(Session held at the 2014 SharpBrains Virtual Summit; October 28-30th, 2014) 10:00–11:30am. Inno­v­a­tive part­ner­ships to improve life­long brain health and customer/ patient satisfaction - Bill Pren­ovitz, Global Prod­uct and Ser­vice Man­age­ment at Philips Healthcare’s Aging-in-Place Program - Dr. Michael Weiner, Lead Sci­en­tific Inves­ti­ga­tor of the Brain Health Registry - Tommy Sagroun, CEO of CogniFit - Chair: Rita Carter, Author, Broad­caster and BBC Contributor Learn more here: http://sharpbrains.com/summit-2014/agenda/

1. Innovative partnerships to improve lifelong brain
health and customer/ patient satisfaction

2. Sponsors
Welcome!

3. Innovative partnerships to improve lifelong brain
health and customer/ patient satisfaction
Chaired by: Rita Carter,
Author, Broadcaster and
BBC Contributor
Bill Prenovitz,
Global Product and Service
Management at Philips Healthcare’s
Aging-in-Place Program
Dr. Michael Weiner,
Lead Scientific Investigator of
the Brain Health Registry
Tommy Sagroun,
CEO of Cognifit

4. 4
Bringing Brain Fitness to Market
Bill Prenovitz
Philips HealthTech
October 28, 2014

5. Introducing Philips HealthTech
5
As recently announced, Philips has merged its Healthcare and Consumer
Lifestyle sectors into a single, integrated business: Philips HealthTech
Philips
Healthcare
Philips
Consumer Lifestyle
Philips HealthTech
The Home Monitoring business unit is focused on improving the
aging process for seniors and their family caregivers. Directly and
through professional caregivers and their organizations.

6. What we wanted to accomplish with Brain Fitness
6
• Seniors want to age well and at home, and are concerned
about the many things which challenge this, including:
– Cognitive Aging
– Falls
– Auto accidents (for those who drive)
• Philips Brain Fitness can help with these challenges
• Adding another component to the Philips Aging-in-Place
suite of services which help seniors and their caregivers
with Safety, Health and Connectedness.

7. What are the learning objectives?
7
• Test brain fitness in the senior market
– Receptivity
– Adoption
– Churn
• Test cost of customer acquisition
– As cross sell
– As independently marketed service
• Determine most effective positioning
– Specific to the direct cognitive benefits vs. other potential benefits

8. Our Partner Selection Criteria
8
After deciding to enter the market, and to collaborate with an experienced
partner, we evaluated the potential partners using these criteria
• Credibility
• Clinical evidence
• Endorsements
• Usability
• User engagement and length on service
• Business systems
• Level of business maturity
• Long term viability
• Strategic fit
• Economic alignment

9. We partnered with Posit Science
9

10. Learnings from Marketing Direct to Seniors
• The results of the in-market test confirmed that seniors are concerned
about the consequences of cognitive aging and that a segment are willing
to purchase a product.
• The brain fitness field still has a very long way to go to separate itself
from excessive claims of the past and to fully leverage the real, clinically-proven
10
potential.
• Awareness of the brain fitness concept is growing, but there is limited
understanding of the category, especially with seniors.
• Direct to consumer mass marketing remains challenging; more targeted
initiatives (such as cross-selling or point solutions) will expand the field.

11. 11

12. Innovative partnerships to improve lifelong brain
health and customer/ patient satisfaction
Dr. Michael Weiner,
Lead Scientific Investigator of
the Brain Health Registry

13. The Brain Health Registry:
An Internet-Based Registry
Recruitment, Assessment, & Longitudinal Monitoring
Use Of Computer Games To Identify Subjects At Risk
For Cognitive decline
Michael W. Weiner, M.D.
Professor of Radiology, Medicine, Psychiatry and Neurology:
University of California, San Francisco
13

14. BACKGROUND
• Currently there are few effective treatments for
Alzheimer’s disease, and many other serious brain
disorders
• Major obstacle towards developing treatments
– High costs of recruitment: a slow process
– High rates of screen fails
– Identifying subjects at risk for cognitive decline

15. GOALS:
• To reduce costs of AD clinical trials
– An on line registry for recruitment, screening, and
monitoring progression
– Available to investigators for all types of
neuroscience studies
• To establish a large cohort of subjects who are
monitored longitudinally
• To share the data and to provide subjects to other
investigators to facilitate their studies
• To provide prescreened and longitudinally
monitored subjects for randomized treatment trials
15

16. OUR APPROACH:
BRAIN HEALTH REGISTRY.org
• BrainHealthRegistry.org
• UCSF based, informed consent, questionnaires
• Cogstate
– Established computer-based neuropsychological tests
• Lumosity
– Computer games: 50 million registrants
– Cognitive tests in addition to games
16

18. 25%

21. Longitudinal Growth of the Project
Over 10,000 Registered
6 month followup rate is 40%

22. Location of Registrants

23. Location in California

24. Gender

25. Age

26. Family History of Alzheimer’s

27. OUR PARTNERS:
COGSTATE
27

28. COGSTATE CARD TESTS
A. Simple
Reaction time
task
B. Choice RT task
C. 1-card learning
& 1-card back
tasks
28

29. PRELIMINARY RESULTS
ON LINE TESTS
• Results on 3500 subjects who took Cogstate and
Lumos, on line, in an unsupervised setting
• Results agree remarkably well with previous
normative data
• Our results show: age related changes, lower
scores on subjects with memory complaints
• Results support the use of on-line testing

30. One card learning accuracy
Age group
18-34
Age group
35-49
Age group
50-59
Age group
60-69
Age group
70-79
Age group
80-89
N Mean SD N Mean SD N Mean SD N Mean SD N Mean SD N Mean SD
Cogstat
e
683 1.05 0.13 212 1.01 0.12 206 1.02 0.11 575 1.02 0.11 531 1.00
0.10
132 0.97 0.11
BHR 316 1.02 0.13 504 1.02 0.12 983 1.00 0.12 1563 0.99 0.12 854 0.96 0.12 167 0.93 0.14

31. INITIAL RESULTS - COGSTATE

32. LUMOS LABS: SHARING CONTACTS & DATA
32

33. USE OF INTERNET GAME
SCORES TO IDENTIFY
SUBJECTS AT RISK FOR
COGNITIVE DECLINE
Jason Geyer, Scott Mackin, Joe
Hardy, Daniel Sternberg, Michael
Scanlon, Faraz Farad, Philip Insel,
Michael Weiner

34. ANALYSIS OF INTERNET
GAME SCORES
• Lumosity’s Memory Match (LMM) ) is an
online visual working memory game
• Change in LMM scores may be associated
with individual differences in age-related
changes in memory.

35. GOALS
• Develop a model that would explain
variation of LMM data in terms of learning
and forgetting effects.
• Determine association between age and
longitudinal changes in LMM learning rates
• Identify suspected decliners from estimated
changes in learning rate
• Estimate statistial power in a putative
clinical trial

36. Caveats
• Neither Memory Match nor any Lumosity
game is a validated cognitive test
• Training sessions are played intermittently
with different training times for different
individuals
• Lumosity participants may not represent the
general population
36

37. Changes in the Score Depend on the
Rates of Learning & Forgetting
• Learning rate is a measure of change
between consecutive sessions closely
spaced in time
• Forgetting rate is a measure of change
between sessions separated by large time
gaps
• Age influences learning & forgetting
37

38. Learning and forgetting
38

39. METHODS
• Effects of age and time on LMM learning and
forgetting rates were estimated using 2,212
registered Lumosity users (ages, 40 – 79).
• linear mixed effects regression model with R
• estimated LMM learning rates, forgetting
rates, longitudinal changes in learning rates
• effects of age on learning rates, forgetting
rates and longitudinal changes in learning
rates

40. Sample (Ages 40 - 79)
40
Age Group
Variable 40 – 59 60 – 79 All Ages
Women 817 706 1523
Men 409 280 689
Age Group Total 1226 986 2212
Age Group
Variable 30 – 59 60 – 79 All Ages
Mean Age (S.D.) 51.0 (5.5) 66.9 (5.0) 58.1 (9.5)

41. MEMORY MATCH ~ TIME*AGE
41

42. RESULTS
Using the mixed effects linear model
• There were significant effects of age on
lower initial LMM scores (β = -.39, P <
.0001), lower initial learning rates (β = -
.0031, P < .0001) and greater declines in
learning rates over time (β = -8.00E-06, P <
.001).

