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Can Brain Games Make You Smarter?

Can we “train” our brains to be brighter, sharper, faster?

A while back I wrote a post about a big study looking at “brain training”. The researchers wanted to know whether training programs that look like video games (like Brain Age andLumosity) could significantly improve brain performance on various tests. The results, in a nutshell, showed that while participants improved on the tasks they trained on (e.g., if the game involved ranking balls from smallest to biggest, the participants got *really* good at ranking balls from smallest to biggest), the improvement didn’t carry over to general brain function.Turns out ranking ball sizes doesn’t help you remember where you left your keys this morning.

Two years later, what’s the word?

I’m going to shift a little from how I normally do things (review a single article) and tell you about findings I learned about at the recent Aging and Society conference. At the conference, several researchers talked about brain training in the context of aging. We know that as we get older our cognitive abilities decline – we forget names and words, misplace our shopping lists, and process information a little bit more slowly. Wouldn’t it be fantastic if we could just spend ten minutes a day playing games on our iPad and successfully counter this decline? Of course it would be fantastic. Not just for us, but also for the companies who are trying very hard to convince us to buy their products to improve our cognition.

The problem is that skills are specific. If you want to become a fabulous jazz pianist, you have to play the piano (preferably jazz songs, too). If you want to become a star ballet dancer, you have to practice ballet. If you want to become a better mountain biker, you have to mountain bike – road biking will improve your leg strength and fitness, but ultimately it won’t make you a better mountain biker. So why should things be any different for brain skills?

As it turns out, they aren’t. Two years later, nearly all the research conducted in the field of brain training is turning up the same results: people only get better at the tasks they trained on – the improvement doesn’t cross over to more general skills, different skills, or everyday life. In one study, a researcher compared a commercially available brain training program with what she called an “active control” – a group that simply played regular video games like Tetris. She found that the group who spent time on the commercially available brain training program actually saw some aspects of their cognition decline compared with the control group. Bummer.

Now don’t throw out your Brain Age game yet – everyone at the conference agreed that engaging your brain in training programs is better than not doing anything. And most of the researchers felt that while the programs don’t work now, it’s not to say they’ll never work. We are increasingly more knowledgeable about how the brain works, what happens when we get old, and what different training tasks do. So it’s quite possible that sometime in the near-ish future (don’t ask me when) we could see the advent of brain training programs that do have a significant and lasting impact on cognition.

Until then, there is one thing you can do to have a significant and lasting impact on your brain health… And I’ll tell you in the next post.

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Dr. Julie Robillard is a neuroscientist, neuroethicist and science writer. You can find her blog at scientificchick.com.


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Richmond, VA – In an effort to simplify inpatient medical billing, one area hospitalist group has determined that “altered mental status” (ICD-9 780.97) is the most efficient code for use in any patient work up.

“When you enter a hospital, you’re bound to have some kind of mental status change,” said Dr. Fishbinder, co-partner of Area Hospitalists, PLLC. “Whether it’s confusion about where your room is located in relationship to the visitor’s parking structure, frustration with being woken up every hour or two to check your vital signs, or just plain old fatigue from being sick, you are not thinking as clearly as before you were admitted. And that’s all the justification we need to order anything from drug and toxin screens, to blood cultures, brain MRIs, tagged red blood cell nuclear scans, or cardiac Holter monitoring. There really is no limit to what we can pursue with our tests.”

Common causes of mental status changes in the elderly include medicine-induced cognitive side effects, disorientation due to disruption in daily routines, age-related memory impairment, and urinary tract infections.

“The urinalysis is not a very exciting medical test,” stated Dr. Fishbinder. “It doesn’t matter that it’s cheap, fast, and most likely to provide an explanation for strange behavior in hospitalized patients. It’s really not as elegant as the testing involved in a chronic anemia or metabolic encephalopathy work up. I keep it in my back pocket in case all other tests are negative, including brain MRIs and PET scans.”

Nursing staff at Richmond Medical Hospital report that efforts to inform hospitalists about foul smelling urine have generally fallen on deaf ears. “I have tried to tell the hospitalists about cloudy or bloody urine that I see in patients who are undergoing extensive work ups for mental status changes,” reports nurse Sandy Anderson. “But they insist that ‘all urine smells bad’ and it’s really more of a red herring.”

Another nurse reports that delay in diagnosing urinary tract infections (while patients are scheduled for brain MRIs, nuclear scans, and biopsies) can lead to worsening symptoms which accelerate and expand testing. “Some of my patients are transferred to the ICU during the altered mental status work up,” states nurse Anita Misra. “The doctors seem to be very excited about the additional technology available to them in the intensive care setting. Between the central line placement, arterial blood gasses, and vast array of IV fluid and medication options, urosepsis is really an excellent entré into a whole new level of care.”

“As far as medicine-induced mental status changes are concerned,” added Dr. Fishbinder, “We’ve never seen a single case in the past 10 years. Today’s patients are incredibly resilient and can tolerate mixes of opioids, anti-depressants, anti-histamines, and benzodiazepines without any difficulty. We know this because most patients have been prescribed these cocktails and have been taking them for years.”

Patient family members have expressed gratitude for Dr. Fishbinder’s diagnostic process, and report that they are very pleased that he is doing everything in his power to “get to the bottom” of why their loved one isn’t as sharp as they used to be.

“I thought my mom was acting strange ever since she started taking stronger pain medicine for her arthritis,” says Nelly Hurtong, the daughter of one of Dr. Fishbinder’s inpatients. “But now I see that there are deeper reasons for her ‘altered mental status’ thanks to the brain MRI that showed some mild generalized atrophy.”

Hospital administrators praise Dr. Fishbinder as one of their top physicians. “He will do whatever it takes to figure out the true cause of patients’ cognitive impairments.” Says CEO, Daniel Griffiths. “And not only is that good medicine, it is great for our Press Ganey scores and our bottom line.”

As for the nursing staff, Griffiths offered a less glowing review. “It’s unfortunate that our nurses seem preoccupied with urine testing and medication reconciliation. I think it might be time for us to mandate further training to help them appreciate more of the medical nuances inherent in quality patient care.”

Dr. Fishbinder is in the process of creating a half-day seminar on ‘altered mental status in the inpatient setting,’ offering CME credits to physicians who enroll. Richmond Medical Hospital intends to sponsor Dr. Fishbinder’s course, and franchise it to other hospitals in the state, and ultimately nationally.

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