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.Â 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of California at San Francisco was awarded a $1.1 million grant from National Institute of Mental Health in 2005 (unpublished results as of February 2008).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 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).
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.