43. Evidence for age-associated
cognitive change
Estimate Standard Error P-Value
Intercept 23.06 0.16 <.0001
(Age - 58) -0.39 0.02 <.0001
Initial Learning Rate 0.27 5.49E-03 <.0001
Initial Learning Rate * (Age - 58) -3.05E-03 5.81E-04 <.0001
Δ Learning Rate 1.60E-04 2.29E-05 <.0001
Δ Learning Rate * (Age - 58) -8.00E-06 2.42E-06 0.0009
Forgetting Rate -7.68E-03 3.90E-04 <.0001
Forgetting Rate * (Age - 58) 9.60E-05 4.10E-05 0.02

44. Initial Score by Age
44

45. INITIAL LEARNING RATE BY AGE
45

46. Identifying decliners
• Even though older people function at a
lower level than younger people
• Over all the over 60 group did not decline
during the period studied
• This is consistent with many other studies
• However, a substantial fraction of older
subjects did show signs of decline
• We chose the lower 25 % of the older
group

47. Simulated Trial Using Prior
Lumos Memory Match Data
• 56 sessions – 4 sessions per day for 14 days
• Time points : 1, 2, 30, 31, 87, 88, 172, 173,
201, 202, 258, 259, 343, 344
• Subjects selected from the lower quartile of
the declining learners
47

48. Lower 25th of Declining Learners
Learning Rate by Time
48

49. Simulated Trial Results
• 80% power, 5% significance
• 202 subjects per arm
49

50. SUMMARY
• Establishing a large cohort of subjects followed
longitudinally will assist recruitment, reduce costs,
and improve statistical power of AD trials
• Problems of feasibility, reliability, validity, and
generalizability need to be addressed
• This new approach has promise to accelerate
progress in neuroscience research
• Analysis of Lumos game data suggests that subjects
at risk for cognitive decline may be identified by
longitudinal game data
• Our goal is to provide subjects and data to other
investigators and clinical trials to facilitate their work
50

51. www.TheBrainHealthRegistry.org
51
Coming to a computer near you:
Desktop, laptop, iPad – the choice is yours!

52. Tommy Sagroun, CEO

53. About the Company
● Founded in 1999 by neuroscientists
● Computerized cognitive assessments and brain training
software
● Mission: to improve quality of life through brain fitness
● 15 years of scientific validation: independent institutions and
peer-reviewed publications
● Personalized brain fitness programs

54. What is MS?
● Multiple sclerosis (MS): incurable disease of the central
nervous system that disrupts the flow of information within
the brain, and between the brain and body
● Symptoms: frequency and duration vary
 Physical symptoms: loss of muscle control, vision, balance, and
sensation
 Hidden symptoms: fatigue, cognitive impairment and socio-psychological
problems
● Treatment: incurable disease but various treatment options to
decrease the frequency of relapses and to delay disease
progression

55. Bayer long-term commitment in MS
● Bayer HealthCare Pharmaceuticals: pioneer in the field of MS
with a long-term commitment. First company to offer an
efficacious and innovative treatment for MS
● Bayer optimizes existing therapies and offers physicians and
patients a complete help network, including a 360° support
approach:
 Efficacious MS therapy
 Innovative application system
 Direct MS-nurse support
 Informative and practical materials
● Next step: help MS patient train their cognition

56. Peer-reviewed publications
● Examples of peer-reviewed publications showing that CogniFit
programs help improve cognitive function:
 In MS patients
 In older adults
 In people with intellectual and developmental disabilities (IDD)
 And reduce depression levels in patients with unipolar and bipolar
disorder
 And improve sleep quality in older adults with insomnia
 And mobility in sedentary seniors
 And boost reading skills in dyslexic students
● CogniFit and Bayer collaboration: specific and exclusive brain
training program for Bayer patients with MS

57. How does the CogniFit program work?
● CogniFit and Bayer collaboration: specific and exclusive brain
training program for Bayer patients with MS
● Scientific approach: starts with a baseline assessment of your
cognitive profile
● Patented methodology: automatically builds your optimal brain
training regimen
● Revolutionary technology: assesses and tracks 20+ key cognitive
skills

58. The partnership
● Initial collaboration with Bayer global
● Local Bayer entities review regulations and marketing strategies
for their market
● CogniFit is available in 13 languages
● First product’s roll out in Bayer’s parent company country
● Bayer teams work locally with doctors, nurses and health care
providers

59. Key lessons
● Largest global companies recognize brain fitness
● CogniFit’s scientific credibility increases
● Stronger patient’s involvement in fighting the disease
● Customized brain fitness for specific targets
● Other partnerships with large companies from different
industries such as health and wellness, and driving academies

60. Thank you
Thank you
Tommy Sagroun, CEO

61.  To learn more, visit SharpBrains.com