Accel­er­at­ing inno­va­tion is poised to enable sys­tem­atic brain health self-monitoring and self-care, which in turn can trans­form what it means to live healthy and ful­fill­ing lives. What con­crete steps can indi­vid­u­als take to man­age and enhance brain health and heal ill­ness through­out the var­i­ous stages of life? - Chair: Alvaro Fer­nan­dez, CEO of Sharp­Brains, YGL Class of 2012 - Bar­bara Arrow­smith Young, author of The Woman Who Changed Her Brain - Alexan­dra More­house, VP Brand Man­age­ment at Kaiser Permanente This session took place at the 2013 SharpBrains Virtual Summit: http://sharpbrains.com/summit-2013/agenda/

1. What is the future of
personal brain health?

2. Chaired by: Alvaro Fernandez,
CEO of Sharp Brains, YGL Class of 2012
Alexandra Morehouse,
VP Brand Management at Kaiser Permanente
Barbara Arrowsmith Young,
author of The Woman Who Changed Her Brain
Elisabeth Zelinski,
Director of the Center for Digital Aging at USC
What is the future of personal brain health?

3. Alexandra Morehouse,
VP Brand Management at
Kaiser Permanente
What is the future of personal brain health?

4. 4 4
Kaiser Brand
Manifesto:

5. Mind-Body-Health is the opportunity for KP
5
Health
Advocate,
Proactive
Philosophy
Excellence
Expertise, Compassion,
Innovation, Leadership
Personal Partnership
Relationship With Health Care Professional
Mutual Investment
Competence
Adequate coverage, capable doctors
Care You Can Count On
Better Safety Net, Stability, Reliability, Reassurance
Emotional
Equity
Rational
Needs
The
Opportunity
The
Basics
Consumers’ Health Care Needs Hierarchy
5

6. 6

15. Q&A
10 minutes
(Included in session
recording)

16. Barbara Arrowsmith Young,
author of The Woman Who
Changed Her Brain
What is the future of personal brain health?

17. Strengthening Learning Capacities®
A personal journey into the world of
the brain:
Shaping our Brains
The Woman Who Changed Her Brain
Barbara Arrowsmith-Young

18. Strengthening Learning Capacities®
The Pre-Neuroplastic Paradigm
• Brain’s anatomy is fixed and
unchangeable
• Brain is hard-wired
• Brain function can not be altered if
damaged or limited

19. Strengthening Learning Capacities®

20. Strengthening Learning Capacities®
Lyova Zazetsky and A.R. Luria

21. Strengthening Learning Capacities®
Angular Gyrus Courtesy of Center for Brain and Cognition, University of California, San Diego

22. Strengthening Learning Capacities®
Somatosensory Cortex

23. Strengthening Learning Capacities®
Parietal
Lobe

24. Strengthening Learning Capacities®
Foundation of Arrowsmith
• Alexander Luria:
Identification of Function
• Mark Rosenzweig:
Stimulation of Function

25. Strengthening Learning Capacities®
Unique Cognitive Profile
• Every individual has a unique
learning profile due to his or
her combination of cognitive
strengths and deficits
• Cognitive deficits combine to
create various academic and
social learning problems
• Arrowsmith works with 19
cognitive areas
• Goal: Create a personalized
program of cognitive
exercises to meet individual’s
specific learning needs

26. Strengthening Learning Capacities®
Special Education Approaches
• Compensatory - Use tools and technology to reduce the impact of the
learning disability
• Content/Skill Based – Task analysis, match the strengths of the learner
to the method of teaching
• Strategy – Teach the learner rules or strategies to approach the material
Premise: The learner is fixed (PreNeuroplastic Paradigm)
• Capacity Based – Learning capacities can be strengthened and
changed through targeted cognitive stimulation
Premise: The learner can be modified (Neuroplastic Paradigm)

27. Strengthening Learning Capacities®
Reduce Negative Factors
Chronic Stress
Prolonged Anxiety
Chronic Pain
Sleep Deprivation
Increase Positive Factors
Active Sustained
Engagement
Effortful Processing
Novelty & Complexity
Reward/Performance
Feedback
Exercise
Harnessing Neuroplasticity

28. Strengthening Learning Capacities®
Principles of Arrowsmith Program
• Design a task that stimulates a specific cognitive area
(targeted/differential stimulation)
• Start the level of task difficulty just above the level of
current functioning of the area (effortful
processing/complexity)
• Remove the support of areas that could compensate
for weaker functioning (effortful processing/novelty)
• Build in performance mastery criteria that is rewarded
– accuracy, consistency, automaticity (attention/active
engagement/dopamine)

29. Strengthening Learning Capacities®
Mastery
Criteria
Implications
Why: Accuracy, Automaticity,
Consistency?
Attainment of mastery criteria results in
proficient performance that now requires
little effort or thinking
Neural network now processing efficiently
Ready for increase in complexity and
effortful processing to step up activation
from this new functional base
Training often stops prior to achievement of this level of
mastery, leading to decline in functioning over time

30. Strengthening Learning Capacities®
Change Sustained Over Time
“Whether those changes are very temporary, involving mainly synaptic
strength and temporary facilitation or inhibition, or entail longer term
change in the numbers of synapses in a cortical field, has importance for
how those connections will be used.
If one wants only a temporary trick, it can be induced quickly; if
one wants it to last, it must be induced gradually, allowing for
harder neuroplastic change.”
“Regardless of the source, a sustained change in a pattern of neural
activity is a necessary trigger for neuroplasticity.
Lillard & Erisir (2011)

