Computer Software for Brain Fitness

A lot of advertising today touts computer software for brain fitness or brain training activities. Some of the software is (relatively) inexpensive, and some costs a fair amount (for example, about $400 for one program). Several websites offer memberships that give you access to stimulating games and other training activities.

How do you decide what software you should use?

First, I think it’s important to remember that nothing has been shown to stop cognitive aging or to prevent Alzheimer’s disease. Brain fitness, a brain gym, or any other cognitive fitness program may help you maintain your current level of function and may improve some specific skills, such as memory and thinking speed. These are important benefits and make brain fitness programs worth considering.

As for the software, as with many things, it depends. Some software programs have been subjected to more rigorous testing than have others. On the other hand, most brain fitness software programs have similar content. They often include activities that try to help you improve your working memory, your ability to think and react quickly, and your capacity to do several things at once. Some software programs have very original ways to improving your ability to do things. Posit Science’s new offering, Cortext, now includes a software program that helps you improve your visual attention to the world around. This program was developed by Dr. Karlene Ball at the University of Alabama, and has been shown to improve older driver’s skills. It’s called the Useful Field of View, or UFOV.

Some activities built in computer brain training software and often used in brain gyms are pretty much the same whether you’re using an inexpensive handheld trainer. Others, like the UFOV, are only available in a specific package. So whether one program or another is best for you may depend on what kind of memory or other cognitive problems you are having trouble with, and what you want to improve.

A recent article in the International Herald Tribune describes some of the available software programs, and some creative ways that some older adults are figuring out how to maintain their function. The author of the article quotes Dr. Gene Cohen, Director of the Center on Aging at George Washington University, who says that what’s essential is some activity to “challenge your brain.” (Click here to see the article.)

One man, for example, reads books upside down to improve his cognitive flexibility. Another man takes opportunities to memorize numbers he sees around him. The author quotes one of the persons in this article as saying “Smart people find new ways to exercise their brains that don’t involve buying software or taking expensive workshops.”

I would say there are three important issues in deciding whether you use brain fitness software or go to a brain gym.

• The first is whether you want an evaluation of your strengths and weaknesses to help you guide your work in the brain gym. A comprehensive assessment also will give you a baseline to help determine whether any of your abilities change over time.
• The second issue is whether you want to benefit from a specific training activity that is only available in a specific software package. Some people think doing the brain puzzles of Sudoku (a game that asks to do mental arithmetic across several parts of a puzzle) is helpful. You can do that in books you can buy at the grocery store, or you can do it in an inexpensive handheld gaming device such as the Nintendo DS. On the other hand, if you want to work on certain visual or auditory skills, some of the software programs may be a better bet.
• The third issue is whether you want the help, encouragement, and support you can get from the staff in a brain fitness program. Just as many people do well in working out in a gym they have in their home, others find that actually going to a health club helps them stick with their program. This may be especially true if you have a personal trainer or are in a group.

A Consumer’s Guide to Research: I. Observational Studies

I spend a lot of time teaching medical students, residents, fellows, and other health care professionals. Since I think it’s critical that we base our clinical practice on the best evidence available, I like to talk about what research evidence shows. This means that at least some of the time I have to explain a little bit about how research studies are done, what kind of evidence they produce, and why some studies are generally considered to give us better or stronger evidence than others.

One of the most important issues that comes up in discussions of research in the media and with patients and clinicians has to do with research design. Not all research is done in the same way, and we can draw certain kinds of conclusions from one research design but not others. We often want to decide whether something either causes disease (for example, smoking) or helps prevent it (for example, does vitamin C prevent colds?). Two basic kinds of research studies deal with these issues in different ways, and give us different kinds of information.

The most common type of study that gives us information about factors associated with disease is the observational study.  These studies are very common, and usually involve collecting information from a group people at one point in time, and then collecting the information on other occasions. We might, for example, ask a group of people in the community about their memory, diet, exercise, and use of vitamin supplements. Later, we would ask them the same questions again. Perhaps some of the people would say that their memory had gotten worse. We could then find out if their diet, exercise, or use of vitamins was different from the people who said their memory was OK.

The good thing about this kind of study is it’s easy to do and therefore less expensive than many other kinds of research. The weakness is we can’t control all the things that might affect the study’s outcome.

Suppose we found that people who took vitamins were less likely to say their memory got worse. Would that mean that taking vitamin C is good for your memory? No. Although this kind of study is often interpreted this way, it’s not true. We don’t know whether something else is going on that is related to taking vitamin C but also affects memory.

A good example are the results of observational studies that ask people about taking drugs called non-steroidal anti-inflammatory drugs (NSAIDS). These are medications like ibuprofen; there are many brand names. Studies have shown that people who took NSAIDS for arthritis are less likely to develop Alzheimer’s disease. So far, so good. But when controlled clinical trials of NSAIDS in people with memory problems were done, they didn’t show any benefit.

Observational studies are really useful for helping us understand what may cause a disease, but they usually aren’t very good at nailing down exactly how to treat one.