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GE N E R ATIONS – Journal of the American Society on Aging

By Alvaro Fernandez

Solving the Brain Fitness
Puzzle Is the Key to
Self-Empowered Aging
What works to preserve cognitive abilities?
Much like the human brain, the answer is
complicated, individual, and nuanced.

A

s the concept of brain
fitness (or, the brain’s
ability to function efficiently
and effectively in personal
and professional life) goes
mainstream, the proliferation
of scientific findings, media
reports, and commercial
claims is generating much
noise and confusion. Knowing
what to believe and what to
do presents a real-life puzzle,
leading many people to either
inaction or toward a focus on
the wrong priorities.

There is scientific
‘consensus’ that brain
training both does, and
does not, work.
This past October, sixtynine scientists, convened by the
Stanford Center on Longevity,
released an announcement
stating that there is a scientific

consensus that brain training
does not work (Allaire et al.,
2014). By December 2014,
127 scientists worldwide had
signed another statement,
challenging the previous
“consensus” and supporting the
value of brain training (AlescioLautier et al., 2014).
The problem here is not
seeing the forest for the trees.
Eighty-three percent of more
than 3,000 early adopters
surveyed by the independent
market research firm SharpBrains (which I co-founded)
agreed that “adults of all ages
should take charge of their own
brain fitness, without waiting
for their doctors to tell them to”
(Fernandez et al., 2013). When
we conducted in-depth focus
groups and interviews with
respondents, the main question
many had was not what has
perfect science behind it, but
what has better science than
the other things people are

Copyright © 2015 American Society on Aging; all rights reserved. This article may not be duplicated, reprinted or
distributed in any form without written permission from the publisher: American Society on Aging, 575 Market
St., Suite 2100, San Francisco, CA 94105-2869; e-mail: info@asaging.org. For information about ASA’s publications
visit www.asaging.org/publications. For information about ASA membership visit www.asaging.org/join.

doing—solving crossword
puzzle number million-andone, taking “brain supplements,” or doing nothing at all
until depression or dementia
hits home.
And the unequivocal answer
to that question, based upon the
most authoritative systematic
reviews of the evidence conducted to date (The Government Office for Science, 2008;
AHRQ, 2010), is that one thing
does work better than most
common alternatives. The
challenge is that “thing” is
different for everyone.
Given that more than 50
percent of older adults in a
recent survey expressed a
strong willingness to spend
money on tools or resources
to maintain or improve brain
health (David and Gelfeld,
2014), how do we guide them
in the right direction? Further,
how can we empower everyone
to make decisions that are more

Spring 2015 • Vol. 39 . No. 1 | 37

GE NER ATIO NS – Journal of the American Society on Aging

likely to help with navigating
the available scientific evidence
and applying it in the way most
relevant to a person’s circumstances and objectives?
First, we need to educate the
public on a fuller, more nuanced
approach that emphasizes a global view of brain fitness, one
that is not restricted to the
prevention or treatment of
dementia, but encompasses the
lifelong trajectory of one’s brain
health and performance.
Notice the opportunity
presented in Figure 1 (this
page). If we can help more
people’s brain performance
advance through life, following
the trajectory of the line on top,
we would help millions to improve their quality of life and
their productivity for years
more and, at the same time,
delay future morbidity, potentially halving the prevalence of
Alzheimer’s Disease.

We May Not Stop Dementia,
But We Can Prolong Function

Through our independent
and comprehensive analysis
of hundreds of randomized
clinical trials and dozens of
meta-analyses, conducted as
preparation for the book The
SharpBrains Guide to Brain
Fitness: How to Optimize Brain
Health and Performance at
Any Age (Fernandez, Goldberg,
and Michelon, 2013), we found
multiple evidence-based ways
to promote and protect a range
of brain functions: aerobic exercise; learning a new language;
mastering meditation; rotating
through complex professional
assignments; following the
proper nutrition; volunteering;
cognitive training; biofeedback;
and more.
Given space constraints,
we cannot go into the specific
guidelines for each of the
pieces in the “brain fitness
jigsaw puzzle” presented in
Figure 2 (see page 39), but
the often overlooked main finding is that based upon the best

Pages 37–40

available evidence, no shoe fits
all: different interventions work
best for specific purposes and
for specific populations.

