Marketplace of Memory

What the Brain Fitness Technology Industry Says About Us and How We Can Do Better

Daniel R. George, PhD, MSc; Peter J. Whitehouse, MD, PhD

Disclosures

Gerontologist. 2011;51(5):590-596. 

In This Article

Abstract and Introduction

Abstract

In the therapeutic void created by over 20 failed Alzheimer's disease drugs during the past decade, a new marketplace of "brain fitness" technology products has emerged. Ranging from video games and computer software to mobile phone apps and hand-held devices, these commercial products promise to maintain and enhance the memory, concentration, visual and spatial skills, verbal recall, and executive functions of individual users. It is instructive to view these products as sociocultural objects deeply imbued with the values and ideologies of our age; consequently, this article offers a critique of the brain fitness technology marketplace while identifying limitations in the capacity of commercial products to realistically improve cognitive health. A broader conception of brain health is presented, going beyond the reductionism of the commercial brain fitness marketplace and asking how our most proximate relationships and local communities can play a role in supporting cognitive and psychosocial well-being. This vision is grounded in recent experiences at The Intergenerational School in Cleveland, OH, a multigenerational community-oriented learning environment that is implementing brain fitness technology in novel ways.

Introduction

The story of brain aging is complex and idiosyncratic: a product of innumerable psychosocial, physical, and environmental contexts that impact upon our brains and bodies over a life span (Stein, Schettler, Rohrer, & Valenti, 2008). Even so, most contemporary discourse on improving memory focuses on so-called Alzheimer's disease (AD; Whitehouse & George, 2008) and the capacity for biological drugs to intercede in its progression, most commonly through the mechanism of removing or pre-empting the formation of amyloid. Unfortunately, despite billions of dollars of investment in anti-amyloid drugs, over 20 candidate compounds have failed in Phase III trials in the past decade (Diamond, 2010). Most recently, compounds such as Dimebon, Alzhemed, and Flurizan have failed to live up to the hype (Miller, 2010), while the amyloid vaccine developed by the drug company Elan did not demonstrate capacity to prevent neurodegeneration and improve cognition (Holmes et al., 2008). More recently, the drug semagacestat from Eli Lilly actually worsened cognitive decline in patients who took it, casting further doubts on whether drugs that target amyloid pathways are a viable therapeutic option (Imbimbo et al., 2011). Many experts believe that the currently approved symptomatic drugs to treat AD—a condition that increasingly appears to be heterogeneous and intimately related to aging—are not particularly effective in clinical practice and are not helpful in milder memory problems (Whitehouse & George, 2008). Attempts to develop so-called smart drugs (some in the form of conventional drugs as well as herbs, vitamins, and nutraceuticals) to enhance cognition in those without symptoms or with mild memory problems have also consistently failed and may produce unwanted side effects. Despite this fact, consumers continue to infuse these markets with their dollars in order to get an edge in today's complex and competitive world.

As the pharmaceutical machine slows, a new marketplace of technological "brain fitness" products is emerging to address the fear of brain aging and desire to enhance cognition that are prevalent in modern populations. These products are sociocultural objects deeply imbued with the values and ideologies of our age, and this article considers their material evolution while also examining limitations in their real-world contribution to cognitive health. Ultimately, a broader and more complex story of "brain health" is advanced, which goes beyond the hype and reductionism of the "brain fitness" commercial marketplace and demonstrates how local communities can play a vibrant role in supporting cognitive and psychosocial well-being across the life span.

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