Skewering the Emerging “Brain Fitness” Industry

Capture brain fitnessPerhaps I should look into joining The New Yorker as a staff writer now that major articles on dementia seem to have become a regular feature of the magazine. In this week’s issue, humorist Patricia Marx skewers the emerging “brain fitness “ industry.  Her tone is breezy and light compared to the gravity of the two articles I reviewed in my previous post, going for laughs by probing the tension between mid-life anxiety about cognitive decline and the range of improbably diverse claims for the cognitive benefit of various activities:

It’s a pretty regular occurrence for me to leave my reading glasses God knows were or lose my train of thought or have trouble recalling the word `phlogiston’ – and, egads, what happened to all that stuff I used to know about Charlemagne’s in-laws? In my darkest moments, I imagine that my friends are humoring me when they insist that their amnesiac lapses are no less alarming than mine. (“Have you ever squeezed toothpaste onto your contact lenses?” a friend asked triumphantly.) Am I, like so many of my gang, just another one of the `worried well?’(A 2011 survey found that baby boomers were more afraid of losing their memory than of death.) Should I get out a crossword? Learn to play bridge? Chew gum? Take a nap? Drink more coffee? Eat blueberries? Give up tofu? There are studies that tout the benefits that each of these undertakings has on the brain. What to do?”

Readers who themselves are struggling with significant cognitive loss, or caring for people with dementia, may be put off by the tone of the article. But Marx is making an important point about how the purveyors of brain training software and other “neurobic exercise” programs are forging a billion dollar industry on anxiety about dementia and scientific sounding claims about various techniques for re-invigorating the brain.

Marx is not, however, completely dismissive of recent findings about neuroplasticity and the potential for diet, exercise and stress management to prevent cognitive decline. The work of Kenneth Kosik, a neuroscientists at the University of California at Santa Barbara and founder of a non-profit brain fitness center, comes off as reasonable, legitimate, and firmly grounded in real science. Citing the well-known nun study and other recent research, Kosik explains the scientific basis for believing that social, physical and intellectual enrichment that promotes good brain health across the lifespan can increase the resilience of the brain and help prevent dementia. Kosik, who is also involved in more mainstream biomedical research, is careful to keep claims about brain fitness modest, arguing that they should be part of an overall health lifestyle. Of his brain fitness center , Kosik says that “I’m sure some of my colleagues in Boston would look at this as a fringe operation, a storefront with walnuts and incense. On the other hand, we can wait for science to come up with a cure or we can jump in and try to create an atmosphere that is conducive to good brain health.”

Though Kosik is clearly right that this holistic approach to brain health as a factor in dementia is at odds with the reductionist drive in biomedicine to find the key to curing or preventing dementia in specific pathological mechanisms, he is quite wrong about how the brain fitness industry looks. The companies Marx spends most of the article quite justifiably mocking are careful not to look like smoky dens of new age mysticism. Rather, they relentlessly deploy neuroscience lingo and wildly extrapolate from limited research evidence to make absurdly inflated claims for the efficacy of their products.

After a crash course of several weeks Marx concludes:

Judging from the series of questionnaires I’d filled out during the course of my training, my mood brightened, my sleep was more restful and I felt more confident. I may also have become a bigger liar on questionnaires but that was not evaluated. As for the exercises, my scores were higher across the board. In an email summing up my progress, Merzenich [neuroscientist and co-founder of BrainHQ] wrote `Your advances on these exercises comes from brain remodeling. If we had recorded from/imaged your brain before and after training, we could have easily shown that you now have a `better’ (stronger, faster, more reliable, more accurate) brain.’ (Wouldn’t they make dandy wallet photos?) Compared with my poky old brain, my souped-up brain, according to Merzenich, has more synapses, better wiring, stronger connections, and more forceful activity. (Doesn’t that sound like an ad for a five-thousand-dollar stereo?)

I’m not sure I noticed my newfound cognitive abilities in everyday life. It’s hard to be both scientists and lab rat. On the positive side, I am slightly less troubled about the size of my hippocampus. On the negative side, why did I sprinkle NutraSweet on my broiled salmon last night?”

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Forgetting Defines Us

If, as is often claimed, Alzheimer’s disease is “the disease of the century,” or at least one of the peculiarly emblematic diseases in America at the turn of the twenty-first century, it is not just because of its rising prevalence and  devastating symptoms, but because it has a  strong  resonance with some of the deepest concerns of contemporary culture. This is one of a series of occasional posts that will explore this  cultural resonance. 

One of the most salient concerns in contemporary culture is memory, and it is clear that the prominence of Alzheimer’s is in large part a result of the prominence of memory failure among its many symptoms. But the authority of medicine in popular discourse on Alzheimer’s has fostered a reductive  approach to memory, regarding it essentially to the ability to store and recall information. In this post, I want to gesture toward the broader meanings of  memory and memory by considering how they are used in two important songs in the oeuvre of   one of my heroes — indie music  goddess Ani Difranco. The songs are the title tracks to Dilate (1996) and Little Plastic Castle (1998).

“Dilate” (complete lyrics)  is essentially a song about love gone wrong, but it is lifted above the banality of countless songs on that theme by its images of  memory failure and confusion that reach toward a characterization of the human condition in late modernity.

Lifted out of the context of the song, the imagery of memory failure and confusion could be taken as  a fairly standard description of  nightmarish memory failure in dementia:

i wake up in the night 
and i don’t know where the bathroom is 
and i don’t know what town i’m in 
or what sky i am under 
and i wake up in the darkness and i 
don’t have the will anymore to wonder 

….

and i learn every room long enough 
to make it to the door 
and then i hear it click shut behind me 
and every key works differently 
i forget every time 
and the forgetting defines me 
that’s what defines me” 

But in the  context of the song, these images have a quite a different meaning.  Though the song is meticulously evasive about what is actually going on in the narrator’s life, nothing in it  suggests that the forgetting which defines the narrator is a literal inability  to recall information, or that the problem is a defect in her brain. Nor is she simply using memory loss and confusion as a metaphor for the feelings that accompany a bad love affair. Rather, the song suggests that the banality of life has come to defy her ability to render it meaningful, and that this  disruption of meaning has come to define her. The song concludes by embracing this situation, painful as it may be.

“Little Plastic Castle” (complete lyrics) is a celebration of unorthodox sexuality, articulating the joy to be experienced and the social price to be paid for for violating heterosexual norms of femininity, for simply being different.

But the song begins with an evocation of  quotidian memory failure. The problem is not  with the narrator’s mind or brain, but with  a mass culture that replicates experience endlessly so that location and time are blended together into an undifferentiated now.

in a coffee shop in a city
which is every coffee shop in every city
on a day which is every day
i picked up a magazine
which is every magazine
read a story, and then forgot it right away”

The next verse goes further to suggest that this sort of forgetfulness is not an accident, but a structured, imposed feature of  a modern social life that is full of little plastic castles.

they say goldfish have no memory
i guess their lives are much like mine
and the little plastic castle
is a surprise every time
and it’s hard to say if they’re happy
but they don’t seem much to mind”

This is the trap, the false promise of late modern consumer culture that leads the narrator to to forget where she is, to forget the hostility that she will inevitably have to endure and that she describes in the remainder of the song.

In these songs, memory  is not merely the ability to recall information and be oriented in time and place. It is the ability to make meaning, to connect the past, the present and future together into a meaningful life story. And memory failure is not caused only by something gone wrong in an individual body and brain, but also by the oppressive banality and social contradictions of contemporary experience in late modern consumer culture.  Keeping these broader meanings of memory and forgetting in mind can deepen the way we think about the experience of confusion and memory loss in dementia.