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The Business and Ethics of the Brain Fitness Boom – Part 4: The Future

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.

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?

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.


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

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:

Credit for pic: BigStockPhoto.

Read previous articles here:


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. 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.” 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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