Perhaps 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?”