Veteran-Affairs

How to mea­sure and improve brain-based out­comes that mat­ter in health care

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Pio­neers advanc­ing health research, pre­ven­tion and treat­ment helped us under­stand emerg­ing best prac­tices where [Read more…] about How to mea­sure and improve brain-based out­comes that mat­ter in health care

Ten Reflections on Cognitive Health and Assessments

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Let me sum­ma­rize ten high­lights and reflec­tions from stim­u­lat­ing dis­cus­sions on cog­ni­tive health and assess­ments I have had this month so far.

Jan­u­ary 8–9th: Sym­po­sium on Co-Adap­tive Learn­ing: Adap­tive Tech­nol­o­gy for the Aging (details Here), orga­nized by the Ari­zona State Uni­ver­si­ty’s Cen­ter for Adap­tive Neur­al Systems:

1. Cog­ni­tive health is a crit­i­cal fac­tor in over­all health­care, but is often approached in a frag­ment­ed, non-sys­tem­at­ic way. Most speak­ers in the sym­po­sium did men­tion how cog­ni­tive health issues inter­act with their spe­cif­ic areas of focus (aging, Parkin­son’s Dis­ease, trau­mat­ic brain injury, Alzheimer’s…) but there was a lack of a com­mon frame­work and tax­on­o­my to define the prob­lem and iden­ti­fy solu­tions and inter­ven­tions to mea­sure and help main­tain cog­ni­tive health across the lifespan.

2. For exam­ple, Parkin­son’s Dis­ease. Did you know (I did­n’t) that a sig­nif­i­cant per­cent­age of Parkin­son’s patients have well-iden­ti­fied cog­ni­tive impair­ments, most­ly in their exec­u­tive func­tions but also per­cep­tu­al problems?

3. We tru­ly need a Cul­ture of Cog­ni­tive Health, as Ran­dal Koene point­ed out.

4. May online cog­ni­tive games serve as ongo­ing, real-time assess­ment of cog­ni­tive func­tion? Misha Pavel thought so. He also added we may well see “cog­ni­tive exer­cise coach­es” some­time in the horizon.

5. Skip Riz­zo pre­sent­ed how vir­tu­al real­i­ty can help address Post Trau­mat­ic Stress Dis­or­der (PTSD) and even to admin­is­ter inno­v­a­tive cog­ni­tive assessments.

6. My pre­sen­ta­tion, titled The Emerg­ing Cog­ni­tive Fit­ness Mar­ket: Sta­tus, Trends and Chal­lenges, is avail­able Here

7. Jan­u­ary 22nd: Con­sumer Reports orga­nized a health sum­mit titled [Read more…] about Ten Reflec­tions on Cog­ni­tive Health and Assessments

Brain Training: No Magic Bullet, Yet Useful Tool. Interview with Elizabeth Zelinski

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Sharon Beg­ley, Newsweek’s sci­ence reporter, recent­ly wrote that

- “With the nation’s 78 mil­lion baby boomers approach­ing the age of those dread­ed ‘“where did I leave my keys?” moments, it’s no won­der the mar­ket for com­put­er-based brain train­ing has shot up from essen­tial­ly zero in 2005 to $80 mil­lion this year, accord­ing to the con­sult­ing firm SharpBrains.

- “Now comes the largest and most rig­or­ous study of a com­mer­cial­ly-avail­able train­ing pro­gram, and it shows that there is hope for aging brains. This morn­ing, at the meet­ing of the Geron­to­log­i­cal Soci­ety of Amer­i­ca, sci­en­tists are pre­sent­ing data show­ing that after eight weeks of dai­ly one-hour ses­sions with Brain Fit­ness 2.0 from Posit Sci­ence, elder­ly vol­un­teers got mea­sur­ably bet­ter in their brain’s speed and accu­ra­cy of processElizabeth Zelinski IMPACTing.

