he numbers are staggering. Brain-training
products are a billion-dollar industry whose revenues are predicted to surpass $6
billion by 2020.1 One of the more popular brain-training programs, Lumosity, recently reached the milestone
of 50 million members,2 likely in part due to an advertising
campaign that spanned radio, television, and the Internet. Nintendo’s Brain Age has sold millions of copies
and is among the best-selling Nintendo DS games of all time.3 These
statistics suggest a belief that brain training produces meaningful benefits,
and this belief does not appear to be restricted to individual consumers. The
fact that health-insurance companies have begun making brain-training products
available to their clients suggests a perception in the health-care industry
that the products work.
But the issue of what does and doesn’t work is complex. The
basic assumption behind almost all commercial brain-training programs is that
practicing one or more tasks leads to improved performance of other, untrained
tasks. The programs often present individuals with a series of simple games
that might require the player to remember the properties of briefly presented
pictures, to keep track of multiple moving objects, to recognize complex
patterns, or to rapidly detect the presence of target objects in the visual
periphery. With practice, players become faster and more accurate at performing
these tasks. These products would be of little value if players improved only on the trained games, however. The
critical question is whether transfer of training
occurs. Does extended practice of the trained games result in general
perceptual and cognitive improvements that boost performance of meaningful,
real-life tasks such as driving, remembering names and faces, and keeping track
Where It Began
Psychologists have systematically studied the issue of
transfer of training for over a century. The early work of American
psychologist Edward Thorndike (1874–1949) set the stage for much of the
research that followed. Thorndike, a professor at Columbia University’s
Teachers College, conducted a series of influential studies in which
participants practiced one task (for example, estimating the area of a
rectangle) repetitively for an extended period of time. After participants
demonstrated improvement, he would ask them to perform a different, so-called
transfer task (such as estimating the area of a triangle). Thorndike consistently
observed large gains on practiced tasks, but these gains were weakly (if at
all) associated with improved performance on transfer tasks. Thorndike also tested
the idea that training in Latin would result in a more disciplined mind, which
would improve performance in a variety of other subjects. He observed no such
Thorndike’s research led him to conclude that transfer of
training occurred only if the practiced task and the transfer tasks shared
“identical elements,”4 and that the elements of most tasks are
different enough from those of other tasks that transfer of training was rare. He
believed that “the mind is so specialized into a multitude of independent
capacities that we alter human nature only in small spots, and any special
school training has a much narrower influence upon the mind as a whole than has
commonly been supposed.”5
Thorndike’s conclusions are consistent with modern theories
proposing that practice results in cognitive adaptations that develop over time
and are specific to the practiced task,6 as well as with theories of
learning that link improved task performance to the retrieval from memory of
specific instances of the same task encountered previously.7 The
implication of Thorndike’s empirical findings and theoretical views is that
attempts to train a person on one task and thus bring about improvements in
tasks other than the trained task are likely to fail unless the tasks are
similar in terms of their elements or components.
Other scholarly views, however, allow for greater
possibilities when it comes to transfer of training. Some research suggests
that important moderators influence the degree of transfer resulting from
training. One moderator is the degree of variability encountered during
training, such that more variable training leads to greater transfer.8, 9
Transfer may also be more likely to occur when performance of the practiced
task and the transfer task depend on overlapping neural circuits. For example, some
researchers observed transfer between a trained and an untrained task to the
extent that both tasks activated a region of the brain called the striatum,
while they observed no transfer when this region was not activated during an
certain types of training may sharpen abilities that are so fundamental to a wide
variety of tasks that performance of additional untrained tasks improves. For example,
the performance of all tasks requires some degree of learning. If cognitive
training helps individuals make better use of statistical/probabilistic
information within a task, it could account for superior performance across a
variety of untrained tasks. (For discussion of the “learning to learn”
hypothesis of transfer, see 11.)
While many theoretical accounts of learning reflect
skepticism regarding the ability of cognitive training to improve the
performance of untrained tasks, under certain conditions and with certain types
of training, these effects may be observable. These theoretical accounts make
it clear that it is not safe to assume that all types of cognitive training
will produce meaningful benefits affecting important everyday tasks.
