A recent article in McKnight's Long Term Care news relates that there are still
some major obstacles to overcome in brain fitness programs —namely, the lack of solutions aimed at
cognitively impaired seniors.
According to the article, it's a shortcoming that seems both logical and perplexing. On one hand,
it's understandable that brain fitness solutions would be geared toward
those who are still mentally sharp. The goal is preventing dementia or,
at least, delaying its onset. On the other hand, one could reasonably
argue that residents already experiencing cognitive decline also could
benefit from brain fitness strategies—even if they can't fully reverse
the existing damage.
While experts generally agree that every senior, regardless of where he
or she falls on the cognitive impairment spectrum, would benefit from
brain fitness solutions, a number of obstacles have inhibited the
widespread development of tools for those with dementia.
“Trials and testing with cognitively compromised populations is harder
in terms of obtaining Institutional Review Board approvals for studies
and trials, obtaining informed consent from participants, training the
individuals to use the brain fitness, and getting them to comply with
the fitness program,” explains Majd Alwan, Ph.D., director of the
Center for Aging Services Technologies, which is affiliated with the
AAHSA trade group.
The belief that Alzheimer's and dementia are irreversible presents
another barrier to the development of mental exercises for the
As Alwan points out, efforts to prove that an intervention is effective
in slowing down the progression of dementia (let alone reversing it)
require years of follow-up and active control. Beyond that, there are
challenges in designing brain fitness technologies for the
dementia/Alzheimer's resident that are fun, familiar (such as those
that mimic appliances and other recognizable devices), easy to use and
“It is too early to have more specific evidence-based guidelines on
what program to use,” says Alvaro Fernandez, CEO and co-founder of
SharpBrains, a provider of senior-focused online brain teasers and
In the absence of such data, SharpBrains encourages communities to
conduct their own pilot studies to measure pre- and post-cognitive
function to determine which practices may be most appropriate in their
Those that do could very well find their efforts well rewarded. In
fact, there's strong evidence that through creative program development
and a community-wide commitment to brain fitness, virtually every
resident can experience improved cognitive function and quality of life.
“Communities usually start offering programs to their high-functioning
[residents] first. These individuals tend to have the ability and
motivation to complete the often demanding programs and are not
intimidated by computers,” Fernandez notes. “This may be a good place
to start, but it is essential to offer appropriate cognitive
stimulation, technology-based or not, at each stage of cognitive
Some communities also incorporate the Nintendo Wii into their
brain fitness programming. Aside from being fun, Straus said simulated
activities, such as bowling, golfing and driving, have helped improve
residents' hand-eye coordination, as well as their overall balance and
gait movement. For more, read the story.
Robert W. Carter, Jr. is a Virginia attorney whose law practice is
dedicated to protecting the rights of the victims of nursing
home and assisted living neglect and abuse in Richmond, Roanoke,
Norfolk, Lynchburg, Danville, Charlottesville, and across Virginia.
Posted on Sat, May 16, 2009
by Robert Carter