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Technology For Brain Health: an Upcoming Revolution

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In April 2008, Baycrest, a leading research institute focused on aging and brain function, received $10-million from the Ontario Government to create a groundbreaking Centre for Brain Fitness. Its stated goal was to "develop and commercialize a range of products designed to improve the brain health of aging Ontarians and others around the world."

"Our government is proud to support Baycrest and its invaluable work, which is already leading to the discovery of important new tools and approaches to treating brain diseases associated with aging," said Minister of Research and Innovation, John Wilkinson.

We have Baycrest's CEO with us today, to explore why Ontario and Baycrest chose to become pioneers in this area, and discuss some of the main opportunities, and challenges. Dr. William E. Reichman is President and CEO of Baycrest. Dr. Reichman, an internationally-known expert in geriatric mental health and dementia, is also Professor of Psychiatry on the Faculty of Medicine at the University of Toronto.

Alvaro Fernandez: Bill, thank you for your time. Let me start by asking, given that you just spoke at the recent Consumer Electronic Show, what do you make of the growing brain fitness field?

Bill Reichman: It looks like a classic example of a very promising but still early stage field -- a lot of opportunity and enthusiasm, but also a lot of product claims that are not backed by solid research. Think about the physical fitness analogy: even today, after decades of progress, you still see people buying research-based products such as treadmills but also all types of random machines they see on TV and have not been subject to any validation. Similarly, consumers today do not know what to make of growing brain fitness claims. As another speaker pointed out, for the industry to fulfill its promise, it will need to be careful with research and claims, not to end up like the nutraceuticals category.

By the way, let me recognize that the work you are doing with SharpBrains reports and your website is very important to offer quality information.

Thank you. Let's step back for a moment. Taking a, say, 10 years view, what is the main opportunity that technology-based brain fitness can offer to society?

First of all, let me say that I think we have an opportunity to make major progress in Brain Health in the twenty-first century, similar to what happened with Cardiovascular Health in the twentieth, and technology will play a crucial role.

Given the rapid advances we are witnessing today in the research and technology arenas, I feel confident in saying that in less than 10 years we will have both valid and reliable assessments of cognitive functions, that will be used both by consumers at home and in a variety of health settings, and a better knowledge of what specific cognitive rehabilitative interventions may help specific groups of patients.

Quality and widely available assessments are a critical part of the puzzle. Consumers and professionals need easy-to-use, low cost, assessments to measure both their needs and the impact of different interventions. Baycrest is going to take a leadership role in this area -- we believe that the development of a tool equivalent to the blood pressure cuff will have great impact on brain health in the areas of prevention and treatment.

Tell us both about the Centre for Brain Fitness launched last year, and the Women's Brain Health Initiative you have just announced.

As you know, the government of Ontario and local donors invested $20m in a new center here, housed in the Rotman Research Institute, to develop and commercialize brain fitness technologies. Baycrest has traditionally been more focused on the research than the development side, so this is new and exciting step for us. We are now looking to hire the inaugural Director for the Centre of Brain Fitness, so let us know if you have any suggestions. We are looking for a globally recognized leader in neuroplasticity research and cognitive neurorehabilitation. As an adjunct to the Centre, we are in the process of creating a spin-off that will help identify and prioritize commercial applications of our research. You have discussed this with Veronika Litinski from MaRS Venture group who is partnering with us.

Our traditional research strengths have been cognitive assessments and cognitive rehabilitation, so it is a natural extension for us to expand our focus to include healthy aging and the needs of an aging workforce, and to investigate new platforms such as PDAs to enable people to function at the highest possible level.

The Women's brain health initiative was spearhead by friends of Baycrest, active women of the baby boomer generation. They are interested in research to identify strategies and methods to prevent Alzheimer's Disease, which affects women disproportionally given their longer life expectancy and frequent status as caregivers, and also in specific gender related topics such as the impact of female hormones on brain development and function. They are raising funds to support new initiatives in women's brain health and aging at Baycrest and supporting women neuroscientists and enabling their research to be relevant and sensitive to women's brain health concerns.

A quick clarification -- you mention your traditional focus on cognitive rehabilitation. Neuropsychologists have been using computerized cognitive training programs for years to support post-stroke and post-traumatic brain injury recovery, two problems that affect millions of people yet don't seem to attract enough attention given the current media theme on baby boomers and healthy aging. What is your center doing in that area?

Two of our researchers, Drs. Donald Stuss and Gordon Winocur, in collaboration with Ian Robertson of Trinity College, Dublin, recently released the main textbook in that area, titled Cognitive Neurorehabilitation, published by Cambridge University Press. You should ask them more specific questions about the present state of the field.

I will. Finally, what is the main obstacle you see today for the development of a sustainable brain fitness market that can fulfill its promise?

I'd say the lack of widely accepted standards for outcome measures. There are myriad ways to measure the impact of cognitive exercise and other lifestyle options -- we can talk psychometrics, assessments of daily living, neuroimaging findings. But, there is not a consensus yet on what to measure and how. Dr. Gary Small and I were talking recently about the need to step up in this area, figuring out how to engage a variety of serious stakeholders in solving this important issue.

I agree with that sentiment. We have already run over the time for this interview, but we need to follow-up on that. Thank you for your time!

My pleasure.

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