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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.

Turning Back The Clock Could Mean More Car Accidents: Tips For Better Night Vision

Our annual “fall back” time change that gives us an extra hour of sleep is welcome news for most of us. But there are some unintended consequences of darker evenings, especially for drivers. According to the National Safety Council, traffic death rates are three times greater at night than during the day.

In a special rebroadcast of the Healthy Vision with Dr. Val Jones show, I interviewed Dr. Christina Schnider, Senior Director, Professional Communications for VISTAKON® Division of Johnson & Johnson Vision Care, about common nighttime driving problems such as dry eyes, headaches, and eye fatigue. I also spoke with John Ulczycki, Group Vice President – Strategic Initiatives, for the National Safety Council, about safe driving tips. You can listen to the show here:

Most people experience a drop in visual acuity in the dark, and this can cause difficulty seeing traffic signs, pedestrians and roadside objects. The primary reason why it’s difficult to see at night is that our pupils dilate to let in as much light as possible. The trade off with large pupils is that visual acuity suffers. It’s normal for the average person’s visual acuity to drop from 20/20 to 20/40 in low light conditions.

Because of vision challenges, driving in low-light conditions can fatigue the eyes and head and neck muscles as the driver strains to see the environment more clearly. Dry eyes can occur from reduced blink rates and motor vehicle heating and cooling systems. Glasses wearers may have a reduced field of vision which further complicates driving in the dark. In fact, in a recent survey one -in-three drivers reported that they didn’t see well at night.

Dr. Schnider and Mr. Ulczycki suggest that night time driving may be safer (and more comfortable) with these tips:

1.  Update your eyeglass or contact lens prescription(s). Since darkness reduces visual acuity, wearing lenses that correct your vision to 20/20 in normal light conditions is extra important. Old glasses or contacts with outdated vision correction power can make driving in the dark more hazardous. If you experience significant challenges seeing at night, you may have a condition called “nighttime myopia” and should visit your eye doctor for advice.

2. Avoid driving long distances in low-light conditions. Since we already know that driving in the dark can cause eye fatigue, dry eyes, and reduced visual acuity, it’s best to minimize the time you spend behind the wheel during dark hours. Whenever possible, plan your travel so that the majority of your driving time occurs during daylight hours.

3. Take frequent breaks. Even though it’s tempting to push through your fatigue and finish driving those last miles to your destination, it’s safer to give yourself (and your eyes) a break. Stopping for gas or at a rest area may improve your alertness and visual fatigue. Remember that impaired drivers are more likely to be on the road at night, so vigilance on your part may prevent an accident.

4. Decrease your night-time driving speed. If you do need to drive in the dark, doing so more slowly may prevent accidents. Traveling at a slower speed can improve reaction time under lower-visibility conditions.

5. Check your headlights. It is estimated that 50% of all motor vehicle headlights are not optimally aligned. Potholes and bumps in the road can jolt the lights out of alignment. It’s important not to look directly at oncoming headlights. This can temporarily blind you as your pupils adjust to a quick change in lighting conditions.

For more safety tips, please listen to the full Healthy Vision podcast.

*Val Jones, M.D. is a paid consultant for Johnson & Johnson Vision Care, Inc.*

Rock Stars Want To Franchise Specialty Teen Cancer Centers Across America

Rock superstars Roger Daltrey and Pete Townshend of “The Who” have a new cause: sparking a franchise of teen-oriented cancer treatment centers across America. To kick off the launch of Teen Cancer America, Daltrey & Townshend were featured at a conference held at the National Press Club in Washington, D.C. I was fortunate to be invited to sit at the head table next to teen cancer survivor Sarah Sterner – a bright and confident young woman from Atlanta who was cured of brain cancer two years ago.

Sarah told the crowd what it was like to be a fifteen-year-old in a pediatric oncology unit populated by ukulele-playing clowns and screaming infants. The extreme age-related disconnect between her pscho-social needs and that of younger kids and babies served to make her feel even more isolated during her course of treatment. She longed for the companionship of others like her, but without any national cancer centers focused on the special needs of teens, she was on her own.

Roger Daltrey became interested in teen cancer when his personal physician took up the cause in the U.K. and turned to him for support. Daltrey’s decades of playing music to teen audiences made him keenly aware of their unique psycho-social needs. “When you’re a teenager, it’s horrifying if you have a spot on your nose. Imagine what it’s like if you have cancer!” said Daltrey.

Teen Cancer America began as a movement called the Teen Cancer Trust in the U.K. According to Daltrey, preliminary research (comparing teens treated in a typical NHS cancer ward versus a unit sponsored by the Teen Cancer Trust) suggests that there may be as much as a 15% survival advantage in being treated in the special units. Daltrey attributes this to increased morale that helps teens and families find the will to fight through life-threatening treatments.

When asked how American cancer centers compare to those in the U.K. Daltrey immediately responded that he believed the U.S. centers were far superior. He described the incredible resources available at UCLA and Duke, and how the facilities themselves were unbelievably beautiful, sporting plant-filled atria, massive skylights, and high tech imaging and radiation equipment. Nonetheless, he noted, “Teens don’t want to hang out in an atrium. There is just no place that appeals to teenagers at these centers.”

Whether specialized teen cancer treatment environments in the U.S. will dramatically improve survival rates remains to be seen, but there’s no doubt that recognizing the unique psycho-social needs of teenagers would be a boon for patients and families at pediatric cancer centers. Like post-traumatic stress disorder in military personnel, the psychological ravages of cancer may well be under recognized, especially in the teen and young adult populations.

