By Alvaro Fernandez

A spate of recent global news coverage on cognitive fitness and "brain training" reflects
a growing interest in innovative interventions to keep our brains sharp as we age. This interest is very timely, given an aging population, the increasing prevalence of Alzheimer’s, and the growing body of research linking a number of clinical conditions with specific cognitive deficits.

US brain fitness market: significant and growing

We estimate the size of the US brain fitness market was $225m in 2007 – more than double what it was in 2005. Consumers were responsible for most of the growth from 2005 to 2007, followed by health care and insurance providers. We estimate that the consumer segment grew from a few million in 2005 to $80m in 2007, and the health care/ insurance one from $35m to $65m, and foresee continued growth in both.

Market dynamics

Health care executives often ask us a variety of questions:

– Why are we talking about brain fitness at all? Since
2005, the market for brain fitness software products (which we define
as "software and online applications that help assess and/ or train
cognitive functions) has grown significantly. One of the companies that
has perhaps done the most to spark the commercial adoption of brain
fitness products is Nintendo with its Brain Age games. Less visible is
the growing number of developers that are bringing to market brain
fitness products with more solid clinical validation to assess and/ or
enhance specific cognitive functions.

– Who is buying these brain fitness software products? We
see four key customer segments purchasing commercialized brain fitness
software products: consumers (mostly adults over 50 looking for ways to
protect their memory and prevent or delay dementia, as well as some
younger adults); health care and insurance providers (ranging from
health systems looking for computer-based cognitive assessments to
retirement communities seeking the latest programs for their members);
K12 administrators (interested in applications that can help students
with dyslexia and related learning difficulties); and Fortune 1000
companies, the military and sports teams (looking for advancements in
productivity).

– Is there science behind the claims made by brain fitness software products? Do these products work? It
depends how "working" is defined. If "working" is defined as
quantifiable short-term improvements after a number of weeks of
systematic training to improve specific cognitive skills and alleviate
clinical symptoms, then yes, a number of the brain fitness software
programs do seem to work. If, on the other hand, "working" means
measurable long-term benefits, such as better overall brain health as
we age, or lower incidence of Alzheimer’s symptoms, then the answer is
that circumstantial evidence suggests they may work. But, it is still
too early to tell.

Open questions

Since this is a new, rapidly growing field, we have many open
questions about the industry, which will only be clarified with time:

– Will consumer behavior change to adopt preventive brain exercises that take more time and effort than swallowing a pill?

– How can consumers and professionals assess which cognitive priorities
require most attention and track progress due to brain training? In the
absence of clear biomarkers, will cognitive assessments become
commonplace as objective baselines?

– What business model and offering will succeed? Software
product sales? Online subscriptions? Fun games with unproven brain
benefits? Programs that improve the mental skills involved in specific
activities, such as driving? Applications that help slow down the
progression from Mild Cognitive Impairment to full-blown Alzheimer’s
symptoms?

– Will therapeutic applications be regulated by the FDA?

Top three trends to watch: 2007-2015

Here are some of the predictions we made:

– Brain fitness goes mainstream. An increased emphasis on
brain fitness and maintenance will spread to retirement communities,
gyms and health clubs. Will health clubs one day offer brain fitness
programs, and perhaps "brain coaches" alongside rowing machines and
step-masters? We think so, as we expect physical and mental exercise to
become better integrated.

– Leveraging better assessment and training tools. Better and
more widely available assessments of cognitive function will enable us
to establish an objective baseline of how our minds are evolving,
identify priorities for "workouts" and lifestyle interventions, and
help us measure progress. Just as we find a variety of machines in
health clubs today, in the future we can expect different programs
tailored to train specific cognitive functions and desired outcomes.

– A growing ecosystem around those tools, including
widespread incentives to use brain fitness products. For example,
insurance companies will introduce incentives for members who want to
follow brain fitness programs and companies will offer brain fitness
training programs to attract and retain mature workers who want access
to the best and the latest innovations to keep their minds sharp.

Recent developments

Here are some of the recent market developments that we have reported on, reflecting a rapidly evolving field:

1) Major Initiatives by Insurance Companies:
– Allstate launched a large-scale research project to measure impact of
Posit Science InSight (visual processing training) on driver safety for
adults over 50.
– OptumHealth announced a 3-year, $18m agreement with Brain Resource to
offer web-based cognitive assessments as part of clinicians’ decision
support systems.
– Humana decided not to renew its agreement with Posit Science to offer
Posit’s auditory processing training program to Medicare members.

2) Public policy initiatives:
– The Government of Ontario, Canada, announced a $10m investment in
Baycrest Research Center to help develop and commercialize brain
fitness technologies.
– In the US, The Paul Wellstone and Pete Domenici Mental Health Parity
and Addiction Equity Act of 2008 was signed into law, included in the
recently-approved economic bailout bill.

3) Venture & Angel Fundraising for Cognitive Training companies: A
number of developers have raised money. CogniFit received $5m (from
Milk Capital), Lumos Labs $3m (FirstMark Capital, Norwest Venture
Partners), Scientific Brain Training $1.5m (issued shares), Vivity Labs
$1m (undisclosed angel investors), This is, of course, on top of the
February $10.6 investment in Dakim (Galen Partners).

4) New Research: In a significant new study, a team from the
University of Michigan published a high-quality paper in the
Proceedings of the National Academy of Sciences showing how
computerized working memory training can generalize and improve fluid
intelligence (one of the domains that tends to decline with age).

Note: This article is an adaptation from SharpBrains’ The State of the Brain Fitness Software Market 2008 report, released earlier this year, and from the 6-Month Market Update that SharpBrains is releasing later this month to its Premium Research Sponsors.
SharpBrains is a research & advisory firm devoted to helping
companies, health providers, investors, policy makers and individuals
understand and participate in the emerging brain fitness field through
a variety of market-intelligence products and services.