Chess Total Training
Brain Fitness Interview with Dr. Shlomo Breznitz of CogniFit
The following is a discussion of brain fitness, brain training and neuroscience between Dr Shlomo Breznitz of CogniFit and Alex Colket of PlayWithYourMind
Alex: In order to properly frame our conversation, can you start things off by taking a moment to explain neuroplasticity and briefly discuss the implications of this science for the emergent brain fitness industry?
Dr. Breznitz: Until quite recently, neuroplasticity was regarded as the capacity of the brain to respond to stimulation in early life. The main interest in this came from the study of language development and the “miracle” of the ability of a small child to learn any language that happens to be in his/her environment. Thus, neuroplasticity was seen as the ability of the brain to develop the necessary connections and pathways between neurons on the basis of the information received. Furthermore, up to a certain age, so went the argument, the brain had the capacity to rearrange those connections if needed. However, during the last decade or so, research revealed that a significant amount of plasticity remains in adult brains and even old brains. This means that the brain is responding to new stimulation and new types of information by establishing new connections between neurons. We know today that the more connections a brain cell has to other cells the more protected it is from death cell, which affects primarily cells that are isolated. This principle makes a lot of sense, since if a cell is isolated it means that it was inactive for a very long time and hence its loss would not impact the functioning of that person. On the other hand, a well connected cell implies its frequent usage and hence of greater relevance to what the person does and needs in the future. There are other mechanisms besides networking between cells that point out the advantages of new stimulation, but we can enter into those later, if you wish. In any event, these discoveries imply that cognitive training can enhance brain function and open the window of opportunity for specific software that does just that.
Alex: So throughout adulthood, and even into old age, our brains are still capable of learning, adapting and growing – and they seemingly benefit from this process. What great news for us all (there goes the adage “You can’t teach an old dog new tricks”)! Presumably, there are a number of different ways to get the mental exercise necessary to keep the brain working, but it seems like computer games have become a particularly popular way of doing so. Why do you think CogniFit and other brain fitness programs have chosen this route? What is it about games that make them a logical choice for keeping our brains active and fit?
Dr. Breznitz: The computer has several advantages that make it the natural choice for brain training exercises (I prefer to think that ours are fun, but not really games). Chief among them is the opportunity to measure a whole host of data that would be otherwise unavailable. Thus, we can measure the precise speed of any decision, any movement with the mouse, even the slightest hesitations. In addition, all information is stored and like in our case sent into a database for both online processing and offline future research. It is precisely this feature that makes it possible for us to adjust the level of challenge to each individual for each task, which is critical for the effectiveness of the whole enterprise. Internet based applications, like our CPC, have the additional advantage that tasks can be interchanged (downloading new ones) according to needs, with particular advantage to making the program more interesting over time. The computer milieu also allows excellent feedback to the user and this feedback can be immediate, which is extremely useful for learning any skill.
Alex: OK, well it sounds like online brain exercises are a perfect tool in theory, but what are people finding in practice? What tools can you use to determine if programs like yours are effective? How are these computer-based mental exercises impacting participants in their day to day lives? What has the scientific community found when they have studied the efficacy of brain fitness workouts?
Dr. Breznitz: There are now a growing number of studies, including a multi-site NIH sponsored effort, that demonstrate the significant impact of computerized brain training on both standard measures of cognition and indicators of daily lives. Your question is an important one, since in psychology there are no clear indicators to quality of life and we have to rely on self reports. At the same time, self reports are a pretty robust indicator of morale, which in itself if of central, since it impacts everything we think, feel and do. The research record is developing now very rapidly and in spite of a few skeptic that are still around, the verdict seem to be positive.
Alex: In light of this growing body of scientific and anecdotal evidence, where do you see the brain fitness industry in 10-20 years? Do you think that mental exercise will one day be as emphasized and widespread as physical exercise is today? On that note, do you see this as something that people should be engaged in throughout their lives, not just in the latter part of them?
Dr. Breznitz: You could not have phrased it better. Yes, I am confident that cognitive fitness would be just another part of “total fitness”, which includes physical exercise, proper food, and mental exercise. And yes, I believe that while it is never too late to start, the sooner the better. It would become part of an enlightened person’s routine commitment and will be encouraged by the media, by the health professionals and by insurance companies.
Alex: I just read an article today about a recent finding of the Advanced Cognitive Training for Independent and Vital Elderly (ACTIVE) study suggesting that cognitive exercises decrease the incidence of depression. A week ago I came across a report that some doctors have started prescribing brain exercise routines to their patients. Do you believe computer-based brain fitness programs can do more than help us keep track of our keys and play a mean game of bridge; do you think they might also play a role in keeping us happier or physically healthier? If so, what role do you think the health care industry should have in promoting this preventative approach to mental health?