Thank you Roger Daltry and Pete Townshend for bringing this to our attention.

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Find out how to support Teen Cancer America here.

Check out The Who themed cookie from the press club event (delicious!):

Are Primary Care Physicians Being Assimilated By The Borg?

If you live in a small town or rural area of the United States, you may have noticed that family doctors are becoming an endangered species. Private and public health insurance reimbursement rates are so low that survival as a solo practitioner (without the economies of scale of a large group practice or hospital system) is next to impossible. Some primary care physicians are staying afloat by refusing to accept insurance – this allows them the freedom to practice medicine that is in the patient’s best interest, rather than tied to reimbursement requirements.

I joined such a practice a few years ago. We make house calls, answer our own phones, solve at least a third of our patients’ problems via phone (we don’t have to make our patients come into the office so that we can bill their insurer for the work we do), and have low overhead because we don’t need to hire a coding and billing team to get our invoices paid. Our patients love the convenience of same day office visits, electronic prescription refills, and us coming to their house or place of business as needed.

Using health insurance to pay for primary care is like buying car insurance for your windshield wipers. The bureaucracy involved raises costs to a ridiculously unreasonable level. I wish that more Americans would decide to pay cash for primary care and buy a high deductible health plan to cover catastrophic events. But until they do, economic pressures will force primary care physicians into hospital systems and large group practices. My friend and fellow blogger Dr. Doug Farrago likens this process to being “assimilated by the Borg.”

Doug offered a challenge to his readers – to customize the definition of Star Trek’s Borg species to today’s healthcare players. I gave it my best shot. Do you have a better version?

Who are the Borg:

The Borg are a collection of alien species that have turned into cybernetic organisms functioning as drones of the collective or the hive. A pseudo-race, dwelling in the Star Trek universe, the Borg take other species by force into the collective and connect them to “the hive mind”; the act is called assimilation and entails violence, abductions, and injections of cybernetic implants. The Borg’s ultimate goal is “achieving perfection”.

My attempt to customize the definition:

Hospitalists are a collection of primary care physicians that have turned into cybernetic organisms functioning as drones of the collective or hive. Hive collective administrators (HCAs), in association with partnered alien species drawn from the insurance industry and government, take other primary care physicians by economic force and connect them to “the hive mind”; the act is called assimilation and entails crippling reimbursement cuts, massive increases in documentation requirements, oppressive professional liability insurance rates, punitive bureaucratic legislation, and threat of imprisonment for failure to adhere to laws that HCA- partnered species interpret however they wish. The HCAs’ ultimate goal is “achieving perfect dependency” first for the drones, then for their patients, so that HCAs and their alien partners will become all powerful – dictating how neighboring species live, breathe, and conduct their affairs. Resistance is futile.

***

To learn more about my insurance-free medical practice, please click here. We can unplug you from the Borg ship!

Does Normalizing Obesity Do More Harm Than Good?

It is estimated that 44% of Americans will be obese by the year 2030. The AMA warns that increasing obesity rates will lead “to millions of additional cases of type 2 diabetes, stroke and coronary heart disease, as well as arthritis and hypertension. Billions of dollars will be wasted through lost economic productivity and skyrocketing medical costs.”

And yet, a funny thing is happening in consumer land – efforts to normalize obesity are gaining momentum via social media platforms. Take the “beauty comes in all sizes” ad for example. This was shared with me by an old grade school friend on Facebook. And while I can appreciate the sentiment that women of various genetic predispositions are beautiful, I stopped short at the idea that obesity itself was attractive. There is a growing movement among obese men and women to promote acceptance of their size, and if they win this argument they could substantially undermine efforts to help Americans become healthy and avoid disease. I know this sounds harsh, but to me, promoting beauty of all sizes – when that includes obesity- is tantamount to promoting a “smoking is cool” campaign.

Smoking rates in the United States have dropped from 42.4% in 1965 to 19% in 2010. Although one-in-five people still smoke, we have successfully reduced the smoking burden by more than half. The reasons for this reduction are complex, but they include public awareness campaigns regarding the harmfulness of cigarette smoking, increasing taxes on cigarettes, and public policy regarding where and when people can smoke in public.

The same exact approach can’t work for obesity because while people can simply quit smoking, we can’t quit eating. And what we eat is less important than how much we eat. I personally do not favor “fat taxes” on specific food items because almost any food could cause weight gain if consumed in large enough quantities. I also don’t favor singling out obese people for portion reduction at restaurants (this has actually been proposed), or other policies that are similar to what we’ve done with smoking in public spaces. Promoting prejudice against the obese is not constructive.

So that leaves us with public perception/education and peer pressure as our primary national strategy for reducing obesity rates.  (Of course smaller initiatives can help: employers can incentivize weight loss and wellness, policy makers can encourage new housing developments that promote active lifestyles, and local groups and non-profits can promote fitness initiatives and healthy eating behaviors.)

My concern is that if too many people decide that normalizing obesity is better than fighting it, America will lose this battle. Obesity-related disease is already costing us about twice as much as smoking-related illnesses. And both smoking and obesity are nearly 100% avoidable.

Obesity is not beautiful, and we must redouble our efforts to win the hearts and minds of the public on this subject without resorting to the other extreme (idolizing anorexia). Good health lies somewhere in the middle – and keeping our middles within a reasonable range is the most important health goal we have.

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