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From Anti-Alzheimer's 'Magic Bullets' to True Brain Health

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If you followed latest headlines surrounding the release of the National Alzheimer's Plan, you'd probably conclude that the likely solution to maintain lifelong brain health is simple: Simply wait until 2025 for a "magic bullet" to be discovered to cure (or end or prevent) Alzheimer's disease and aging-associated cognitive decline. These kinds of beliefs, often reinforced by doctors and advertising, may explain the billions spent today by pharma companies on discovering new compounds, and by consumers on supplements like ginkgo biloba. But the failures to produce better drugs and conflicts of interest are making many people ask what is wrong with this picture.

We need a new culture of lifelong brain health to empower that 80 percent of the 38,000 adults over 50 surveyed in the 2010 AARP Member Opinion Survey who indicated "staying mentally sharp" as their top ranked interest and concern, not to mention youth, workers and elders facing cognitive and emotional challenges.

The problem? That the "magic bullet" approach neither reflects existing clinical evidence or emerging neuro-scientific thinking, nor does it address the lifelong needs and demands of our citizens.

That's why we need to shake the Etch-a-Sketch and create a new image of the future.

Let's first draw our true objective: Is it to promote mental vitality and collective wisdom, or to declare war on Alzheimer's plaques and tangles? Those are two radically different objectives, leading to very different priorities. For example, let's imagine the implications of being able to maximize cognitive performance and to delay cognitive decline.

Second, let's build on what we know today. We know that 30 percent or more of the population with plaques and tangles do not manifest significant cognitive decline. This is a fact -- often explained via the "cognitive reserve" theory. It is also a fact (ignored in the report's presentation and related media coverage) that the most exhaustive systematic evidence review, performed in 2010 under the auspices of NIH, found that nonpharmacological factors (such as physical exercise, cognitive engagement, cognitive training, and Mediterranean diet) seemed to be protective against cognitive decline, whereas "magic pill" interventions (drugs, supplements such as vitamins and gingko biloba) had no such effect.

Third, let's select the right framework and toolkit. While biomedical research is indeed part of the solution, public health/education initiatives and technology innovation are equally important. The 2011 SharpBrains Virtual Summit, which brought together more than 260 research, technology and industry innovators in 17 countries, highlighted the need to devote sufficient attention and resources to preventive brain health strategies across the whole lifespan, and the need to bring to market a new generation of reliable and inexpensive assessment and monitoring strategies of cognitive and emotional health -- in order to target and deliver those preventive strategies in efficient ways. Innovative public education initiatives, such as Experience Corps and the Intergenerational School, may lead to better cognitive and health outcomes over the long haul.

It simply makes no sense to put all our eggs in the biomedical basket. Each of this column's co-authors produced a different conference in June: Dr. Whitehouse and colleagues on "Healthy Environments Across Generations" (June 7-8, NYC) and Mr. Fernandez on "Optimizing Health via Neuroplasticity, Innovation and Data" (June 7-14th, fully online). There are a number of exciting and complementary approaches to "Staying Mentally Sharp" such as physical exercise, mindfulness meditation, biofeedback, cognitive therapy and training, volunteering... How can consumers make informed and relevant decisions today? And how can they use these reenergized healthy brains to solve challenges like global climate change and economic stagnation?

Sure, more research is better than less, and we hope that the new funded trials will result in useful drugs. But neither policymakers nor citizens should wait until then to foster and make lifestyle decisions than can maximize cognitive performance across the lifespan.

JFK challenged us not only to go to the moon, but to take proactive care of our physical fitness. Perhaps the time has come for a serious open national conversation on true brain health and how the newly announced Alzheimer's strategic plan must include healthier and brainier thinking than a war on Alzheimer's plaques and tangles.

Dr. Peter Whitehouse is a Professor of Neurology at Case Western Reserve University and co-author of The Myth of Alzheimers: what you aren't being told about today's most dreaded diagnosis. Alvaro Fernandez, recently named a Young Global Leader by the World Economic Forum, is the co-author of The SharpBrains Guide to Best Fitness: 18 Interviews with Scientists, Practical Advice, and Product Reviews, to Keep Your Brain Sharp, an AARP Best Book, and producer of the 2012 SharpBrains Virtual Summit: Optimizing Health through Neuroplasticity, Innovation and Data (June 7-14th, 2012).

For more by Alvaro Fernandez, click here.

For more on Alzheimer's, click here.

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