Is Your Brain as Fit as It Could Be?

Colin T. Son


December 09, 2008

That gym membership comes in handy when you want to exercise your biceps. That jogging suit comes in handy when you want to exercise your heart. But ways to exercise your brain have been largely ignored until recently. With an aging populace, more and more interest is now being paid to preserving and improving cognitive function.

Indeed, a whole commercial industry has arisen around providing people with the resources to exercise their mind. This rapidly expanding industry is represented online by a unique consulting company. The firm, SharpBrains, also runs an interesting corporate blog where writers comment on cognitive fitness.

SharpBrains co-founder and Chief Executive Officer Alvaro Fernandez was gracious enough to explain the company to me recently.

Alvaro Fernandez: We are a market research company covering healthcare applications of cognitive science and neuropsychology. We publish market reports and offer advisory services to help our clients (think Kaiser Permanente, health insurance companies, major hospitals, seniors housing operators, investors, research institutes) make informed decisions about the growing "brain fitness" field: what assessments and training products to use, if any; whom to partner with, what are best practices to implement and to innovate...

The big picture here is that healthcare and insurance providers can play a major role in helping address a growing "cognitive gap": Longer lives in a rapidly evolving environment are placing enormous lifelong cognitive demands on our brains. We can view Alzheimer's disease and mild cognitive impairment as evidence of that "gap."

The good news is that today we know the brain is more resilient than we once thought, and cognitive neuroscience and neuropsychology have started to provide some guidance on how to help maintain cognitive functions: a balanced diet, cardiovascular physical exercise, stress management, and mental exercise that incorporates well-directed novelty, variety, and challenge. And a growing number of tools can assist in assessing and enhancing cognitive functions in more scalable ways than the traditional pen and paper or face-to-face instruments.


SharpBrains hosts Grand Rounds
December 9, 2008



Colin Son: You all were asked to participate in a task force on the challenges of gerontology organized by the World Economic Forum. What is the forum discussing? What conclusions has the forum come to so far?

Alvaro Fernandez: Fifteen world-wide experts have been invited to discuss the main challenges and opportunities we face given increasing life and health spans and to propose solutions to business leaders and policy makers. This is a year-long process that started early last month in Dubai.

I can summarize some of the main themes so far: The world is aging -- on average in healthier ways, but with growing variability. Our healthcare and retirement systems are on track to go bankrupt, since their premises are outdated. And the current disease-based research agenda compounds the problem. Some potential solutions? We need to (1) promote healthy lifestyles that help maintain lifelong physical and cognitive functional abilities, (2) redesign environments to foster health, engagement and financial security, and (3) develop an integrated healthy living and aging research agenda.

Colin Son: The baby-boom generation is falling into an age where concern over memory and cognitive function start to become more pronounced. Is the "brain fitness" field a direct response to that, or is there a lengthier history for the industry? What has an aging population meant for the "brain fitness" industry?

Alvaro Fernandez: Excellent question. Our co-founder, Dr. Elkhonon Goldberg, has been both a researcher and clinical neuropsychologist for over 30 years, and used many computerized cognitive assessment and training tools for at least the last 10 of those, as part of the cognitive rehabilitation that follows strokes and traumatic brain injury. More than half of the revenues we estimated for 2007 ($225 million) come from institutional buyers, not consumers. There are many programs whose value has nothing to do with aging -- think working memory training to alleviate attention deficit symptoms, auditory processing to help kids with dyslexia, ongoing research on MCI, schizophrenia, and so-called "chemo-brain."

But it is true that what has captured popular imagination has been the more recent "healthy aging" angle, thanks to Nintendo Brain Age, the publication in December 2006 in JAMA of the 5-year results of the ACTIVE trial, and PBS' "Brain Fitness Program." There is a lot of interest out there -- and a lot of confusion -- so we are preparing a guide for consumers and professionals who want to better navigate the field.

Colin Son: What, if anything, does cognitive training have to offer for younger individuals, such as students?

Alvaro Fernandez: Let me first broaden the question. What can one do to improve cognitive functioning? There is no general solution or "prescription" that works for everyone and everything. If I am sedentary, probably the best thing to do is to ensure a minimum of cardiovascular exercise -- if I am completely stressed out, perhaps yoga, meditation, or biofeedback to manage stress. If I eat fast food day and night, well, you know what I will say: better nutrition (not supplements or vitamins). If I watch TV 4 hours per day...perhaps I could try some structured cognitive training.

A team of Michigan researchers published a great paper in the Proceedings of the National Academy of Sciences this year, showing how students in their mid-20s who trained their working memory improved what researchers call "fluid intelligence," which according to the scientist interviewed here can help students "follow lectures more easily, understand math better." So there is a range of options, and we all can make informed, relevant decisions.

Colin Son: The blog at SharpBrains has been a pretty significant member of the medical blogosphere. What led to the creation of the blog? What does it contribute to the SharpBrains market research and consulting business?

Alvaro Fernandez: In 2006 we realized that our topic was becoming more mainstream and that a blog could be a great resource to make the emerging research and field accessible to professionals, consumers, and reporters, and at the same time help us reach potential clients, so we have invested a lot of energy here, and now have a broad base of contributors offering content, from articles to interviews with scientists to fun brain teasers.

Our challenge right now is how to keep different audiences happy, since some readers are mostly interested from a personal point of view and some from a professional one; so we are trying to find the best ways to strike the right balance.

Colin Son: Give us a hint at the future of "brain fitness."

Alvaro Fernandez: We have already mentioned a few emerging trends, such as the role of insurance companies, the future of baseline cognitive assessments, the complementary value of several lifestyle habits, and emerging tools to help maintain cognitive functions. Medscape readers may also find these 10 Future Trends valuable.

Let me just highlight one trend: the need for in-depth professional development focused on neurocognitive research and implications for physicians, psychologists, and health professionals in general. The Mental Health Parity Law recently passed into law will contribute towards a much-needed increased healthcare focus on the brain and cognition.

Colin Son: On December 9, 2008, SharpBrains hosts Grand Rounds the weekly collection of submissions from around the medical blogosphere. Check out this medical carnival and learn more about the world of cognitive fitness.


Comments on Medscape are moderated and should be professional in tone and on topic. You must declare any conflicts of interest related to your comments and responses. Please see our Commenting Guide for further information. We reserve the right to remove posts at our sole discretion.
Post as: