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Can tech help Alzheimer's sufferers?

From CNET Magazine: Brain-training apps might one day help the millions of Americans living with Alzheimer's.

Ian Sherr Contributor and Former Editor at Large / News
Ian Sherr (he/him/his) grew up in the San Francisco Bay Area, so he's always had a connection to the tech world. As an editor at large at CNET, he wrote about Apple, Microsoft, VR, video games and internet troubles. Aside from writing, he tinkers with tech at home, is a longtime fencer -- the kind with swords -- and began woodworking during the pandemic.
Ian Sherr
5 min read

I'll never forget the look of fear on my mother's face.

My mother was a brilliant woman. She earned three bachelor's degrees and a master's, and could have become a doctor if not for the rampant sexism she faced in college in the early '60s.

Instead, she worked for a major airline, where she applied her math smarts calculating a cargo load's weight and balance that would allow a plane to safely take off.

But after spending nearly a decade working the overnight shift, she was starting to get absent-minded. At first it was little things, like she'd go somewhere without the documents she needed. Then it was big things. Then she got in a car accident.

My mother was shocked when she came out of the doctor's office after weeks of testing. She was diagnosed with early-onset Alzheimer's disease. At 57 years old.

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An MRI shows the brain of an Alzheimer's suffer.

UIG via Getty Images

My mother was told to do anything that required thinking. She did crosswords. She read books. And since she was already good at math, she calculated the value of her invested retirement nest egg against the stock market's moves.

If she were alive today, she probably would type Alzheimer's into an app store. The first hit is an Alzheimer's patient-care app called MindMate, which includes interactive brain games it claims will "stimulate user's cognitive abilities based on world-leading research." There are dozens more.

Over the past few years, there's been an explosion of apps and websites promising to solve what medical science hasn't. Many claim they'll improve the brain, or even help fend off the disease. Experts say nearly all are peddling false hope to people who have just been told they're going to lose their minds. There's no scientific proof any of these apps do what they claim. But since more than 5 million Americans are living with Alzheimer's there's big demand for a fix.

"People are willing to try anything when they're desperate," says Creighton Phelps, a deputy director at the National Institute on Aging.

So what helps? Data suggests activities like learning a new language or reading about something far outside your comfort zone could delay the symptoms from worsening. And researchers this year reported that a specific kind of computer game could even prevent dementia.

Mental exercise

Brain-training games typically ask players to perform tasks like remembering the shape on a card, re-creating a pattern or identifying the direction fish are swimming.

You might get good at the games, but there's no scientific proof they, or apps like them, do any more than entertain.

Remember the marketing blitz from Lumos Labs? The company claimed its puzzle app Lumosity could do just about anything, from helping with schoolwork to protecting against dementia -- even improve "outcomes in combat veterans suffering from traumatic brain injuries."

That got the attention of Michelle Rusk, an attorney in the Federal Trade Commission's Bureau of Consumer Protection. She found science didn't support Lumos' marketing. The FTC filed a complaint against Lumos (PDF) alleging it deceived consumers with "a host of false or misleading" claims, including scientific studies "that prove training with Lumosity provides a long list of real-world benefits."

"Lumosity preyed on consumers' fears about age-related cognitive decline, suggesting their games could stave off memory loss, dementia and even Alzheimer's disease," the FTC said in a statement earlier this year. "But Lumosity simply did not have the science to back up its ads."

A judge agreed and fined Lumos $50 million.

"Lumosity's case is interesting because we didn't say it was absolutely fraudulent and of no value," says Rusk. Instead, the order banned Lumos from making claims it can't back up.

The company now sells Lumosity as "delightful" entertainment.

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So far, Double Decision from Posit Science is the only brain-training game to have a clinical impact on dementia. Posit Science acquired the game after a 10-year study showed it could cut the risk of dementia by half.

Posit Science

"If you're going to spend time, why not spend time doing something that's fun and entertaining and emotionally makes you feel better?" says Lumos CEO Steve Berkowitz.

MindMate, one of the top hits on the app store for Alzheimer's searches, has taken a similar tack. The company, which calls itself the "world's leading Alzheimer's platform," has said its interactive brain games "increase user's cognitive abilities based on world-leading research." But it's begun to change its marketing materials after research consultants raised concerns.

"We're not claiming we're slowing down progression," says Patrick Renner, co-founder and managing director at MindMate. Well, not anymore.

MindMate's app includes memory games along with nutrition and exercise advice meant to help users "stay physically and mentally fit" and a music and TV section that lets users watch hits from the '40s through the '80s. In March, the Scotland-based company won a contract with the National Health Service operating in the Glasgow region, for use of the app by support groups, family caregivers and assisted living housing facilities. About 15,000 people use the app at least once a month, the company said.

Game on

A speed-training game used in a 10-year study made headlines earlier this year when the Alzheimer's Association highlighted results showing it can cut the risk of dementia by half.

The study -- called Active, for Advanced Cognitive Training in Vital Elderly -- asked 2,832 healthy adults, ages 65 to 94, to simultaneously identify objects in the center and along the edges of a computer screen. It's called speed training because correct answers trigger the game to display more objects at an ever-faster rate.

The game could look like this: You see cows in a pasture. Two cars are in the center of the pasture and road signs are scattered around the edges. Now identify one of the cars (the convertible, not the coupe) and the Route 66 sign, but without moving your head or eyes. As you progress, you'll see more distractions but have less time to spot them.

"It's fundamentally a new kind of medicine," says Henry Mahncke, CEO of Posit Science. In 2008, the company acquired the brain-training game used in the Active study. Posit Science now offers an updated version, called Double Decision, as part of its BrainHQ online service.

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Mark Mann

Mahncke emphatically believes such apps could rewire the brain, and he thinks doctors will begin writing prescriptions for apps like Posit's within the next five years. He plans to seek approval from the Food and Drug Administration sometime soon. Doctors "want low-cost intervention," he says. After regulatory approval that's exactly what these apps will offer.

But using apps won't be the only thing doctors tell patients to do. Joaquin A. Anguera, assistant professor at the University of California, San Francisco's School of Medicine, says treating Alzheimer's will ultimately require "a cocktail effect" of exercise, medicine and, yes, an app. "You need a little of this, a little of that and a little of another."

No one really knows why my mother got so sick so early in her life. Between poor record keeping and the general fuzziness that comes with time, it's hard to tell how far back Alzheimer's or dementia goes in my family. I do know my father's mother had it. My father hasn't developed symptoms and neither has my older brother.

In the meantime, I look at my infant son and wonder if there's anything I can do today to avoid what happened to my mother.

There is no cure. I'm hopeful there will be.

This story appears in the winter 2016 edition of CNET Magazine. For other magazine stories, click here.