What is the future of per­sonal brain health?


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Accel­er­at­ing inno­va­tion is poised to enable sys­tem­atic brain health self-monitoring and self-care, which in turn can trans­form what it means to live healthy and ful­fill­ing lives. What con­crete steps can indi­vid­u­als take to man­age and enhance brain health and heal ill­ness through­out the var­i­ous stages of life?

- Chair: Alvaro Fer­nan­dez, CEO of Sharp­Brains, YGL Class of 2012
- Bar­bara Arrow­smith Young, author of The Woman Who Changed Her Brain
- Alexan­dra More­house, VP Brand Man­age­ment at Kaiser Permanente

This session took place at the 2013 SharpBrains Virtual Summit: http://sharpbrains.com/summit-2013/agenda/

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  • Define term: Cognitive Deficit – a part of the brain that is not functioning at the level of the individual’s other areas so it affects learning; it acts as a drag on the system and interferes with learning – is the source of the individuals learning disability/learning dysfunction
  • What is the future of per­sonal brain health?

    1. 1. What is the future of personal brain health?
    2. 2. Chaired by: Alvaro Fernandez, CEO of Sharp Brains, YGL Class of 2012 Alexandra Morehouse, VP Brand Management at Kaiser Permanente Barbara Arrowsmith Young, author of The Woman Who Changed Her Brain Elisabeth Zelinski, Director of the Center for Digital Aging at USC What is the future of personal brain health?
    3. 3. Alexandra Morehouse, VP Brand Management at Kaiser Permanente What is the future of personal brain health?
    4. 4. 4 4 Kaiser Brand Manifesto:
    5. 5. Mind-Body-Health is the opportunity for KP 5 Health Advocate, Proactive Philosophy Excellence Expertise, Compassion, Innovation, Leadership Personal Partnership Relationship With Health Care Professional Mutual Investment Competence Adequate coverage, capable doctors Care You Can Count On Better Safety Net, Stability, Reliability, Reassurance Emotional Equity Rational Needs The Opportunity The Basics Consumers’ Health Care Needs Hierarchy 5
    6. 6. 6
    7. 7. Q&A 10 minutes (Included in session recording)
    8. 8. Barbara Arrowsmith Young, author of The Woman Who Changed Her Brain What is the future of personal brain health?
    9. 9. Strengthening Learning Capacities® A personal journey into the world of the brain: Shaping our Brains The Woman Who Changed Her Brain Barbara Arrowsmith-Young
    10. 10. Strengthening Learning Capacities® The Pre-Neuroplastic Paradigm • Brain’s anatomy is fixed and unchangeable • Brain is hard-wired • Brain function can not be altered if damaged or limited
    11. 11. Strengthening Learning Capacities®
    12. 12. Strengthening Learning Capacities® Lyova Zazetsky and A.R. Luria
    13. 13. Strengthening Learning Capacities® Angular Gyrus Courtesy of Center for Brain and Cognition, University of California, San Diego
    14. 14. Strengthening Learning Capacities® Somatosensory Cortex
    15. 15. Strengthening Learning Capacities® Parietal Lobe
    16. 16. Strengthening Learning Capacities® Foundation of Arrowsmith • Alexander Luria: Identification of Function • Mark Rosenzweig: Stimulation of Function
    17. 17. Strengthening Learning Capacities® Unique Cognitive Profile • Every individual has a unique learning profile due to his or her combination of cognitive strengths and deficits • Cognitive deficits combine to create various academic and social learning problems • Arrowsmith works with 19 cognitive areas • Goal: Create a personalized program of cognitive exercises to meet individual’s specific learning needs
    18. 18. Strengthening Learning Capacities® Special Education Approaches • Compensatory - Use tools and technology to reduce the impact of the learning disability • Content/Skill Based – Task analysis, match the strengths of the learner to the method of teaching • Strategy – Teach the learner rules or strategies to approach the material Premise: The learner is fixed (PreNeuroplastic Paradigm) • Capacity Based – Learning capacities can be strengthened and changed through targeted cognitive stimulation Premise: The learner can be modified (Neuroplastic Paradigm)
    19. 19. Strengthening Learning Capacities® Reduce Negative Factors Chronic Stress Prolonged Anxiety Chronic Pain Sleep Deprivation Increase Positive Factors Active Sustained Engagement Effortful Processing Novelty & Complexity Reward/Performance Feedback Exercise Harnessing Neuroplasticity
    20. 20. Strengthening Learning Capacities® Principles of Arrowsmith Program • Design a task that stimulates a specific cognitive area (targeted/differential stimulation) • Start the level of task difficulty just above the level of current functioning of the area (effortful processing/complexity) • Remove the support of areas that could compensate for weaker functioning (effortful processing/novelty) • Build in performance mastery criteria that is rewarded – accuracy, consistency, automaticity (attention/active engagement/dopamine)
    21. 21. Strengthening Learning Capacities® Mastery Criteria Implications Why: Accuracy, Automaticity, Consistency? Attainment of mastery criteria results in proficient performance that now requires little effort or thinking Neural network now processing efficiently Ready for increase in complexity and effortful processing to step up activation from this new functional base Training often stops prior to achievement of this level of mastery, leading to decline in functioning over time
    22. 22. Strengthening Learning Capacities® Change Sustained Over Time “Whether those changes are very temporary, involving mainly synaptic strength and temporary facilitation or inhibition, or entail longer term change in the numbers of synapses in a cortical field, has importance for how those connections will be used. If one wants only a temporary trick, it can be induced quickly; if one wants it to last, it must be induced gradually, allowing for harder neuroplastic change.” “Regardless of the source, a sustained change in a pattern of neural activity is a necessary trigger for neuroplasticity. Lillard & Erisir (2011)
