The Business and Ethics of the Brain Fitness Boom (2011)

The recent discovery that experience can change brain structure and function at any age has sparked numerous health, education, and productivity applications whose value and limitations we are only starting to grasp. Brain fitness has quickly become a mainstream aspiration among baby boomers and elders, primarily in North America. It has fueled a growing interest in brain fitness classes, brain fitness centers, and brain fitness programs, along with attendant opportunities and challenges. An increasing number of adults want useful tools to protect cognitive health and performance-not necessarily to reverse aging-and what they are finding is an expanding and noisy marketplace where they (and also professionals) need to carefully evaluate their own needs and the available options (Fernandez and Goldberg, 2009). The recent discovery that experience can change brain structure and function at any age has inspired a range of health, education, and productivity applications whose value and limitations we are only starting to grasp. If you can envision the array of equipment available to train different muscles in a typical modern health club, you can anticipate the value-and perhaps the limitations- of having an expanding toolkit to measure and enhance cognition and mental wellness. The burgeoning brain fitness industry needs to define and refine itself, to mature, before it can be as established as today's physical fitness industry. The good news is that adults of all ages are paying more attention to the impact of lifestyle options on cognitive health, and that there are more tools available than ever before to assess, monitor, and enhance a variety of cognitive, emotional, and self-regulation skills. The bad news is that there is no magic pill and that, as often happens in emerging markets, the overwhelming amount of superficial media coverage and hyped marketing claims are provoking consumer confusion and skepticism among researchers and professionals. The Business of Brain Fitness First, some perspective. I estimate that the size of the worldwide digital brain fitness software market (defined as automated applications that help assess, enhance, or repair targeted brain functions) in 2009 was $295 million, representing an annualized growth rate of 31 percent since 2005 (Fernandez, 2010). Around half of that amount, or $148 million, was spent by U.S.-based buyers. Compare this to other fitness market segments: in 2007, American consumers bought $3 billion worth of treadmills, and in 2009, American health club memberships amounted to $19.5 billion. Off-label drug prescription revenues in the United States alone exceed $10 billion per year, and the current estimate for the North America's vitamins, minerals, and supplements market is $17.7 billion. The brain fitness software industry is only in its infancy; it is an emerging and largely unregulated market where many products have limited clinical validation and often present confusing claims that make it difficult for consumers to separate wheat from chaff. If this is the case, can we expect this industry's significant and continued growth in the foreseeable future? Demand drives supply A growing portion of the 78 million baby boomers in the United States is investing time and effort into retaining their mental sharpness. This motivates healthcare and insurance providers to introduce and test innovative solutions in areas such as driving safety. The often unrecognized role of brain fitness software is that it can serve as both an assessment and an enhancement tool, and databasedriven cognitive care solutions have started to become available. At the same time, new community-based models for preventive services have begun to pop up to help customers put all the puzzle pieces together and navigate the overwhelming array of research, products, and claims. Science and research drive policy There is accumulating evidence that basic cognitive, emotional, and self-regulation brainbased capacities are more malleable than once thought and that lifestyle, non-invasive interventions, and invasive interventions can all play a role in augmenting or maintaining cognitive and emotional health. …