Expect more and better tools to assess and improve cognitive functions

Assess­ment of cog­ni­tive functions

Bet­ter and more wide­ly avail­able assess­ments of cog­ni­tive func­tion will serve as objec­tive base­lines to mea­sure the impact of cog­ni­tive train­ing inter­ven­tions. There will also like­ly be bet­ter diag­nos­tic tests to iden­ti­fy ear­ly symp­toms of dementia.  Reli­able diag­nos­tic assess­ments of cog­ni­tive abil­i­ties will help move this field for­ward just as jump­ing on a scale is help­ful in telling you if your phys­i­cal fit­ness and diet pro­gram is working.

It may sound like sci­ence-fic­tion but seri­ous ini­tia­tives are under­way. Dr. Arthur Kramer explains how The Nation­al Insti­tute of Health is prepar­ing an “NIH Tool­box”. This tool­box aims at pro­vid­ing reli­able instru­ments that researchers and clin­i­cians could all use, instead of using many dif­fer­ent, non-com­pa­ra­ble, mea­sures. This ini­tia­tive was launched in 2006 and is a five years effort.

Com­put­er-based tools to improve clin­i­cal conditions

Bet­ter com­put­er-based tools to improve clin­i­cal con­di­tions will appear. The grow­ing pipeline of research stud­ies will enable the mar­ket lead­ers and new entrants to refine exist­ing tools and devise new ones. More clin­i­cal stud­ies will show the ben­e­fits of brain fit­ness pro­grams to address spe­cif­ic clin­i­cal con­di­tions and learn­ing disabilities.

Dr. Jer­ri Edwards points out that although more research is need­ed to deliv­er tai­lored inter­ven­tions, cog­ni­tive train­ing may become increas­ing­ly use­ful for a vari­ety of health con­di­tions, such as Parkinson’s dis­ease and Alzheimer’s type demen­tia (see Dr. Edwards’ inter­view at the end of Chap­ter 5).

Some of the ongo­ing stud­ies are in the fol­low­ing areas:

• Schiz­o­phre­nia: Dr. Sophia Vino­gradov from the Uni­ver­si­ty of Cal­i­for­nia at San Fran­cis­co was award­ed a $1.1 mil­lion grant from Nation­al Insti­tute of Men­tal Health in 2005 (unpub­lished results as of Feb­ru­ary 2008). The aim of the study is to inves­ti­gate the effi­ca­cy of com­put­er­ized cog­ni­tive train­ing exer­cis­es on the reme­di­a­tion of cog­ni­tive deficits asso­ci­at­ed with schiz­o­phre­nia. Par­tic­i­pants are assigned ran­dom­ly to receive treat­ment with either com­put­er­ized cog­ni­tive train­ing or com­mer­cial­ly avail­able com­put­er games.
• Alzheimer’s Dis­ease: An ongo­ing NIH study led by Dr. Joel Kramer and Kris­tine Yaffe of Uni­ver­si­ty of Cal­i­for­nia at San Fran­cis­co aims at eval­u­at­ing the effects of a com­put­er-based train­ing pro­gram (“HiFi-AD”) on the mem­o­ry and cog­ni­tive abil­i­ties of indi­vid­u­als diag­nosed with mild Alzheimer’s Type Dementia.
• Autism: Teach­Town is a com­put­er-assist­ed instruc­tion pro­gram that uti­lizes prac­tices such as ABA to teach a vari­ety of skills to chil­dren with autism. Promis­ing pre­lim­i­nary results pub­lished in 2006 by Waren and her col­leagues showed that the use of the soft­ware suc­cess­ful­ly enhanced social com­mu­ni­ca­tion and decrease inap­pro­pri­ate behav­iors. The same team is cur­rent­ly con­duct­ing research fund­ed by the U.S. Depart­ment of Education.
• Can­cer: Chemother­a­py for can­cer is asso­ci­at­ed with a num­ber of neg­a­tive side effects. One of these side effects is a deficit in cog­ni­tive func­tion, a con­di­tion com­mon­ly referred to as “chemo­brain”. Cog­ni­tive decline is often report­ed to affect mem­o­ry, atten­tion, exec­u­tive func­tions and pro­cess­ing speed. Posit Sci­ence and Lumos­i­ty are being used in sep­a­rate ongo­ing NIH tri­als to eval­u­ate whether cog­ni­tive train­ing can accel­er­ate the reha­bil­i­ta­tion need­ed to address the cog­ni­tive effects of chemotherapy.

Low-tech options

Low tech options will play an increas­ing role in the brain fit­ness field. Already, increas­ing research is show­ing the cog­ni­tive val­ue and brain plas­tic­i­ty impact of inter­ven­tions such as med­i­ta­tion and cog­ni­tive ther­a­py (see Chap­ter 3). More research and wider appli­ca­tions will help refine our under­stand­ing of when and how they can be most helpful.

The future years will see a great increase in the num­ber of old­er adults. The con­se­quent cog­ni­tive declines pre­sent­ed by patients in sev­er­al med­ical insti­tu­tions may over­whelm the health­care sys­tem. It will be impor­tant for health prac­ti­tion­ers to keep cur­rent on the dif­fer­ent tech­niques avail­able to deal with cog­ni­tive decline. High-tech, com­put­er­ized, tech­niques may not always be the answer. Low-tech, more acces­si­ble, solu­tions may be of great util­i­ty to pro­fes­sion­als like nurs­es who inter­act dai­ly with old­er adults (see the arti­cle by Vance and col­leagues pub­lished in 2008 in The Jour­nal of Neu­ro­science Nursing)

The school sys­tem will play a role in the devel­op­ment of low-tech meth­ods of brain train­ing. As Dr. James Zull explains, “If I had to select one men­tal mus­cle that stu­dents should real­ly exer­cise and grow dur­ing their school years, I would say they need to build their “learn­ing mus­cle” – to learn how to learn” (see Dr. Zull’s inter­view in Chap­ter 1).

Keep learn­ing by read­ing more arti­cles in the Resources sec­tion, and also please con­sid­er join­ing our free month­ly Brain Fit­ness eNewsletter

This new online resource is based on the con­tent from the book The Sharp­Brains Guide to Brain Fit­ness (May 2009, $19.95), by Alvaro Fer­nan­dez and Dr. Elkhonon Goldberg.