A human brain showing fronto-temporal lobe degeneration, often associated with dementia
Dementia is a significant health burden of increasing significance as our population ages. Worldwide the prevalence of dementia is 5-7% in people 60 years and older, with risk doubling every 5 years after age 60. About 5.4 million Americans are living with dementia.
Dementia is a general category referring to a chronic decline in overall cognitive function. The most common cause of dementia is Alzheimer’s disease, accounting for about half of cases. There is also a category of mild cognitive impairment (or cognitive impairment not dementia) that is milder and does not meet the diagnostic criteria for full dementia.
There is some good news, however. A recent study published in JAMA finds that in the US the prevalence of dementia in those 65 and older declined between 2000 and 2012, from 11.6 to 8.8%. This is both statistically significant and clinically significant.
This also mirrors evidence from other countries also showing a decline in dementia prevalence over the last 20 years, including the UK, Denmark, and Sweden.
The big question, of course, is what is causing this decline? If we can determine the major factors then perhaps we could use that knowledge to further decrease dementia risk.
Lumosity is a company that provides online and mobile games that it claimed are scientifically designed to enhance memory, focus, mental flexibility, and even stave off dementia. In a recent decision, the Federal Trade Commission (FTC) concluded that Luminosity’s claims are not based on adequate scientific evidence. They imposed a $50 million judgement against Lumos Labs, the company who sells Lumosity, and allowed them to settle for $2 million.
Being mentally active
The idea behind “brain training” is not a bad one, it’s just easy to misrepresent as something it isn’t. The basic notion is that using your brain makes it function better. It is better to be mentally and physically active than inactive. This overview summarized the evidence: (more…)
Finding a simple fix for complex problems is highly appealing, which drives a persistent market in simple fixes, whether or not they are actually effective. The growing “brain training” industry is an example of this – the concept being that performing simple tasks, such as playing particular games, can have wide-ranging cognitive benefits. Unfortunately the evidence has not been kind to this notion.
Related to the brain training concept is auditory integration training. One permutation of this, the Tomatis Method, describes it this way:
The sound message is correctly heard but poorly analyzed in an emotional framework. The brain protects itself by constructing barriers that can result in the development of various disorders.
You can do the listening sessions repeatedly by using specially designed devices that stimulate the brain and progressively help it more effectively analyze the sensory message.
Your ear is not used only for hearing. It also stimulates your brain and establishes your balance. Well-tuned listening is therefore an essential component for promoting personal development.
This is a common approach to marketing such therapies – argue that one factor is a dominant cause of a host of problems, describe the method for addressing that one factor, which then leads to a happy, healthy, fulfilling life. This marketing formula appears well established. (more…)
Websites such as Luminosity.com make some bold promises about the effectiveness of computer-based brain-training programs. The site claims:
“Harness your brain’s neuroplasticity and train your way to a brighter life”
“Your brain’s abilities are unique. That’s why your Personalized Training Program adapts to fit your brain and your life goals.”
“Just 10 hours of Lumosity training can create drastic improvements. Track your own amazing progress with our sophisticated tools.”
Wow – in just 10 hours I can become smarter by playing fun video games personalized to my brain. I’m a huge fan of video games, and I would love to justify this hobby by saying that I’m training my brain while I play, but what does the scientific evidence have to say about such claims?
Not surprisingly, the published evidence is complex and mixed.
Snake oil often resides on the apparent cutting edge of medical advance. This is a marketing strategy – exploiting the media hype that often precedes actual scientific advances (even ones that don’t eventually pan out). The slogan of this approach could be, “Turning tomorrow’s possible cures into today’s pseudoscientific snake oil.”
The strategy works because, to the average person, the claims will sound plausible and scientific and will contain familiar scientific buzz words. There is therefore a proliferation of stem cell clinics, anti-oxidant supplements, and personalized genetic medicine.
We can add to the list of cutting edge pseudoscience, neural plasticity and brain training. Neuroscientists are discovering that even the adult brain has greater capacity for plasticity than was previously thought. Plasticity is the capacity of the brain to rewire itself, to acquire new abilities or compensate for damage. Mostly this is simply a technical description of a very common phenomenon – learning. Shoot a basketball 1000 times and (surprising to no one) you (meaning your brain) will get better at shooting baskets. Some of this is physical, such as developing the necessary strength in the involved muscles, but mostly this is the brain learning how to shoot baskets through plasticity.
The health marketplace has a life of its own, mostly separated from science and evidence. Generally the marketplace gets a hold of an idea and runs with it, before the science is carefully worked out. Since most new ideas in science turn out to be wrong, that means most products will eventually be found to be worthless.
One such idea is that “brain training” can improve overall cognitive function – so of course now there is an industry of products which claim to train your brain. Lumosity (just to pick a random example served up by Google) claims on their website:
* Improve memory and attention
* Shown to improve cognitive function
* Neuroscience based brain training
* Train your brain today
I always enjoy the phrase “scientifically designed” or “scientifically formulated” – they are wonderful marketing phrases that invoke “science” without making any specific claims.
I’m a big fan of video games, puzzles, and brain teasers. So the notion that so-called “brain training” games can help improve mental function and stave off dementia has some appeal to me. It also makes a certain amount of sense – exercise your brain and its function will improve.
And yet, as a skeptic, I have always been bothered by the specific claims made by marketers of games, websites, devices and programs. The formula is probably familiar to you, a specifically designed program is optimized to stimulate brain function, improve integration of information, and improve global function.
The website promotion for Brain Age, for example, claims:
Everyone knows you can prevent muscle loss with exercise, and use such activities to improve your body over time. And the same could be said for your brain. The design of Brain Age is based on the premise that cognitive exercise can improve blood flow to the brain. All it takes is as little as a few minutes of play time a day. For everyone who spends all their play time at the gym working out the major muscle groups, don’t forget – your brain is like a muscle, too. And it craves exercise.
The blood flow argument is pure hand-waving. The muscle analogy is perhaps more apt than intended – do muscles respond to a specific exercise or to any exercise?