Solving the Brain Fitness Puzzle Is the Key to Self-Empowered Aging

What works to preserve cognitive abilities? Much like the human brain, the answer is complicated, individual and nuanced.

As the con­cept of brain fit­ness (or, the brain’s abil­i­ty to func­tion effi­cient­ly and effec­tive­ly in per­son­al and pro­fes­sion­al life) goes main­stream, the pro­lif­er­a­tion of sci­en­tif­ic find­ings, media reports, and com­mer­cial claims is gen­er­at­ing much noise and con­fu­sion. Know­ing what to believe and what to do presents a real-life puz­zle, lead­ing many peo­ple to either inac­tion or toward a focus on the wrong priorities.

This past Octo­ber, six­ty-nine sci­en­tists, con­vened by the Stan­ford Cen­ter on Longevi­ty, released an announce­ment stat­ing that there is a sci­en­tif­ic con­sen­sus that brain train­ing does not work (Allaire et al., 2014). By Decem­ber, 127 sci­en­tists world­wide had signed anoth­er state­ment, chal­leng­ing the pre­vi­ous “con­sen­sus” and sup­port­ing the val­ue of brain train­ing (Alescio-Lau­ti­er et al., 2014).

The prob­lem here is not see­ing the for­est for the trees. Eighty-three per­cent of more than 3,000 ear­ly adopters sur­veyed by the inde­pen­dent mar­ket research firm Sharp­Brains (which I co-found­ed) agreed that “adults of all ages should take charge of their own brain fit­ness, with­out wait­ing for their doc­tors to tell them to” (Fer­nan­dez et al., 2013). When we con­duct­ed in-depth focus groups and inter­views with respon­dents, the main ques­tion many had was not what has per­fect sci­ence behind, but what has bet­ter sci­ence than the oth­er things peo­ple are doing—solving cross­word puz­zle num­ber one mil­lion and one, tak­ing ‘brain sup­ple­ments,’ or doing noth­ing at all until depres­sion or demen­tia hits home.

And the unequiv­o­cal answer to that ques­tion, based upon the most author­i­ta­tive sys­tem­at­ic reviews of the evi­dence con­duct­ed to date (The Gov­ern­ment Office for Sci­ence, 2008; AHRQ, 2010), is a resound­ing yes—one thing does work bet­ter than most com­mon alter­na­tives. The chal­lenge is that “thing” is dif­fer­ent for everyone.

Giv­en that more than 50 per­cent of old­er adults in a recent sur­vey expressed a strong will­ing­ness to spend mon­ey on tools or resources to main­tain or improve brain health (David and Gelfeld, 2014), how do we guide them in the right direc­tion? Fur­ther, how can we empow­er every­one to make deci­sions that are more like­ly to help with nav­i­gat­ing the avail­able sci­en­tif­ic evi­dence and apply­ing it in the way most rel­e­vant to a person’s cir­cum­stances and objectives?

First, we need to edu­cate the pub­lic on a fuller, more nuanced approach that empha­sizes a glob­al view of brain fit­ness, one that is not restrict­ed to the pre­ven­tion or treat­ment of demen­tia, but encom­pass­es the life­long tra­jec­to­ry of one’s brain health and performance.

We May Not Stop Demen­tia, But We Can Pro­long Function

Notice the oppor­tu­ni­ty pre­sent­ed in Fig­ure 1 below. If we can help more people’s brain per­for­mance advance through life fol­low­ing the tra­jec­to­ry of the line on top, we would help mil­lions to improve their qual­i­ty of life and their pro­duc­tiv­i­ty for years more and, at the same time, delay future mor­bid­i­ty, poten­tial­ly halv­ing the preva­lence of Alzheimer’s Disease.

Noth­ing has been shown to pre­vent dementia’s pathol­o­gy, but there are evi­dence-based ways to improve and pro­long brain func­tion­al­i­ty, and to reduce the prob­a­bil­i­ty of man­i­fest­ing disease—a very hope­ful mes­sage that often gets for­got­ten in the eter­nal search for the next “mag­ic pill.”

To cap­ture the oppor­tu­ni­ty, we need to mas­ter a new toolk­it of inter­ven­tions and assess­ments, com­bin­ing lifestyle options and tech­nolo­gies as appro­pri­ate (Fer­nan­dez, Gold­berg, and Mich­e­lon, 2013). Through our inde­pen­dent and com­pre­hen­sive analy­sis of hun­dreds of ran­dom­ized clin­i­cal tri­als and dozens of meta-analy­ses, con­duct­ed as prepa­ra­tion for the book The Sharp­Brains Guide to Brain Fit­ness: How to Opti­mize Brain Health and Per­for­mance at Any Age (Fer­nan­dez, Gold­berg, and Mich­e­lon, 2013), we found mul­ti­ple evi­dence-based ways to pro­mote and pro­tect a range of brain func­tions: aer­o­bic exer­cise, learn­ing a new lan­guage, mas­ter­ing med­i­ta­tion, rotat­ing through com­plex pro­fes­sion­al assign­ments, fol­low­ing the prop­er nutri­tion, vol­un­teer­ing, cog­ni­tive train­ing, biofeed­back and more.