Cross-Training Our Brains
Brain fitness should begin with
a basic understanding of how
the brain works, followed by
the pillars of a healthy lifestyle:
balanced nutrition, aerobic
exercise, stress management,
mental stimulation, and social
engagement.
Cross-training our brains—
exercising a wide range of
cognitive, emotional, and
executive functions—can help
us and build up targeted brain
functions over time. Researchbased methodologies include
meditation, reframing (cognitive therapy), biofeedback, and
cognitive training.
Where I see most people
failing today is in how to prioritize options—how to identify one’s weak points and
find suitable evidence-based

Figure 1
Nothing has been shown to
prevent dementia’s pathology,
but there are evidence-based
ways to improve and prolong
brain functionality, and to
reduce the probability of
manifesting disease—a very
hopeful message that often gets
forgotten in the eternal search
for the next “magic pill.”
To capture the opportunity,
we need to master a new toolkit
of interventions and assessments, combining lifestyle
options and technologies as
appropriate (Fernandez,
Goldberg, and Michelon, 2013).

38 | Spring 2015 • Vol. 39 . No. 1

Copyright © 2015 American Society on Aging; all rights reserved. This article may not be duplicated, reprinted or
distributed in any form without written permission from the publisher: American Society on Aging, 575 Market
St., Suite 2100, San Francisco, CA 94105-2869; e-mail: info@asaging.org. For information about ASA’s publications
visit www.asaging.org/publications. For information about ASA membership visit www.asaging.org/join.

Pages 37–40

Self-Empowered Aging

Figure 2

Potential Solution: Julián
is trying to remain cognitively
engaged, but not in ways that
supply novelty, variety, and
challenge—the ingredients of
real mental exercise. His brain
would be better served by
volunteering, perhaps providing financial planning advice
to low-income families for a
nonprofit organization. He
also could regularly use selfassessments, such as Cogniciti
or BrainBaseline (see sidebar,
page 40), to better monitor his
memory and cognition over
time and to inform conversations with his doctor.
when she does find that time,
solutions for action. Here are
Kelly, age 75, has been
she spends it watching TV.
three simplified vignettes,
retired for a while. She stopped
Unregulated stress may be a
adapted from The SharpBrains
exercising when her mobility
Guide to Brain Fitness (Fernan- major factor behind her cogniand strength declined. Her
tive difficulties. She could start
dez, Goldberg, and Michelon,
husband passed away four
2013), that show how important integrating exercise and medita- years ago. Though she has
tion into her schedule, maybe in several good friends nearby, she
it is to identify personal priorities and, thus, the best tools, the evenings, spending a bit less is hesitant to drive to visit
based upon an individual’s par- time in front of the television, or them. More and more, Kelly
going to the gym twice a week
ticular starting point, needs,
prefers to stay safe at home
during lunchtime or on the
and goals.
rather than risk taking the car,
weekends. Using HeartMath’s
Charlotte is an accomand so at times she feels lonely.
Inner Balance Trainer (see side- She loves reading novels, in
plished 58-year-old reporter.
She has been watching her diet bar, page 40) could help her
English as well as in her
quickly master stress regulation. half-forgotten French.
for years. It is getting harder
Julián, a recently retired
now, especially at work, for her
Potential Solution: Kelly
67-year-old financial advisor,
to concentrate and to process
would benefit from resuming
complex new information, and finally has the time to take care an appropriate exercise rouof himself, and to swim often at tine, perhaps a routine of
she notices more memory
the local community center.
lapses. Charlotte feels highly
light-to-medium exercise
Still, he misses the constant
stressed these days, trying to
such as walking regularly and
interaction with clients and col- participating in chair yoga
juggle her demanding job and
leagues in the office. He feels
acting as her parents’ primary
once a week. She could also
that his mental power and
caregiver. To cope with stress,
join a book club, or better yet,
speed are not what they used to find some contracts editing
she often spends evenings
watching TV for several hours. be, so he is trying to “use it” by college essays or a related
watching documentaries on TV activity that would tap into her
Potential Solution: Charand by raising his daily quota of love of books. Given that her
lotte’s schedule does not allow
crossword puzzles and Sudoku. fear of driving inhibits these
for much time for herself, and
Copyright © 2015 American Society on Aging; all rights reserved. This article may not be duplicated, reprinted or
distributed in any form without written permission from the publisher: American Society on Aging, 575 Market
St., Suite 2100, San Francisco, CA 94105-2869; e-mail: info@asaging.org. For information about ASA’s publications
visit www.asaging.org/publications. For information about ASA membership visit www.asaging.org/join.

