Obstacles Still Abound for Seniors' Brain Fitness Programs

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 cognitively impaired.

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 engaging.

“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 interactive games.

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 environments.

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 impairment.”

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. 


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