Giv­en space con­straints, we can­not go into the spe­cif­ic guide­lines for each of the pieces in the “brain fit­ness jig­saw puz­zle” pre­sent­ed in Fig­ure 2, but the often over­looked main find­ing is that based on best avail­able evi­dence, no shoe fits all: dif­fer­ent inter­ven­tions work best for spe­cif­ic pur­pos­es and for spe­cif­ic populations.

Cross-training our brains

Brain fit­ness should begin with a basic under­stand­ing of how the brain works, fol­lowed by the pil­lars of a healthy lifestyle: bal­anced nutri­tion, aer­o­bic exer­cise, stress man­age­ment, men­tal stim­u­la­tion, and social engagement.

Cross-train­ing our brains—exercising a wide range of cog­ni­tive, emo­tion­al, and exec­u­tive functions—can help us and build up tar­get­ed brain func­tions over time. Research-based method­olo­gies include med­i­ta­tion, refram­ing (cog­ni­tive ther­a­py), biofeed­back, and cog­ni­tive training.

Where I see most peo­ple fail­ing today is in how to pri­or­i­tize options—how to iden­ti­fy one’s weak points and find suit­able evi­dence-based solu­tions for action. Here are three sim­pli­fied vignettes, adapt­ed from The Sharp­Brains Guide to Brain Fit­ness (Fer­nan­dez, Gold­berg, and Mich­e­lon, 2013), that show how impor­tant it is to iden­ti­fy per­son­al pri­or­i­ties and, thus, the best tools, based upon an individual’s par­tic­u­lar start­ing point, needs, and goals.

Char­lotte is an accom­plished 58-year-old reporter. She has been watch­ing her diet for years. It is get­ting hard­er now, espe­cial­ly at work, for her to con­cen­trate and to process com­plex new infor­ma­tion, and she notices more mem­o­ry laps­es. Char­lotte feels high­ly stressed these days, try­ing to jug­gle her demand­ing job and act­ing as her par­ents’ pri­ma­ry care­giv­er. To cope with stress, she often spends evenings watch­ing TV for sev­er­al hours.

Poten­tial Solu­tion: Charlotte’s sched­ule does not allow for much time for her­self, and when she does find that time, she spends it watch­ing TV. Unreg­u­lat­ed stress may be a major fac­tor behind her cog­ni­tive dif­fi­cul­ties. She could start inte­grat­ing exer­cise and med­i­ta­tion into her sched­ule, maybe in the evenings, spend­ing a bit less time in front of the tele­vi­sion, or going to the gym twice a week dur­ing lunchtime or on the week­ends. Using HeartMath’s Inner Bal­ance Train­er (see resource box, below) could help her quick­ly mas­ter stress regulation.

Julián, a recent­ly retired 67-year-old finan­cial advi­sor, final­ly has the time to take care of him­self, and to swim often at the local com­mu­ni­ty cen­ter. Still, he miss­es the con­stant inter­ac­tion with clients and col­leagues in the office. He feels that his men­tal pow­er and speed are not what they used to be, so he is try­ing to “use it” by watch­ing doc­u­men­taries on TV and by rais­ing his dai­ly quo­ta of cross­word puz­zles and Sudoku.

Poten­tial Solu­tion: Julián is try­ing to remain cog­ni­tive­ly engaged, but not in ways that sup­ply nov­el­ty, vari­ety, and challenge—the ingre­di­ents of real men­tal exer­cise. His brain would be bet­ter served by vol­un­teer­ing, per­haps pro­vid­ing finan­cial plan­ning advice to low-income fam­i­lies for a non­prof­it orga­ni­za­tion. He could use reg­u­lar self-assess­ments such as Cog­nic­i­ti or Brain­Base­line (see resource box, below) to bet­ter mon­i­tor his mem­o­ry and cog­ni­tion over time and to inform con­ver­sa­tions with his doctor.

Kel­ly, age 75, has been retired for a while. She stopped exer­cis­ing when her mobil­i­ty and strength declined. Her hus­band passed away four years ago. Though she has sev­er­al good friends near­by, she is hes­i­tant to dri­ve to vis­it them. More and more, Kel­ly prefers to stay safe at home rather than risk tak­ing the car, and so at times she feels lone­ly. She loves read­ing nov­els, in Eng­lish as well as in her half-for­got­ten French.