Spring 2015 • Vol. 39 . No. 1 | 39

GE NER ATIO NS – Journal of the American Society on Aging

Pages 37–40

New Brain Fitness Tools
BrainBaseline: A free mobile app featuring dozens of cognitive tests that can be retaken over time, and
that facilitate self-monitoring; www.brainbaseline.com/.
BrainHQ: A Web-based cognitive training program that includes Useful Field of View (UFOV) training
(UFOV is an important component of safe driving); www.brainhq.com/.
Cogniciti: A free Web-based cognitive assessment designed to measure whether the test-taker’s cognition
is within a normal range given their age, or warrants a visit to the doctor; www.cogniciti.com/.
CogniFit Senior Driver: A Web-based cognitive training program that assesses and trains for ten drivingrelated cognitive skills; https://lifestore.aol.com/category/online-learning/cognifit-senior-driver.
HeartMath Inner Balance: A mobile Heart Rate Variability (HRV) sensor designed to help measure and
regulate physiological stress; www.heartmath.com/innerbalance/.

opportunities, it would make
sense for her to prioritize
safe-driving classes, and even
use a cognitive training program aimed at safe-driving
skills, such as BrainHQ, or
CogniFit Senior Driver (see
sidebar, above).
In summary, Charlotte,
Julián, Kelly, and millions of

other adults would benefit from
high-quality information and
education to help them to
make effective brain fitness
decisions, and to help them
navigate all options—ones that
would address their unique
circumstances and goals.
No one shoe fits all. Why
should we believe the reverse

of that maxim would apply to
something as diverse and complex as the human brain?

Allaire, J. C., et al., 2014. “A
Consensus on the Brain Training
Industry from the Scientific Community.” Max Planck Institute
for Human Development and
Stanford Center on Longevity.
http://longevity3.stanford.edu/
blog/2014/10/15/the-consensuson-the-brain-training-industryfrom-the-scientific-community/.
Retrieved January 15, 2015.

Fernandez, A., Goldberg, E., and
Michelon, P. 2013. The SharpBrains
Guide to Brain Fitness: How to Optimize Brain Health and Performance
at Any Age. Washington, DC:
SharpBrains.

Alvaro Fernandez, M.A., M.B.A.,
is the co-founder and CEO of
SharpBrains (www.sharpbrains.
com), headquartered in Washington, D.C. He can be contacted at
afernandez@sharpbrains.com.

References
Agency for Healthcare Research
and Quality (AHRQ). 2010. Alzheimer’s Disease and Cognitive
Decline. Rockville, MD: AHRQ.
www.ahrq.gov/clinic/tp/alzcogtp.
htm. Retrieved January 15, 2015.
Alescio-Lautier, B., et al., 2014.
“Open Letter Response to ‘A
Consensus on the Brain Training
Industry from the Scientific Community.’ ” www.cognitivetraining
data.org/. Retrieved January 15,
2015.

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David, P., and Gelfeld, V. 2014.
2014 Brain Health Research Study.
Washington, DC: AARP. www.
aarp.org/research/topics/health/
info-2015/staying-sharper-study.
html. Retrieved January 15, 2015.

Fernandez, A., et al., 2013. The Digital Brain Health Market 2012–2020:
Web-Based, Mobile and BiometricsBased Technology to Assess, Monitor and Enhance Cognition and
Brain Functioning. Washington,
DC: SharpBrains.
The Government Office for Science.
2008. Foresight Mental Capital and
Well-being Project: Final Project
Report. London, UK: The Government Office for Science.

Copyright © 2015 American Society on Aging; all rights reserved. This article may not be duplicated, reprinted or
distributed in any form without written permission from the publisher: American Society on Aging, 575 Market
St., Suite 2100, San Francisco, CA 94105-2869; e-mail: info@asaging.org. For information about ASA’s publications
visit www.asaging.org/publications. For information about ASA membership visit www.asaging.org/join.