease/ prob­lems, but the enhance­ment of our well­ness and pro­duc­tiv­i­ty as citizens

2:27
AlvaroF: Now, dif­fer­ent age groups will of course have dif­fer­ent priorities.

2:28
AlvaroF: Edu­ca­tion­al, work­force, dri­ving safe­ty, health-related…what we are talk­ing about is a new frame­work and toolk­it to enhance tar­get­ed capac­i­ties through life

2:28
Com­ment From Peter Whitehouse
We need to be care­full about what we mean by FDA approved for devices. It may not mean much evi­dence about efficacy.

2:28
AlvaroF: Good point. They did show good effi­ca­cy too

2:28
Com­ment From Peter Whitehouse
We need a new form of men­tal cap­i­tal­ism I guess.

2:29
AlvaroF: We are all men­tal capitalists 🙂

2:29
Com­ment From Rick Moody
Here’s anoth­er thought. Can we begin to iden­ti­fy the typ­i­cal pit­falls and mis­takes that con­sumers make when they approach brain fit­ness prod­ucts? No, I don’t want to pub­lish a “sil­ver fleece” list of boon­dogles or iden­ti­fy any spe­cif­ic prod­ucts for crit­i­cism, but I’d like to see some­one play a “Con­sumer Reports” role in this whole field.

2:29
AlvaroF: Have you heard of SharpBrains 🙂

2:30
AlvaroF: Main prob­lems: con­sumers buy what they don’t need, and don’t buy what they need

2:30
AlvaroF: But we’re not even talk­ing “brain fit­ness”, we’re talk­ing sup­ple­ments, books, class­es, tapes…

2:31
AlvaroF: Infor­ma­tion is pow­er, and I think most peo­ple, not all, would ben­e­fit from first of all under­stand­ing the basics of cog­ni­tion, and sec­ond what are some key pil­lars to enhance cog­ni­tion, and third how can we use spe­cif­ic tools for spe­cif­ic purposes.

2:32
AlvaroF: Let me pro­vide an example

2:32
AlvaroF: One key ingre­di­ent for good men­tal exer­cise is: Challenge

2:33
AlvaroF: It prob­a­bly makes lit­tle sense for young minds to play more videogames, and old­er minds to play more cross­word puzzles.

2:33
AlvaroF: The lev­el of Chal­lenge would be very lim­it­ed, because they’re already very famil­iar with those.

2:34
AlvaroF: But what if kids start doing cross­word puz­zles and old­er adults mas­ter new videogames?

2:34
Com­ment From Peter Whitehouse
How about schools and uni­ver­si­ties etc.? They seem to be in the brain health business.

2:35
AlvaroF: Could­n’t agree more! it is clear that edu­ca­tion lev­el is one of the main ingre­di­ents in build­ing a pro­tec­tive cog­ni­tive reserve

2:36
AlvaroF: Now, what they could be doing bet­ter to be full “brain health” providers would be to incor­po­rate oth­er aspects and tools, and even­tu­al­ly even assess­ments to pin­point an indi­vi­did­u­al’s needs and best course of action.

2:36
Com­ment From Peter Whitehouse
OK I will chal­lenge you! Knowl­edge and bet­ter yet wis­dom is pow­er. Undi­gest­ed and biased infor­ma­tion and data can be disempowering.

2:36
AlvaroF: Agreed, the Inter­net and media today are huge sources of confusion…not of information

2:37
AlvaroF: Which is why at Sharp­Brains we try to 1) curate resources, 2) edu­cate read­ers, so they become WISE builders of knowledge

2:37
Com­ment From Anna G.
Aren’t there ways of increas­ing brain health that are not prod­ucts (i.e., fit­ness, self learn­ing, nutri­tion, etc.) that are just as effective?

2:38
AlvaroF: Yes, we jumped into the prod­uct dis­cus­sion too ear­ly. In the book we start with a much more com­pre­hen­sive dis­cus­sion of main lifestyle fac­tors, and of “non-prod­uct” brain train­ing tech­niques such as med­i­ta­tion. Now, prod­ucts also play a role.

2:39
AlvaroF: And a key take-away is that most inter­ven­tions do NOT sub­sti­tute each oth­er, but they AUGMENT each other.

2:39
Com­ment From Peter Whitehouse
Right so with Sharp­Brains start eval­u­at­ing these kind of inter­ven­tions. Where do we spend out mon­ey indi­vid­u­al­ly and social­ly for best value?

2:40
AlvaroF: BIG question.…as an over­all theme I’d say, Spend more time and mon­ey on non-inva­sive inter­ven­tions that build capacity.

2:41
AlvaroF: The start­ing point in all this is that day after day we see how mal­leable core men­tal abil­i­ties such as atten­tion, work­ing mem­o­ry, self-reg­u­la­tion, processing…are. So, let’s all be men­tal cap­i­tal­ists by invest­ing in our capacities

2:42
AlvaroF: This frame­work is dif­fer­ent, but com­ple­ments, the stan­dard med­ical mod­el based on diseases.

2:42
Com­ment From Anand Deoskar
I think a real­ly inter­est­ing ques­tion is — what stim­u­lates indi­vid­u­als to think? What is the key moti­vat­ing fac­tor for each indi­vid­ual to apply their brains — to speak up, to chal­lenge themselves.

