The company behind the “brain-training” program Lumosity settled a complaint by the Federal Trade Commission last week that it engaged in false advertising when it claimed its online games could delay cognitive impairments — painful indignities of aging like dementia, memory loss and even Alzheimer’s.
The agreement calls for Lumos Labs to cough up $2 million for partial refunds and “prohibits deceptive conduct in the future.” Lumos also had to inform subscribers it “decided to settle a deceptive advertising lawsuit” and — this one’s gotta hurt — provide customers with a link to turn off automatic subscription renewal.
In response to questions about the settlement, Lumos Labs said in a statement: “We agreed to settle for $2m so we can move on and focus on our mission: Delivering engaging cognitive training products to our 70+ million members, continuing research both in-house and with our partner network of 100+ collaborators, and promoting innovation within the field of cognitive training.”
The statement listed research being done by the company’s Human Cognition Project, said it is a firm believer in the peer-review process, and suggested people contact independent researchers to evaluate studies by Lumos and others.
So What Does the Research Say?
In 2010, QUEST reporter Amy Standen talked to several researchers about the efficacy of games like those offered by Lumosity and Posit Science, advertised as beneficial for improving cognitive ability and a defense against age-related mental decline.
“Can you improve your brain so that it’s faster, more adept, more vital?” Dr. Laura Carstensen, founding director of the Stanford Center on Longevity, asked Standen, rhetorically. “That’s what the claims are, and I don’t think there’s really any evidence for that.”
Dr. Joel Kramer, head of neuropsychology at UCSF’s Memory and Aging Center, invoked the one word scientists do agree on.
“I think that the research thus far demonstrates a much clearer link between exercise and brain health,” he said. (He means physical exercise, not mental strain while sitting.)
Okay. That was then, a week before the iPad was released, for crying out loud. What about now, in 2016? Any new developments that may have buttressed the claims of the companies selling these products?
Not according to Dr. Carstensen.
“I think claims these companies have been making — and Lumosity is not alone — have been grossly exaggerated,” she said this week. “They’re trying to argue that we’re going to take you out of that active world … and that we’re going to put you in a room alone in front of a computer screen and you’ll play a game that will make you smarter, and you’re going to pay us to do it.”
“There is no compelling evidence for that,” she said.
This assessment is pretty much in line with the 2014 Stanford Center’s critique of the so-called brain-training industry. Called “A Consensus on the Brain Training Industry From the Scientific Community,” it was signed by dozens of scientists in the field.
“To date, there is little evidence that playing brain games improves underlying broad cognitive abilities,” the analysis said, “or that it enables one to better navigate a complex realm of everyday life.”
Get Off the Computer and Onto Your Bike
Carstensen believes exercise is the only evidence-based activity that will improve cognitive fitness. But even those effects are modest, she said. And most of the studies have been relatively short-term.
“You’re looking at a boost to your cognitive benefit over your baseline after six weeks,” she said. “But it’s not huge.”
Exercise, however, can help stave off the mental decline that comes with many physical diseases.
“If you get cardiosvascular disease, it’s likely to effect your cognitive functioning,” she said. “Getting blood clots means you’re more likely to get a stroke. There’s a lot of evidence that diabetes is related to brain diseases as well.”
Physical exercise is “one of the more reliable approaches,” agreed Dr. Kramer. He said studies have shown “fairly convincingly” that people who engage in higher levels of physical activity have less chance of developing dementia.
The Trouble With Cognitive Training Research
Many researchers in the field of cognitive science think the studies that have found a positive effect from playing brain-training games — research often touted by the companies — have a fundamental problem: The evaluative tests to measure improvement are too similar to the games themselves.
“One of the big criticisms of the cognitive training paradigm is this issue of teaching to the test,” said Dr. Joel Sneed, a professor of medical psychology at Columbia University who has researched the effect of computer cognitive training on depression.
“If I give you a test to see if you got better in something like memory, and your game looks a lot like my test,” he said, “then you’ve just been taking the test a lot, so you’ve gotten better at the test. But that doesn’t mean you can find your keys or stop yourself from losing your wallet.”
