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Spring 2015 Vol. 39 .No. 1 | 37
GENERATIONS Journal of the American Society on Aging
Copyright 2015 American Society on Aging; all rights reserved.
This article may not be duplicated, reprinted or distributed in any
form without written permission from the publisher: American
Society on Aging, 575 Market St., Suite 2100, San Francisco, CA
94105-2869; e-mail: [email protected]. For information about ASAs
publications visit www.asaging.org/publications. For information
about ASA membership visit www.asaging.org/join.
A s the concept of brain fitness (or, the brains 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
doingsolving crossword puzzle number million-and-one, taking
brain supple-ments, 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 con-ducted to date
(The Govern-ment Office for Science, 2008; AHRQ, 2010), is that 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
consensus that brain training does not work (Allaire et al.,
2014). By December 2014, 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 Sharp-Brains (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 it, but what has better
science than the other things people are
By Alvaro Fernandez
What works to preserve cognitive abilities? Much like the human
brain, the answer is complicated, individual, and nuanced.
Solving the Brain Fitness Puzzle Is the Key to Self-Empowered
Aging
There is scientific consensus that brain training both does, and
does not, work.
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GENERATIONS Journal of the American Society on Aging
38 | Spring 2015 Vol. 39 .No. 1
Copyright 2015 American Society on Aging; all rights reserved.
This article may not be duplicated, reprinted or distributed in any
form without written permission from the publisher: American
Society on Aging, 575 Market St., Suite 2100, San Francisco, CA
94105-2869; e-mail: [email protected]. For information about ASAs
publications visit www.asaging.org/publications. For information
about ASA membership visit www.asaging.org/join.
Pages 3740
likely to help with navigating the available scientific evidence
and applying it in the way most relevant to a persons
circum-stances and objectives?
First, we need to educate the public on a fuller, more nuanced
approach that emphasizes a glo- bal view of brain fitness, one that
is not restricted to the prevention or treatment of dementia, but
encompasses the lifelong trajectory of ones brain health and
performance.
Notice the opportunity presented in Figure 1 (this page). If we
can help more peoples brain performance advance through life,
following the trajectory of the line on top, we would help millions
to im- prove their quality of life and their productivity for years
more and, at the same time, delay future morbidity, poten-tially
halving the prevalence of Alzheimers Disease.
We May Not Stop Dementia, But We Can Prolong FunctionNothing has
been shown to prevent dementias pathology, but there are
evidence-based ways to improve and prolong brain functionality, and
to reduce the probability of manifesting diseasea 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 assess-ments, 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 exer-cise; 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 (see page 39), but the often
overlooked main find- ing is that based upon the best
available evidence, no shoe fits all: different interventions
work best for specific purposes and for specific populations.
Cross-Training Our BrainsBrain 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 brainsexercising a wide range of cognitive,
emotional, and executive functionscan help us and build up targeted
brain functions over time. Research-based methodologies include
meditation, reframing (cogni-tive therapy), biofeedback, and
cognitive training.
Where I see most people failing today is in how to pri- oritize
optionshow to iden- tify ones weak points and find suitable
evidence-based
Figure 1
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Self-Empowered Aging
Spring 2015 Vol. 39 .No. 1 | 39
Copyright 2015 American Society on Aging; all rights reserved.
This article may not be duplicated, reprinted or distributed in any
form without written permission from the publisher: American
Society on Aging, 575 Market St., Suite 2100, San Francisco, CA
94105-2869; e-mail: [email protected]. For information about ASAs
publications visit www.asaging.org/publications. For information
about ASA membership visit www.asaging.org/join.
Pages 3740
solutions for action. Here are three simplified vignettes,
adapted from The SharpBrains Guide to Brain Fitness (Fernan-dez,
Goldberg, and Michelon, 2013), that show how important it is to
identify personal pri- orities and, thus, the best tools, based
upon an individuals par- ticular starting point, needs, and
goals.
Charlotte is an accom-plished 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: Char-lottes 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 cogni-tive
difficulties. She could start integrating exercise and medita-tion
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 HeartMaths Inner Balance
Trainer (see side- bar, page 40) could help her quickly master
stress regulation.
Julin, 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 col-leagues 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: Julin is trying to remain cognitively
engaged, but not in ways that supply novelty, variety, and
challengethe ingredients of real mental exercise. His brain would
be better served by volunteering, perhaps provid-ing financial
planning advice to low-income families for a nonprofit
organization. He also could regularly use self- assessments, such
as Cogniciti or BrainBaseline (see sidebar, page 40), to better
monitor his memory and cognition over time and to inform
conversa-tions 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 rou- tine, 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
Figure 2
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GENERATIONS Journal of the American Society on Aging
40 | Spring 2015 Vol. 39 .No. 1
Copyright 2015 American Society on Aging; all rights reserved.
This article may not be duplicated, reprinted or distributed in any
form without written permission from the publisher: American
Society on Aging, 575 Market St., Suite 2100, San Francisco, CA
94105-2869; e-mail: [email protected]. For information about ASAs
publications visit www.asaging.org/publications. For information
about ASA membership visit www.asaging.org/join.
Pages 3740
opportunities, it would make sense for her to prioritize
safe-driving classes, and even use a cognitive training pro- gram
aimed at safe-driving skills, such as BrainHQ, or CogniFit Senior
Driver (see sidebar, above).
In summary, Charlotte, Julin, Kelly, and millions of
other adults would benefit from high-quality information and
education to help them to make effective brain fitness decisions,
and to help them navigate all optionsones that would address their
unique circumstances and goals.
No one shoe fits all. Why should we believe the reverse
of that maxim would apply to something as diverse and com- plex
as the human brain?
Alvaro Fernandez, M.A., M.B.A., is the co-founder and CEO of
SharpBrains (www.sharpbrains.com), headquartered in Washing-ton,
D.C. He can be contacted at [email protected].
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-takers 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/.
ReferencesAgency for Healthcare Research and Quality (AHRQ).
2010. Alz- heimers Disease and Cognitive Decline. Rockville, MD:
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2015.
Alescio-Lautier, B., et al., 2014. Open Letter Response to A
Consensus on the Brain Training Industry from the Scientific Com-
munity. www.cognitivetraining data.org/. Retrieved January 15,
2015.
Allaire, J. C., et al., 2014. A Consensus on the Brain Training
Industry from the Scientific Com- munity. Max Planck Institute for
Human Development and Stanford Center on Longevity.
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