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

Spring 2015 Vol. 39 .No. 1 | 37

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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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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 improve 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 prioritize optionshow to identify ones weak points and find suitable evidence-based

Figure 1

Self-Empowered Aging

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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 priorities 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 sidebar, 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 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

Figure 2


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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 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 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 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: 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 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. 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 Opti- mize Brain Health and Performance at Any Age. Washington, DC: SharpBrains.

Fernandez, A., et al., 2013. The Digi-tal Brain Health Market 20122020: Web-Based, Mobile and Biometrics-Based Technology to Assess, Moni- tor and Enhance Cognition and Brain Functioning. Washington, DC: SharpBrains.

The Government Office for Science. 2008. Foresight Mental Capital and Well-being Project: Final Project Report. London, UK: The Govern-ment Office for Science.

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

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