Poten­tial Solu­tion: Kel­ly would ben­e­fit from resum­ing an appro­pri­ate exer­cise rou­tine, per­haps a rou­tine of light-to-medi­um exer­cise such as walk­ing reg­u­lar­ly and par­tic­i­pat­ing in chair yoga once a week. She could also join a book club, or bet­ter yet, find some con­tracts edit­ing col­lege essays or a relat­ed activ­i­ty that would tap into her love of books. Giv­en that her fear of dri­ving inhibits these oppor­tu­ni­ties, it would make sense for her to pri­or­i­tize safe-dri­ving class­es, and even use a cog­ni­tive train­ing pro­gram aimed at safe-dri­ving skills, such as brain­HQ, or Cog­niFit Senior Dri­ver (see resource box, below).

In sum­ma­ry, Char­lotte, Julián, Kel­ly, and mil­lions of oth­er adults would ben­e­fit from high-qual­i­ty infor­ma­tion and edu­ca­tion to help them to make effec­tive brain fit­ness deci­sions, to help them nav­i­gate all options—ones that would address their unique cir­cum­stances and goals.

No one shoe fits all. Why should we believe the reverse of that max­im to apply to some­thing as diverse and com­plex as the human brain?

 

–Alvaro Fer­nan­dez, M.A., M.B.A., is the co-founder and CEO of Sharp­Brains (www.sharpbrains.com), head­quar­tered in Wash­ing­ton, D.C. He can be con­tact­ed at afer­nan­dez at sharp­brains dot com.

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Resource Box: New Brain Fitness Tools

Brain­Base­line: A free mobile app fea­tur­ing dozens of cog­ni­tive tests that can be retak­en over time, and that facil­i­tate self-mon­i­tor­ing; www.brainbaseline.com/.

Brain­HQ: A Web-based cog­ni­tive train­ing pro­gram that includes Use­ful Field of View (UFOV) train­ing (UFOV is an impor­tant com­po­nent of safe dri­ving); www.brainhq.com/.

Cog­nic­i­ti: A free Web-based cog­ni­tive assess­ment designed to mea­sure whether the test taker’s cog­ni­tion is with­in a nor­mal range giv­en their age, or war­rants a vis­it to the doc­tor; www.cogniciti.com/.

Cog­niFit Senior Dri­ver: A Web-based cog­ni­tive train­ing pro­gram that assess­es and trains for ten dri­ving-relat­ed cog­ni­tive skills; https://lifestore.aol.com/category/online-learning/cognifit-senior-driver.

Heart­Math Inner Bal­ance: A mobile Heart Rate Vari­abil­i­ty (HRV) sen­sor designed to help mea­sure and reg­u­late phys­i­o­log­i­cal stress; www.heartmath.com/innerbalance/.

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References

Agency for Health­care Research and Qual­ity (AHRQ). 2010. Alzheimer’s Dis­ease and Cog­ni­tive Decline. Rockville, MD: AHRQ. www.ahrq.gov/clinic/tp/alzcogtp.htm. Retrieved Jan­u­ary 15, 2015.

Alescio-Lau­ti­er, B., et al., 2014. “Open Let­ter Response to ‘A Con­sen­sus on the Brain Train­ing Indus­try from the Sci­en­tif­ic Com­mu­ni­ty.’ ” www.cognitivetrainingdata.org/. Retrieved Jan­u­ary 15, 2015.

Allaire, J. C., et al., 2014. “A Con­sen­sus on the Brain Train­ing Indus­try from the Sci­en­tif­ic Com­mu­ni­ty.” Max Planck Insti­tute for Human Devel­op­ment and Stan­ford Cen­ter on Longevi­ty. http://longevity3.stanford.edu/blog/2014/10/15/the-consensus-on-the-brain-training-industry-from-the-scientific-community/. Retrieved Jan­u­ary 15, 2015.

David, P., and Gelfeld, V. 2014. 2014 Brain Health Research Study. Wash­ing­ton, DC: AARP. www.aarp.org/research/topics/health/info-2015/staying-sharper-study.html. Retrieved Jan­u­ary 15, 2015.

Fer­nan­dez, A., Gold­berg, E., and Mich­e­lon, P. 2013. The Sharp­Brains Guide to Brain Fit­ness: How to Opti­mize Brain Health and Per­for­mance at Any Age. Wash­ing­ton, DC: Sharp­Brains. http://mybook.to/brainfitness. Retrieved Jan­u­ary 15, 2015.

Fer­nan­dez, A., et al., 2013. The Dig­i­tal Brain Health Mar­ket 2012–2020: Web-based, Mobile and Bio­met­rics-based Tech­nol­ogy to Assess, Mon­i­tor and Enhance Cog­ni­tion and Brain Func­tion­ing. Wash­ing­ton, DC: Sharp­Brains. https://sharpbrains.com/market-report/. Retrieved Jan­u­ary 15, 2015.

The Gov­ern­ment Office for Sci­ence. 2008. Fore­sight Men­tal Cap­i­tal and Well­be­ing Project: Final Project Report. Lon­don, UK: The Gov­ern­ment Office for Sci­ence. https://www.gov.uk/government/publications/mental-capital-and-wellbeing-making-the-most-of-ourselves-in-the-21st-century. Retrieved Jan­u­ary 15, 2015.

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