We recent­ly had the chance to inter­view Dr. Eliz­a­beth Zelin­s­ki of the Uni­ver­si­ty of South­ern Cal­i­for­nia Andrus Geron­tol­ogy Cen­ter, who led the IMPACT (Improve­ment in Mem­o­ry with Plas­tic­i­ty-based Adap­tive Cog­ni­tive Train­ing) Study Sharon Beg­ley refers to in the quote above.

First, some con­text on this study, which is by far the largest high-qual­i­ty study of its kind. The study was prospec­tive, ran­dom­ized, con­trolled, and used a dou­ble blind tri­al. 524 healthy adults 65-year-old and over were divid­ed into two groups. One received an hour a day of train­ing for eight to ten weeks, and the oth­er spent the same amount of time watch­ing edu­ca­tion­al DVDs. The IMPACT study, fund­ed by Posit Sci­ence cor­po­ra­tion, was per­formed in mul­ti­ple loca­tions, includ­ing the Mayo Clin­ic, USCF, and San Fran­cis­co Vet­er­an Affairs Med­ical Center.

The dis­cus­sion cen­ters at his point on the ini­tial results that were pre­sent­ed Geron­to­log­i­cal Soci­ety of Amer­i­ca (the study has­n’t been pub­lished yet).

Alvaro Fer­nan­dez: Dr. Zelin­s­ki. Thank you for being with us. Could you start by set­ting the con­text and pro­vid­ing an overview of how human cog­ni­tive abil­i­ties typ­i­cal­ly evolve as we age based on insights from your Long Beach Lon­gi­tu­di­nal Study?

Eliz­a­beth Zelin­s­ki: Of course. The first con­cept to under­stand is that dif­fer­ent cog­ni­tive skills evolve over the lifes­pan in dif­fer­ent ways. Some that rely on expe­ri­ence, such as vocab­u­lary, actu­al­ly improve as we age. Some tend to decline grad­u­al­ly, start­ing in our late 20s. This hap­pens, for exam­ple, with pro­cess­ing speed (how long it takes us to process and respond to infor­ma­tion), mem­o­ry, and rea­son­ing. We could sum­ma­rize this phe­nom­e­non by say­ing that as we age we get bet­ter at deal­ing with the famil­iar, but worse at deal­ing with the new. We can always learn, but at a slow­er pace.

Are there any spe­cif­ic tip­ping or inflec­tion points in this trend, any age when the rate of decline is more pronounced? 

We don’t have a clear answer to that. It depends a lot on the indi­vid­ual. In gen­er­al it is a grad­ual, cumu­la­tive process, so that by age 70 we sta­tis­ti­cal­ly see clear age declines. Which, for exam­ple, is a strong fac­tor deter­min­ing why old­er adults strug­gle to adapt to new tech­nolo­gies, but why try­ing to learn them pro­vides need­ed men­tal stim­u­la­tion. Now we know that genes only account for a por­tion of this decline. Much of it depends on our envi­ron­ment, lifestyle and actions.

Can you sum­ma­rize what a healthy indi­vid­ual can do to slow down this process of decline, and help stay healthy and pro­duc­tive as long as possible?

One gen­er­al rec­om­men­da­tion is to do every­thing we can to pre­vent or delay dis­ease process­es, such as dia­betes or high-blood pres­sure, that have a neg­a­tive effect on our brains. For exam­ple, it is a tragedy in our soci­ety that we usu­al­ly reduce our lev­els of phys­i­cal exer­cise dras­ti­cal­ly after we leave school.

Let me then ask: what are the rel­a­tive virtues of phys­i­cal vs. men­tal exercise? 

Great ques­tion! That in fact leads into my sec­ond rec­om­men­da­tion. Aer­o­bic exer­cise has been shown to [Read more…] about Brain Train­ing: No Mag­ic Bul­let, Yet Use­ful Tool. Inter­view with Eliz­a­beth Zelinski