Empirical evidence that certain software packages and digital
games are capable of improving perceptual and cognitive abilities that transfer
to untrained tasks is mixed. Some studies had positive results, while others did
not. And even in studies with positive results, interpretations of transfer
effects aren’t always straightforward. This is still a very active area of
There are three popular approaches to improving cognition:
brain-training programs, working-memory training, and video-game training. The ACTIVE
(Advanced Cognitive Training for Independent and Vital Elderly) clinical trial was
the largest test of whether brain training can improve perceptual and cognitive
abilities in older adults.12 Over 2,800 participants were randomly
assigned to one of four conditions: memory training, reasoning training, speed-of-processing
training, or a no-contact control group. Intervention groups received 10 training
sessions, each approximately 60 to 75 minutes long (some participants also
received a few booster sessions in the years following training). Transfer
tasks included laboratory-based tests of cognition (proximal outcomes) and
self-reported and simulated performance-based measures of daily functioning
Immediately after training, researchers observed large
improvements that were specific to each type of training intervention (for
example, speed-of-processing trained participants improved on laboratory tasks
measuring speed but not on tasks measuring memory or reasoning). Participants
maintained most of these improvements even when they were tested 10 years
later. However, researchers observed no improvements on measures of everyday
functioning immediately after training, one year after training, or two years
after training. However, tests of participants 5 and 10 years later indicated
more promise. Compared to the no-contact control group, five years after
training, the reasoning group self-reported fewer daily-living problems, the speed-of-processing
group was less likely to cease driving, the speed-of-processing and reasoning
groups were involved in fewer at-fault automobile crashes, and the speed-of-processing
group reported less of a decline in health-related quality of life. Researchers
attributed these delayed effects to the facts that (1) at the start of the
intervention participants were cognitively healthy, and (2) a certain amount of
decline was necessary in order to reveal transfer effects.
Other studies have had less encouraging results, however. For
example, Adrian Owen and colleagues randomly assigned more than 11,000 online
participants between the ages of 18 and 60 to receive six weeks of reasoning
training, to receive six weeks of visuospatial/attention training, or to be
part of an active control group that answered trivia questions.13 Despite
the tremendous sample size, neither training group demonstrated improved
general ability on a battery of neuropsychological tests.
In general, it is hard to draw straightforward conclusions
from the current body of literature on brain training, even when significant
effects are observed. With the notable exception of the ACTIVE trial, these
studies generally focus on outcome measures based on abstract neuropsychological
tests and utilize weak control groups. A recent test of a popular commercial cognitive-training
program, for example, assessed transfer with an abstract digit/tone
categorization task.14 While researchers observed some evidence of
transfer to neuropsychological tests of alertness and distraction, the extent
to which transfer to the performance of important
everyday tasks was unclear. As with any intervention, brain-training
studies need to prove convincingly that transfer-task improvement cannot be accounted
for by a placebo effect.15 That is, researchers need to rule out any
possibility that the group receiving brain training didn’t improve more than
the control group did simply because their treatment caused them to expect this outcome.16 Julia Mayas
et al. compared a group that received intense brain training to a control group
that participated in discussion groups.14 It is unclear whether
participants who merely discussed issues related to aging would expect as much
improvement on the transfer task compared to participants who received
challenging and adaptive cognitive training.
Much of the recent cognitive-training literature has focused
on the potential of working-memory training to improve IQ and, specifically,
fluid intelligence (the ability to reason and to solve novel problems). Susanne
Jaeggi, Martin Buschkuehl, John Jonides, and Walter Perrig first reported that
training that involved juggling multiple pieces of information in the mind affected
fluid intelligence.17 Training was adaptive, as participants had to
remember visual and auditory information on each trial and compare this
information to the information heard and seen one, two, three, or N trials back (referred to as an N-back
task). When participants were able to remember information more successfully, they
were given more information to remember (N
was increased throughout training). Compared to participants who did not
receive training, participants who received N-back training improved more on
transfer assessments that included problems from standard measures of IQ.
Jaeggi and colleagues interpreted the adaptive nature of
their training and the necessity of working memory to solve complex problems as
being supportive of transfer to measures of intelligence. However, after this
initial positive finding, other scholars raised a variety of methodological
criticisms of this and other working-memory-training studies.18
Furthermore, other studies could not replicate the effect of working-memory
training on fluid intelligence.19–21 A recent meta-analysis found
that when most existing studies were considered together, working-memory
training appeared to have a small but reliable effect on measures of IQ.22
But the most rigorous studies—those that included an active control group to
help address the problem of placebo effects—found almost no effect at all. Given
the mixed state of the literature, two problematic possibilities exist: (1) working-memory
training may not improve fluid IQ, or if it has an effect, the effect may be
small, and (2) important but unknown moderators may determine who benefits from
this type of training and who does not.23
Over the past decade, some commercial and custom video games
have also generated excitement about their potential to improve a variety of
perceptual and cognitive abilities. This excitement has been heavily influenced
by the groundbreaking work of C. Shawn Green and Daphne Bavelier.24 Their
initial study, which focused on the effects of fast-paced action video games
(typically involving violent, first-person shooters), found not only that
action gamers demonstrated superior visual and attentional abilities compared
to nongamers, but also that nongamers could improve these abilities with just a
small amount of action-game training. This finding led to dozens of additional
investigations into other abilities that might be improved through action-game
Researchers have linked superior attention, vision,
processing speed, dual-tasking ability, and decision making to action-game play
through cross-sectional studies comparing gamers to nongamers, intervention
studies training nongamers to play action games, or both.25 Other
studies have suggested that game training could ameliorate age-related
cognitive decline.26 Unlike focused N-back training, video games tap
a variety of perceptual, cognitive, and motor processes, likely ensuring a
greater degree of cognitive and neural overlap between trained and untrained
tasks. This might explain the broad degree of transfer that seems to come from
While this line of research is exciting, and it appears to
indicate transfer that is much broader than that caused by any type of
intervention investigated thus far, we must consider some important caveats
when proposing to improve general cognitive abilities with video-game
interventions. First, game effects do not always replicate, 27, 28
again suggesting either smaller effects on cognition than previously reported
or the existence of moderators that determine whether an individual might benefit
from game training. Second, scholars have raised a variety of methodological
criticisms of the studies that provide evidence in support of game effects.15,
29, 30 Finally, as with previous types of interventions discussed here,
there is a dearth of studies linking video-game interventions to better
performance of meaningful everyday tasks and meaningful activities such as avoiding
crashes while driving, succeeding academically or professionally, and making
complex life decisions such as those involved in the purchase of a new home.
