Brain Exercises Do Not Live Up To The Hype.
Computerized brain-training exercises and games, touted for their ability to improve overall cognitive function, may actually only help you get better at the specific game you’re playing. That’s the conclusion of a wide-ranging review of nearly 400 studies of brain training published last week in the journal Psychological Science in the Public Interest. The review found that none of the studies followed scientific best practices for comparing a group of people practicing an intervention against a control group not getting the intervention. “What we found is that there’s really no compelling evidence that these sorts of interventions lead to objectively measured real-world improvements,” says Daniel Simons, a professor of psychology at the University of Illinois at Urbana-Champaign and first author of the review.
Brain-training exercises generally consist of tasks designed to improve a particular mental ability, such as processing speed or memory. Companies including Posit Science, Lumos Labs and Cogmed market products that make bold claims, including the ability to stave off dementia. Consumers spent $322 million on digital brain-health software in 2013, according to market-research data cited in the review. Lumos Labs paid $2 million earlier this year to settle a deceptive-advertising lawsuit brought by the Federal Trade Commission, which charged that the company was making false claims of protecting against age-related cognitive decline in its brain-training program Lumosity.
The review, performed by seven psychologists, was challenged by neuroscientists at Posit Science, whose products are used in many of the studies. “This is a disciplinary boundary-setting dispute between old-school psychologists and neuroscientists,” says Henry Mahncke, chief executive of the San Francisco-based company. “On the neuroscience side of things, we’ve discovered over the past 30 years that brain plasticity is a real thing. We can reorganize the structure and the function of the brain.” Dr. Simons, the review’s first author, says some of the studies were too small or had subpar statistical analyses to meet research standards. Some used control groups of people that weren’t given a parallel intervention, or that performed tasks that weren’t well matched to the brain-training intervention. When studies assessed outcomes in the real world, they were typically based on subjective, self-reported results rather than objectively measured performance, he adds. The review looked at studies performed through the end of 2015. The placebo effect also could have influenced the study findings. After practicing brain training for hours, participants “form expectations for what should improve and what shouldn’t improve, and those can affect the outcome,” Dr. Simon says. To demonstrate that a brain-training regimen is effective, an intervention study needs a control group that is active and doing something that matches the expectation and motivation of the group receiving the actual intervention, he says. Dr. Simons wouldn’t say there isn’t value in brain training. “If you are playing the games solely because you enjoy them, then why not?”
One of the higher-quality studies—the review notes—is a government-funded trial known as Active, which has been following more than 2,800 elderly participants for 10 years. Published studies have reported that participants showed improvements in driving, cognitive function and the ability to perform daily activities, such as preparing a meal, compared with a control group. The study’s researchers recently presented results at the Alzheimer’s Association International Conference showing that a computer speed-training exercise—now marketed by Posit Science—had the potential to cut the risk of developing dementia. Dr. Simons says the latest results from the Active study, short for Advanced Cognitive Training in Vital Elderly, wasn’t included in the review because it hasn’t been published in a peer-reviewed journal. He says the benefits shown in the Active trial are fairly small and it has flaws, including relying primarily on self reports to assess improvements in performing daily activities.
Murali Doraiswamy, director of the neurocognitive disorders program at Duke University Health System, in Durham, N.C., says the review is fair because the evidence for brain training is mixed. “There’s very little evidence to support the transfer of benefits” from the exercises to daily life, he says. The one exception, Dr. Doraiswamy says, is hand-eye coordination, which can be improved through simulation games. “We need an independent regulatory agency like the FDA to really validate these studies,” Dr. Doraiswamy says. “At the present time you don’t have the rigor that you would if a company was developing a medical device.” Dr. Doraiswamy says Duke and Columbia University are planning a study that will compare brain training with crossword puzzles to evaluate everyday functioning as well as dementia prevention.
Credit: Sumathi Reddy for The Wall Street Journal 10 October 2016