In other words, there is no evidence the skills learned through the games will transfer to the skills people use to navigate the real world.
Another problem, researchers say, is that the control groups have often not been engaged in any activity.
“A lot of these studies say, ‘Come to the lab and play games,’ and they compare them to people who don’t do anything,” said Carstensen.
Such inactivity will negatively affect mental performance, she said.
Dr. Sneed agreed.
“Comparing people who take the training with people who aren’t doing anything is a completely unfair comparison,” he said.
The people doing brain training, Sneed continued, are getting dings and whistles and positive messages onscreen, so researchers don’t know if that’s the reason for improvement or if the training actually works.
Dr. Murali Doraiswamy of the Duke Institute for Brain Sciences, who was less cynical about the potential of brain fitness games in 2010 , is still hopeful today.
“I still believe in the potential of brain training as a therapeutic modality,” he said in an email, “but what we need now are long-term randomized trials to prove they can improve daily performance and delay dementia.”
Doraiswamy, as well as Dr. Sneed, cited a study published in PLoS One in September, which was conducted largely by scientists from Lumos Labs and used a methodology aimed at reducing some of the pitfalls of previous research.
The study divided 4,715 people into two groups: those who went through a Lumosity program of 49 exercises, and a non-passive control group who solved online crossword puzzles. Both groups completed their activities in one 15-minute session at least five days per week, for 10 weeks.
The Lumosity group showed more improvement than the crossword puzzle group on tests measuring memory, problem solving, reasoning, and speed of brain processing. They also showed greater improvement on “self-reported measures of cognitive functioning.”
Sneed said having participants do crossword puzzles is “the kind of equivalence you need in order to be able to say something about your games. … You’re able to make a comparison that is way more realistic” than comparisons made with passive control groups.
Carstensen isn’t buying it. She said having a control group do crossword puzzles is not equivalent to the game-playing of the treatment group
“Crossword puzzles have been shown over and over to have no effects on cognition,” she said. “You don’t learn something new when you do crossword puzzles, because you retrieve information you already know.”
Another study, commonly called the ACTIVE trial, was cited by Dr. Kramer as research that showed promise for cognitive brain training.
The research was led by Dr. George W. Rebok of Johns Hopkins’ Center on Aging and Health and includes scientists from 11 institutions, including several affiliated with Posit Science. The study looked at 2,832 people who were almost 74 years old on average. Three groups were given 10 training sessions for either memory, reasoning, or speed of processing, then booster sessions 11 and 35 months later. A control group received no treatment.
The study found that 60 percent of the participants who underwent the training reported the same or greater ability to perform the so-called instrumental activities of daily living, such as doing laundry and managing medication, while only 50 percent of the control group did.
The study also found that 10 years after the original treatment, those who received training in speed processing and reasoning did better on tests measuring those skills than the control group. The memory training showed no effect.
But the study found “no effect of training or added booster training” on actual tests, as opposed to self-reports, designed to measure daily cognitive function.
More Research Needed
All of the researchers agreed that the advertising claims of companies like Lumosity have not been borne out yet by the research. Dr. Dorasiswamy says the FTC action “will serve as a broadshot to move the entire field away from marketing-driven claims to science-driven claims.”
Dr. Sneed says more — and better — research is needed if the industry wants to uncover the smoking gun that will prove what they’re peddling is beneficial.
“Several studies are promising, but you need a large double-blind placebo trial,” he said.” You need more than one. And you have to be able to show the effect of doing the treatment generalizes to other cognitive skills.”
Even the Stanford Center for Longevity’s call-to-arms against the brain-training industry in 2014 acknowledged that “some intriguing isolated reports do inspire additional research.”
Dr. Kramer, for his part, thinks that Lumosity and other brain-training games could one day prove beneficial.
“The lack of evidence is not the same as evidence of a lack of efficacy,” he said. “There’s still the possibility that Lumosity or other kinds of brain training or cognitive enhancement approaches will have some efficacy.”
“It just hasn’t been adequately established yet,” he said.