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You know your weight. And your physical fitness. And a variety of health-related metrics.
What about your brain fitness?
In years to come, we can expect a growing number of assessments to help each of us address that precise question, using tools that today are only available to researchers and clinicians, raising both opportunities and concerns.
Two recent announcements bring out important events in that direction:
1) Last week, OptumHealth announced an exclusive 3-year agreement (estimated at $18m) with the Australian company Brain Resource.
Quote: "OptumHealth Behavioral Solutions will work with Brain Resource to provide clinicians with a Web-based assessment that measures general cognition (how people process information) and social cognition (how people manage their emotions). This 40-minute assessment is based on well-known and validated tests of memory, attention, executive function, and response speed, and mood, social skills and emotional resilience."
2) A few weeks ago, we could read that U.S. Troops To Get Cognitive Screening
Quote: "The military will begin giving cognitive tests this summer to troops heading to war, in an effort to get a baseline measure of their reaction time, memory, concentration and other brain functions, which could be referenced in case they are injured."
I see these instruments as a critical part in the brain fitness puzzle. Neuroimaging techniques such as MRI and fMRI are very important to support clinical and research work, but are not mature or scalable enough to help measure brain functions in millions of healthy individuals. Neuropsychological testing is still today often done with pen and paper, administered by a trained expert, and very resource-intensive.
Brain scientists don´t recognize one overall "brain age" or "intelligence". We can view our brain functions or cognitive abilities as a variety of skills, some more perception-related, some more memory-related, some more language-related, some more visual, some more abstract-thinking and planning oriented. There is no general "brain age" that can be measured or trained in a meaningful way.
Now, the use of these new technologies also raises concerns, and not just about their reliability and validity.
John Moore of Chilmark Research just commented on the Brain Resource-OptumHealth announcement, pointing out that "it is fairly well-known that many chronic diseases have a high comorbidity factor with mental health, OptumHealth's partnership with Brain Resource, and its success (or lack thereof) will be an interesting one to follow. And while I applaud this effort, it also raises some pretty scary privacy concerns. How will these assessments be used beyond the confines of the clinician's office?, What access will OptumHealth have to the data? And what about the employers who have OptumHealth's parent, United Health Group as an insurer for their employees? Will employers have access to this data, particularly if they start embedding it within HealthAtoZ?"
These are excellent questions. Humana, a health insurance company, recently announced that they were discontinuing their agreement with Posit Science under which they had been offering the Posit Science Brain Fitness Program to their Medicare members. Whereas a number of reasons were offered for that decision (ranging from low uptake rates of the promotions given the legal complexities of reaching out to Medicare users, to low utilization of the product), another concern was mentioned to us during a set of interviews with Humana members: they were concerned about whether a program that had been given to them for free by their insurance company would somehow transmit data back on the mental performance of the user.
Furthermore, we can expect clear public policy implications in this area. Art Kramer recently explained that "the NIH is preparing an "NIH Toolbox" to provide valid, reliable instruments to researchers and clinicians, to solve the problem that exists today, namely, the lack of uniformity among many measures used. The initiative was launched in 2006, and it is a 5-year effort, so we'll need to wait to see results".
A with any new tool, we´ll need the define the rules of the road.
1) First of all, we´ll need to make sure it measures what it is supposed to, and with high degrees of reliability.
2) Second, there need to be clear policies in place as to whom can access which data and for which purpose.
3) Finally, we expect the assessments will lead into actionable personalized recommendations to improve if not help maintain cognitive functions.
The question, "Are You Ready to Measure Your Brain Fitness", may become relevant earlier than we expect.
You probably have been reading much about "brain training" and "brain fitness" and wondered, "What is all the Fuss About?"
After many months of work (and we hope many new neurons and stronger synapses in our brains), we have just released our inaugural report on the emerging Brain Fitness Software Market, and we want to share a few of the key findings with you.
In summary, the whole category is growing. We estimate the size of the US brain fitness software market at $225M in2007, up from $100m in 2005 (50% CAGR). The two segments that fueled the market growth: consumers (grew from $5m to $80m, 300% CAGR) and healthcare & insurance providers (grew from $36m to $65m, 35% CAGR).
Ten Findings from The State of the Brain Fitness Software Market 2008 report include:
1) 2007 was a seminal year for the US Brain Fitness software market, which reached $225 million in revenues - up from an estimated $100 million in 2005.
2) Over 20 companies are offering tools to assess and train cognitive skills to four customer segments: consumers; healthcare and insurance providers; K12 school systems; and Fortune 1000 companies, the military, and sports teams.
3) The Nintendo Brain Age phenomenon has driven much of the growth. The consumer segment grew from a few million in 2005 to an estimated $80 million in 2007.
4) There is major confusion in the market, so education will be key. Users and buyers need help to navigate the maze of products and claims.
5) Over 400 residential facilities for older adults have launched computerized "brain fitness centers." Sales to the healthcare and insurance provider segment grew from $35 million in 2005 to an estimated $65 million in 2007.
6) More than five programs have shown results in randomized controlled trials. Cognitive functions that can be trained include: visual and auditory processing, working memory, attention, and decision-making.
7) A product has obtained 510(k) FDA clearance for rehabilitation of stroke and Traumatic Brain Injury patients. Another product is being used by a growing network of ADHD specialists.
8) Large-scale, fully-automated cognitive assessments are being used in a growing number of clinical trials. This opens the way for the development of inexpensive consumer-facing, baseline cognitive assessments.
9) The potential for K12 Education remains largely untapped due to limited research linking cognitive training to academic performance.
10) Companies, sports teams and the military are finding opportunities to improve productivity. The aging workforce will make this a must.
There are over 20 public and private companies offering tools to assess and train brain functions, with major implications for healthy aging and a number of disorders such as attention deficits, dyslexia, stroke and traumatic brain injury, schizophrenia, autism, mild cognitive impairment, and Alzheimer's disease.
Now you know. Not everything that bills itself as "brain training" really is. But there is more than may meet the eye.