    23. 23. Strengthening Learning Capacities® To ensure the change in functioning is sustained and not just practice effect or short-term temporary wiring change we need to: Keep our brain active over our lifespan Integrate and use the cognitive gains resulting from mental training Reduce factors that lead to negative neuroplastic change Increase factors that lead to positive neuroplastic change This is Hebb’s principle – neurons that fire together wire together – and the more they fire together, the stronger the connections “If a network supporting a brain function is repeatedly stimulated through practice and training, it will become stronger, contributing to the optimization of that brain function” (Fernandez, SharpBrains Guide to Brain Fitness2013) Change Sustained Over Time
    24. 24. Strengthening Learning Capacities®
    25. 25. Q&A 10 minutes (Included in session recording)
    26. 26. Elisabeth Zelinski, Director of the Center for Digital Aging at USC What is the future of personal brain health?
    27. 27. The future of personal brain health: Supporting healthy aging Elizabeth M. Zelinski, PhD Rita and Edward Polusky Chair in Education and Aging Professor of Gerontology and Psychology Supported in part by R01 AG10569, P50 AG005142, US National Institute on Aging and H133E080024, US National Institute on Disability and Rehabilitation Research and the USC Center for Digital Aging
    28. 28. Aging: The Demographic Imperative
    29. 29. Cognitive Changes over Adulthood
    30. 30. • Reduction of risk factors affecting health and cognition that increase with age plus – Cognitive Stimulation – Mediterranean Diet – Exercise NIH State of the Science 2010/CDC Healthy Brain Aging 2005: Body health/Brain health
    31. 31. Older adults are the nearly invisible target population for much brain health technology …and even organizations that deal with health issues in aging ignore the technology benefits for self- care
    32. 32. US HHS objective for dealing with multiple chronic conditions 2010: innovative, multidisciplinary, longitudinal person-centered care models that improve health outcomes and quality of life while maintaining or decreasing net costs and implement evidence-supported models Source: US DHHS, 2010: Multiple chronic conditions: A strategic framework.
    33. 33. | 41 Technology in the health & human services chronic care strategic framework • Electronic Medical Records • Telemedicine • Remote Monitoring • Health InformationTechnology Source: US DHHS, 2010: Multiple chronic conditions: A strategic framework.
    34. 34. | 42 TECHNOLOGY IN THE HHS CHRONIC CARE STRATEGIC FRAMEWORK • Electronic Medical Records • Telemedicine • Remote Monitoring • Health InformationTechnology Source: US DHHS, 2010: Multiple chronic conditions: A strategic framework. Where’s self-care technology?
    35. 35. | 43 Increasing Concern about Brain Health at the CDC • “Opportunities for maintaining cognitive health are growing as public health professionals gain a better understanding of cognitive decline risk factors. The public health community should embrace cognitive health as a priority, invest in its promotion, and enhance our ability to move scientific discoveries rapidly into public health practice.” • CDC Healthy Brain Initiative • http://www.cdc.gov/aging/healthybrain/ • July 12, 2013
    36. 36. Our Preliminary Answer: Let’s Make Aging Normal in the World of Brain Health/Self Care Technology And Let’s make Brain health Technology Normal in the World of Aging
    37. 37. | 45 Already normalized technology to support everyday activities: can they affect health outcomes?
    38. 38. Whether people use existing technology for self- care varies Comorbidities Self Efficacy Physical Functioning Income Education Cohort Age Access to Providers Cognitive Functioning Home Environment Devices Access to Technology TECHNOLOGYRESOURCESHEALTHPERSONAL Social Network User Interfaces
    39. 39. Our Expertise and interests • We understand demographic trends of aging, health, and disability • We will research relative efficacy of different approaches to maintaining and improving brain health – Kinds of training emphasis – Effects of individual difference variables like self efficacy, resources and other important evidence-based predictors of participation – Evaluation of effects of long term adherence – Interventions to encourage appropriate long term use
    40. 40. • A centralized source of aging and supportive technology information – Expert independent evaluation – Training – Dissemination • Incubate new products, programs, application s, services Objectives
    41. 41. • Provide consultative services to companies interested in developing products for older adults • Provide expertise to the developers and designers of software products by creating clinician and consumer focus groups • Provide test beds for innovation • Provide pilot funds to support those who are ready to develop scalable products • Provide advice to older adults, their loved ones, and their clinicians about the best digital solutions for specific problems • Support and develop a “curated” collection of digital products related to various issues. Our Plans
    42. 42. • Interdisciplinary teams with partners from USC schools and institutes • Advisory committee from external constituent groups • Pilot funding • Recognition program • Regularly scheduled summits • Website, blogs, etc How?
    43. 43. Stay Tuned!
    44. 44. Sponsors Partners Thank You for Joining Us!
    45. 45. To Learn More… Summit Recordings Book Market Report sharpbrains. com/book/ sharpbrains. com/summit/ sharpbrains.com /market-report/