2:43
AlvaroF: Great ques­tion. Last year Mar­i­an Dia­mond opened our annu­al vir­tu­al con­fer­ence. After the con­fer­ence we had lunch and I asked her, what do you think is the most impor­tant per­son­al char­ac­ter­is­tic you’d like every­one to have?

2:44
AlvaroF: Her answer: curiosity

2:44
AlvaroF: Curios­i­ty will dri­ve us to learn, and mas­ter new real­i­ties, and think­ing come handy then.

2:45
Com­ment From Rick Moody
Anand Deoskar’s com­ment points us in the direc­tion of gen­uine edu­ca­tion and human devel­op­ment, which is not what the brain fit­ness indus­try has pri­mar­i­ly been about.

2:45
AlvaroF: The prob­lem with the “brain fit­ness indus­try” is that is gets asso­ci­at­ed with the PBS programs

2:46
AlvaroF: Sharp­Brains and many many many peo­ple in our net­work care about human devel­op­ment, but we so far have had lit­tle voice in the main­stream media.

2:47
AlvaroF: Hav­ing said that, we also see the val­ue in new tools when used well, which many peo­ple in “human devel­op­ment” don’t seem to. We’re above all prag­mat­ic and outcome-oriented

2:47
Com­ment From Nas­rin Lakhani
How would you fin­ish the phrase “Invest­ing in our men­tal capac­i­ties causes/enables.….….…”

2:48
AlvaroF: …enhanced well­ness, con­trol of one’s des­tinies, and longer pro­duc­tive lives. It also helps pro­tect against decline by delay­ing it (not pre­vent­ing it)

2:49
Com­ment From Guest
Alvaro, Have you had any com­mu­ni­ca­tion with insur­ance com­pa­nies to see if they intend to pay well­ness dol­lars for peo­ple to take brain health and well­ness cours­es? They fre­quent­ly pay for gym mem­ber­ships for phys­i­cal fit­ness — are they get­ting active in men­tal fitness?

2:49
AlvaroF: Yes, and no. Insur­ance com­pa­nies now see this main­ly as a mar­ket­ing oppor­tu­ni­ty — if more con­sumers show they care about this, the insur­ers will follow.

2:51
AlvaroF: A few of them are doing their own tri­als to see if they’d like to offer prod­ucts for free or reim­burse them, but it is still in the very ear­ly stages. The key is that con­sumers keep dri­ving inter­est ‑oth­er­wise, insur­ers say they have a tril­lion oth­er impor­tant things to do.

2:52
AlvaroF: The same goes for pay­ers and providers: con­sumer inter­est can moti­vate them to take action, and that would help enhance the ratio­nal­i­ty and matu­ri­ty of the field

2:52
Com­ment From Ger­ard Finnemore
Anoth­er issue is that the med­ical pro­fes­sion (often in the role of gate­keep­ers) tend to be skep­ti­cal about cog­ni­tive training/enhancement. Usu­al­ly, this is due to ignorance

2:53
AlvaroF: Well, yes and no. Sure, there’s much igno­rance about cog­ni­tion (please ask your doc­tor to define what “work­ing mem­o­ry” is), but also they play an impor­tant role to pro­tect from the usu­al non­sense con­sumers are exposed to.

2:55
Com­ment From Rick Moody
I know we have only a few min­utes left. This is one step in a long jour­ney. Alvaro and I co-host a Brain Fit­ness Lunch Group at AARP in Wash­ing­ton, and we hope to con­tin­ue these con­ver­sa­tions both in per­son and on-line.

2:55
Com­ment From Alan
How does one know the best invest­ment strat­e­gy to opti­mize indi­vid­ual capac­i­ties across the entire range of human abil­i­ties? Is there a most gen­er­al approach, and if not, how does one indi­vid­u­al­ize the investment?

2:57
AlvaroF: For peo­ple with $15 to spare, I’d say read The Sharp­Brains Guide to Brain Fit­ness and see what spe­cif­ic next step makes sense for you giv­en the infor­ma­tion dis­cussed there. For those with­out, I’d say inte­grate ele­ments of Nov­el­ty, Vari­ety and Chal­lenge in one’s lives and careers, in what­ev­er form or shape that may be possible.

2:58
Com­ment From Rick Moody
Anoth­er fac­tor is is the promi­nent case of the NIH “jury” of experts which con­clud­ed that “noth­ing works” in terms of pre­vent­ing Alzheimer’s (last year, I think, but maybe I don’t remem­ber so well.…)

3:00
AlvaroF: That is true, but the same review found that there are things we can do to low­er risk of cog­ni­tive decline, which is anoth­er impor­tant out­come. What that NIH pan­el was­n’t set up to answer was most of the dis­cus­sion we had above: what can we do today to enhance our cognitive/ emotional/ exec­u­tive capac­i­ties today and tomor­row? it is a dif­fer­ent question.

3:01
Com­ment From Rick Moody
Good­bye to all

3:01
AlvaroF: Thank you for a fun con­ver­sa­tion. Fyi, we’ll pub­lish the tran­script via sharpbrains.com by the end of the day. And remem­ber we’ll have Paul Nuss­baum next Tuesday!

3:01
AlvaroF: Bye Rick and every­one else

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