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More backstory needed on study of ‘brain training’ benefits for dementia

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3 Star

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Brain training' cut dementia risk in healthy adults -U.S. study

Our Review Summary

A preliminary analysis of a 10-year study suggests computer-based cognitive-training software, also known as “brain games,” may lower the risk of dementia among healthy adults. The article exhibits some skepticism as it points out these findings have yet to undergo rigorous peer review. And there’s useful context, including discussion of a previous analysis done on the same dataset which revealed a much less rosy picture. The story also delves into the relationships between past and current investigators, and the company Posit Science which owns BrainHQ.com.

The article would be more complete if a clarification was included on how dementia risk was assessed. The story should also have mentioned — as a competing piece from MedPageToday points out — that the 10-year study wasn’t powered to detect dementia outcomes. In fact, the new secondary analysis presented here could be viewed as an attempt to salvage the 10-year study and show a benefit that wasn’t evident in the primary analysis. This is the drawback of a data mining approach to making statistical inference; if you look hard enough, you will always find something.

 

Why This Matters

Currently, many researchers in cognitive psychology and neuroscience reject the notion that “brain games” have any effect on cognitive functions. This notion, however, may need to be reexamined If new preliminary findings, presented at the recent Alzheimer’s Association International Conference in Toronto, which suggest brain games may cut the risk of dementia in healthy adults, hold up to rigorous peer review and independent replication.

Criteria

Does the story adequately discuss the costs of the intervention?

Not Satisfactory

The article does not explicitly discuss the costs of brain game software programs. It does give Posit Science’s BrainHQ.com as an example so the reader can probably find out the cost rather easily.

Does the story adequately quantify the benefits of the treatment/test/product/procedure?

Not Satisfactory

After an initial analysis revealed lukewarm associations between brain games and various cognitive functions, a secondary analysis was undertaken whose findings are reported in this article. Study participants were divided into three groups who received training for either memory improvement, reasoning, or speed-of-processing. The findings of the secondary analysis reveal that

“speed training showed 33 percent less risk of dementia relative to the control group, while the memory and the reasoning interventions offered no such benefit.”

and that

“people who completed 11 or more speed training sessions were at 48 percent less risk for developing dementia over the 10 years of the study”

But these are relative risk reductions, and the readers has no way to judge the magnitude of the benefit in absolute terms. A competing STAT story, by contrast, gave us the figures we were looking for:

14 percent of ACTIVE participants who received no training had dementia 10 years later, said psychologist Jerri Edwards of the University of South Florida, who led the study. Among those who completed up to 10 60-to-75-minute sessions of computer-based training in speed-of-processing — basically, how quickly and accurately they can pay attention to, process, and remember brief images on a computer screen — 12.1 percent developed dementia. Of those who completed all 10 initial training sessions plus four booster sessions a few years later, 8.2 percent developed dementia.

Does the story adequately explain/quantify the harms of the intervention?

Not Applicable

It’s hard to imagine any serious harms from using brain games, other than time lost.

Does the story seem to grasp the quality of the evidence?

Not Satisfactory

The reader is rightfully reminded throughout the article that the findings of Edwards’ team are only preliminary as evidenced by the following:

“The new findings would be quite promising if they hold up through peer review and publication in a scientific journal, said Dr. John King.”

However, the story doesn’t clarify some key limitations, including the fact that this is a secondary analysis of a study that was never powered to detect dementia outcomes. While the story does mention that this is a “secondary analysis” it doesn’t explain the implications — particularly the fact that re-running the numbers in this way can generate uncertainty in the results.

Finally, we never learn how the risk of dementia is measured, especially in healthy adults.

Does the story commit disease-mongering?

Satisfactory

People at risk for Alzheimer’s may benefit from brain games if the preliminary results presented hold up to further scrutiny. While the article acknowledges this, it does not commit any disease-mongering regarding Alzheimer’s or other cognitive disorders.

Does the story use independent sources and identify conflicts of interest?

Satisfactory

The article introduces past and current investigators of the study, and their relationship to the company Posit Science:

“The new analysis was by Dr. Jerri Edwards of the University of South Florida, whose mentor, Dr. Karlene Ball of the University of Alabama at Birmingham, sold her rights to the program to Posit Science. Edwards also was a paid consultant for the company for part of 2008.”

Does the story compare the new approach with existing alternatives?

Not Satisfactory

The story doesn’t address other factors, such as diet, exercise, social engagement, that have been associated with reduced risk of Alzheimer’s.

Does the story establish the availability of the treatment/test/product/procedure?

Satisfactory

According to the article, there already exist companies such as Posit Science who offer these so-called brain games.

Does the story establish the true novelty of the approach?

Satisfactory

The findings reported may be the first to show that an intervention using brain games could “delay the development of dementia in normal, healthy adults.”

Does the story appear to rely solely or largely on a news release?

Satisfactory

Several sources were interviewed including Dr. John King, who was involved in the original study, and Mayo Clinic Alzheimer’s expert Dr. Ronald Petersen. Based on this, it does not appear the story was based solely on a news release.

Total Score: 5 of 9 Satisfactory

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