Dr. Breznitz: The answer to this is definitely YES. We often see in our clients who use the program that they report higher energy, better morale and more involvement with their surroundings. All these are the antithesis of depression and anything that contribute to such a better state of mind is extremely valuable for elderly people. We believe that cognitive training serves both the treatment of some problems and more importantly, their prevention and/or delay of onset. Just like physical exercise is not prescribed only when one needs physiotherapy, but rather as a means to reach better levels of physical health, so is the case with cognition.
Alex: Having just completed stage 1 of the CogniFit assessment round, I am reminded of another question I wanted to ask you. I think it’s easy for people to see the value in cognitive exercises for memory, hand-eye coordination and planning, but a little more tricky to see the importance in some of the more obscure and less-commonly-used mental faculties (as it is not as apparent how we use these in day-to-day life). Let’s take the timing estimation games for example (in one such game, you are presented with a picture for a period of time, then played a sound, and you are asked which one had the longer duration) – why did you choose to include these exercises in your program and what would you say to someone who might be inclined to skip them due to lack of perceived relevance?
Dr. Breznitz: Time estimation is critical to many everyday life situations. Consider the need to evaluate effectively the time you have left before a traffic light changes from green to red, that can be a matter of life and death. Another important reason is related to diagnostics. The time estimation of certain types of cognitive decline (e.g. dementia) is seriously affected and we would like to know about this for obvious reasons.
Alex: Up until this point, I think we have agreed on just about everything, so I am going to mix things up a little by bringing up a topic that we may not see eye-to-eye on. My website playwithyourmind.com features around 100 different brain games and exercises that I developed without clinical trials, input from professional neuroscientists or any of the other scientific approaches taken by the more professional brain fitness programs. Not too long ago, I wrote an article questioning if these scientifically-developed programs are so much more effective than my amateur offerings as to justify the cost. With so many brain games out available on the web for free, why should people opt for a program like CogniFit Personal Coach that they have to pay for? What features make it more effective than the games on websites such as mine? Take this opportunity to defend your program against folks like myself who believe that there are sufficient opportunities for mental exercise without enrolling in a specific program.
Dr. Breznitz: Thanks for the opportunity to tackle this question. The answer in a nutshell is all about personalization. It also distinguishes CPC from all current competitors. First, the rationale: For any cognitive activity to be of value it must be close to the optimal level of challenge. Not too easy and boring and not too difficult and frustrating. Every person has a different level of challenge in the different cognitive domains. Consequently, the program must first assess the skills of the user as thoroughly as possible. CPC does just that by stating with a quite extensive assessment. The purpose of this is to plan a training regimen that best suits this person. Furthermore, the personalization does not stop there. As one starts training, the data collected feeds into a huge database and serves as an ongoing diagnostic tool to further personalize each exercise. Thus, if we start say with 10,000 people at the same day, after 3-4 training sessions there would not be two people doing precisely the same thing. This level of personalization is not important only for motivational purposes, but for the value of training as such. Stimuli must be novel in order to engage the brain and push it to develop new pathways and connections between neurons. Our brains are basically lazy and quickly learn routines and make the most of repetition in order to function almost automatically, without the need for effortful thinking. Thus, even the most complex activities become routine (chess, bridge, scientific research, etc.) and lose their capacity to challenge our brains. This implies the need to continuously monitor the level of difficulty of each task in order to optimize its impact. One of the main problems of elderly people is their vast experience, which saves a lot of cognitive processing effort, but at some cost to cognitive fitness.
Alex: So you find out where people are at and then give them what they need – a highly personalized program. Sounds good to me. Speaking of personalizing things, I’d like to conclude this discussion with a question about you. I would imagine that you, as an aging neuroscientist involved in cognitive health, are acutely aware of your own mental fitness and any potential decline therein. In your own experience, has there been one particular facet of your mind that you have noticed slipping, and if so, is there something you are doing to combat that change? Do you ever use your own exercises, or is coordinating all that you do exercise enough?
Dr. Breznitz: Like all persons who are not getting younger I have noticed slowing down of information processing. Sometimes a word is missing for a while and one has to develop detours to overcome the problem. Fortunately, it is not to serious and I attribute my luck to both cognitive training (which I do for more than one reason) and to being an entrepreneur at the age of 73, surrounded by smart young people who make sure that I am challenged all the time.
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