Brain training (also called cognitive training) is a program of regular mental activities purported to maintain or improve one's cognitive abilities. It reflects a hypothesis that cognitive abilities can be maintained or improved by exercising the brain, analogous to the way physical fitness is improved by exercising the body.
Although there is strong evidence that aspects of brain structure remain "plastic" throughout life and that high levels of mental activity are associated with reduced risks of age-related dementia, scientific critics assert that support for the concept of "brain fitness" is limited. The term is infrequently used in academic literature, but is commonly used in the context of self-help books and commercial products.
Cognitive reserve is the capacity of a person to meet the various cognitive demands of life and is evident in an ability to assimilate information, comprehend relationships, and develop reasonable conclusions and plans. Cognitive training includes interventions targeted at improving cognitive abilities. One hypothesis to support cognitive training is that certain activities, done regularly, might help maintain or improve cognitive reserve.
By 2016, companies offering products and services for cognitive training were marketing them as improving educational outcomes for children, and for adults as improving memory, processing speed, and problem-solving, and even as preventing dementia or Alzheimers. They often have supported their marketing with discussion about the educational or professional background of their founders, some discuss neuroscience that supports their approach—especially concepts of neuroplasticity and transfer of learning, and some cite evidence from clinical trials. The key claim made by these companies is that the specific training that they offer generalizes to other fields—academic or professional performance generally or everyday life.
In 2016, there was some evidence that some of these programs improved performance on tasks in which users were trained, less evidence that improvements in performance generalize to related tasks, and almost no evidence that "brain training" generalizes to everyday cognitive performance; in addition most clinical studies were flawed. But in 2017, the National Academies of Sciences, Engineering, and Medicine found moderate strength evidence for cognitive training as an intervention to prevent cognitive decline and dementia, and in 2018, the American Academy of Neurology guidelines for treatment of mild cognitive impairment included cognitive training.
CogniFit was founded in 1999, Cogmed in 2001, Posit Science in 2002, and Brain Age was first released in 2005, all capitalizing on the growing interest within the public in neuroscience, along with heightened worries by parents about ADHD and other learning disabilities in their children, and concern about their own cognitive health as they aged.
The launch of Brain Age in 2005 marked a change in the field, as prior to this products or services were marketed to fairly narrow populations (for example, students with learning problems), but Brain Age was marketed to everyone, with a significant media budget. In 2005, consumers in the US spent $2 million on cognitive training products; in 2007 they spent about $80 million.
By 2012, "brain training" was a $1 billion industry. In 2013 the market was $1.3 billion, and software products made up about 55% of those sales. By that time neuroscientists and others had a growing concern about the general trend toward what they called "neurofication", "neurohype", "neuromania", and neuromyths.
To address growing public concerns with regard to aggressive online marketing of brain games to older population, a group of scientists published a letter in 2008 warning the general public that there is a lack of research showing effectiveness of brain games in older adults.
In 2014 another group of scientists published a similar warning. Later that year, another group of scientists made a counter statement, organized and maintained by the Chief Scientific Officer of Posit. They compiled a list of published studies on efficacy of cognitive training across populations and disciplines.
In 2017, a committee of the National Academies of Sciences, Engineering, and Medicine released a report about the evidence on interventions for preventing cognitive decline and dementia.
In 2017, a group of Australian scientists undertook a systematic review of what studies have been published of commercially available brain training programs in an attempt to give consumers and doctors credible information on which brain training programs are actually scientifically proved to work. Unfortunately, after reviewing close to 8,000 studies about brain training programs marketed to healthy older adults that were studied, most programs had no peer reviewed published evidence of their efficacy and of the seven brain training programs that did, only two of those had multiple studies, including at least one study of high quality: BrainHQ and CogniFit.
Regulation and lawsuits
Starting in January 2015, the United States Federal Trade Commission (FTC) sued companies selling "brain training" programs or other products marketed as improving cognitive function, including WordSmart Corporation, the company that makes Lumosity, and Brain Research Labs (which sold dietary supplements) for deceptive advertising; later that year the FTC also sued LearningRx.
The FTC found that Lumosity's marketing "preyed on consumers' fears about age-related cognitive decline, suggesting their games could stave off memory loss, dementia, and even Alzheimer's disease", without providing any scientific evidence to back its claims. The company was ordered not to make any claims that its products can "[improve] performance in school, at work, or in athletics" or "[delay or protect] against age-related decline in memory or other cognitive function, including mild cognitive impairment, dementia, or Alzheimer's disease", or "[reduce] cognitive impairment caused by health conditions, including Turner syndrome, post-traumatic stress disorder (PTSD), attention deficit hyperactivity disorder (ADHD), traumatic brain injury (TBI), stroke, or side effects of chemotherapy", without "competent and reliable scientific evidence", and agreed to pay a $50 million settlement (reduced to $2 million).
In its lawsuit against LearningRx, the FTC said LearningRx had been "deceptively claim[ing] their programs were clinically proven to permanently improve serious health conditions like ADHD (attention deficit hyperactivity disorder), autism, dementia, Alzheimer's disease, strokes, and concussions". In 2016, LearningRx settled with the FTC by agreeing not to make the disputed assertions unless they had "competent and reliable scientific evidence" which was defined as randomized controlled trials done by competent scientists." For the judgment's monetary component, LearningRx agreed to pay $200,000 of a $4 million settlement.
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