31. Strengthening Learning Capacities®
To ensure the change in functioning is sustained and not just practice effect or
short-term temporary wiring change we need to:
Keep our brain active over our lifespan
Integrate and use the cognitive gains resulting from mental training
Reduce factors that lead to negative neuroplastic change
Increase factors that lead to positive neuroplastic change
This is Hebb’s principle – neurons that fire together wire together – and the
more they fire together, the stronger the connections
“If a network supporting a brain function is repeatedly stimulated through
practice and training, it will become stronger, contributing to the optimization of
that brain function” (Fernandez, SharpBrains Guide to Brain Fitness2013)
Change Sustained Over Time

32. Strengthening Learning Capacities®

33. Q&A
10 minutes
(Included in session
recording)

34. Elisabeth Zelinski,
Director of the Center for
Digital Aging at USC
What is the future of personal brain health?

35. The future of personal brain health:
Supporting healthy aging
Elizabeth M. Zelinski, PhD
Rita and Edward Polusky Chair in Education and Aging
Professor of Gerontology and Psychology
Supported in part by R01 AG10569, P50 AG005142, US National Institute on
Aging and H133E080024, US National Institute on Disability and Rehabilitation
Research and the USC Center for Digital Aging

36. Aging: The Demographic
Imperative

37. Cognitive Changes over Adulthood

38. • Reduction of risk factors
affecting health and cognition
that increase with age plus
– Cognitive Stimulation
– Mediterranean Diet
– Exercise
NIH State of the Science 2010/CDC
Healthy Brain Aging 2005: Body
health/Brain health

39. Older adults are the nearly invisible
target population for much brain
health technology
…and even organizations that deal
with health issues in aging ignore
the technology benefits for self-
care

40. US HHS objective for dealing with
multiple chronic conditions 2010:
innovative, multidisciplinary, longitudinal
person-centered care models that improve
health outcomes and quality of life while
maintaining or decreasing net costs and
implement evidence-supported models
Source: US DHHS, 2010: Multiple chronic conditions: A strategic framework.

41. | 41
Technology in the health & human
services chronic care strategic
framework
• Electronic Medical Records
• Telemedicine
• Remote Monitoring
• Health InformationTechnology
Source: US DHHS, 2010: Multiple chronic conditions: A strategic framework.

42. | 42
TECHNOLOGY IN THE HHS
CHRONIC CARE STRATEGIC
FRAMEWORK
• Electronic Medical Records
• Telemedicine
• Remote Monitoring
• Health InformationTechnology
Source: US DHHS, 2010: Multiple chronic conditions: A strategic framework.
Where’s self-care technology?

43. | 43
Increasing Concern about Brain
Health at the CDC
• “Opportunities for maintaining cognitive health are
growing as public health professionals gain a better
understanding of cognitive decline risk factors. The public
health community should embrace cognitive health as a
priority, invest in its promotion, and enhance our ability to
move scientific discoveries rapidly into public health
practice.”
• CDC Healthy Brain Initiative
• http://www.cdc.gov/aging/healthybrain/
• July 12, 2013

44. Our Preliminary Answer: Let’s
Make Aging Normal in the World of
Brain Health/Self Care Technology
And
Let’s make Brain health Technology
Normal in the World of Aging

45. | 45
Already normalized technology to support
everyday activities: can they affect health
outcomes?

46. Whether people use existing technology for self-
care varies
Comorbidities
Self Efficacy
Physical
Functioning
Income
Education
Cohort
Age
Access to
Providers
Cognitive
Functioning
Home
Environment
Devices
Access to
Technology
TECHNOLOGYRESOURCESHEALTHPERSONAL
Social
Network
User
Interfaces

47. Our Expertise and interests
• We understand demographic trends of
aging, health, and disability
• We will research relative efficacy of different
approaches to maintaining and improving brain
health
– Kinds of training emphasis
– Effects of individual difference variables like self
efficacy, resources and other important
evidence-based predictors of participation
– Evaluation of effects of long term adherence
– Interventions to encourage appropriate long
term use

48. • A centralized source of aging
and supportive technology
information
– Expert independent evaluation
– Training
– Dissemination
• Incubate new
products, programs, application
s, services
Objectives

49. • Provide consultative services to companies
interested in developing products for older adults
• Provide expertise to the developers and designers
of software products by creating clinician and
consumer focus groups
• Provide test beds for innovation
• Provide pilot funds to support those who are ready
to develop scalable products
• Provide advice to older adults, their loved
ones, and their clinicians about the best digital
solutions for specific problems
• Support and develop a “curated” collection of
digital products related to various issues.
Our Plans

50. • Interdisciplinary teams with
partners from USC schools and
institutes
• Advisory committee from external
constituent groups
• Pilot funding
• Recognition program
• Regularly scheduled summits
• Website, blogs, etc
How?

51. Stay Tuned!

52. Sponsors
Partners
Thank You for
Joining Us!

53. To Learn More…
Summit
Recordings
Book Market
Report
sharpbrains.
com/book/
sharpbrains.
com/summit/
sharpbrains.com
/market-report/