What do the sellers of cognitive-training products promise? Should
consumers purchase and use them? A careful inspection reveals that most
commercial brain-training companies are relatively conservative with respect to
their advertised claims, at least when explicitly discussing potential improvements
on everyday tasks. It is exceedingly unlikely for a company to claim that its
product could help a driver avoid a dangerous crash, a worker advance his or
her career, or an older adult live independently longer. Instead, claims in
these commercials and advertisements are vague. They highlight improvements to
more abstract qualities, such as reaction time, attention, and memory. Few
specify the exact nature of these improvements—for example, reaction to what?
Memories of what? These vague claims are justified in that the products’ training
tasks involve these abilities, and performance on the training tasks improves
The critical question, however, is the degree to which these
improvements transfer to more meaningful activities. Cognitive-training advertisements
typically ignore this issue. These ads typically feature product users (or
actors portraying users) discussing why
they are using the product (for example, “to remember names of people I meet,” “to
get ahead at work”). The companies’ websites also tend to feature user
anecdotes, as well as a section explaining the science behind their product and
referencing completed, peer-reviewed (but sometimes non-peer-reviewed) studies.
In many instances, however, these studies examine something other than the
program being advertised; they assess benefits with abstract laboratory tasks
rather than everyday ones; and they lack critical control conditions necessary
to link improvements to the product. While pharmaceutical advertisements are
strictly regulated, this is not the case for brain-fitness program
advertisements. This may partly be due to the companies’ lack of explicit
claims regarding improvements to everyday, meaningful activities, as well as
the lack of claims that their products are intended to treat specific conditions,
such as age-related brain diseases.
To Be Determined
Before confidently recommending the use of brain-training
programs to improve cognition meaningfully and to address age-related cognitive
decline, researchers must address the following questions and issues:
Comparative effectiveness. If brain-training programs and video
games are in fact effective, researchers must determine the programs’
comparative effectiveness. Per hour invested, how do brain-training programs
and games compare to one another with respect to their ability to improve
cognition meaningfully? How do they compare to other cognitively beneficial
(and potentially more enjoyable) activities such as aerobic exercise,31
digital photography, quilting, and volunteer work?32–34 Do certain
activities transfer especially well to tasks such as driving, while other
activities improve the memory functions that support medication adherence?
Answers to these questions would help shape recommendations regarding the
amount and type of brain-training activities a given individual should engage
Intervention adherence. As with physical exercise and
pharmaceutical treatments, brain-training programs yield little to no benefit
unless people adhere to them. A recent study found that digital game-based
training associated with a variety of perceptual and cognitive improvements
resulted in no benefit in a sample of older adults, likely due to the fact that
adherence was poor for the intervention expected to produce the largest effect.35
The challenges of ensuring cognitive-intervention adherence may be most
analogous to the challenges of promoting adherence to hypertension treatments.
Given that hypertension is typically asymptomatic, treatment benefits are not
readily apparent, such that the costs (e.g., drug side effects) become more
salient than the real but unseen benefits. Similarly, cognitive training may
not result in immediate, perceptible benefits, but it might reduce cognitive
problems years in the future.36 Thus it is important that
researchers examine individual differences that predict adherence (for such an
attempt with exercise, see 37) as they determine how to promote
adherence to brain-training games and programs.
Moderating variables. Currently we know little about who
benefits most from brain training. However, researchers have begun to use data from the ACTIVE trial in an
attempt to answer this question. George W. Rebok et al. found that
memory-training benefits were greater for participants with higher levels of
education and better self-reported health. The discovery of moderating
variables may help health-care professionals prescribe either general cognitive
training or specific types of cognitive training. However, answering these
questions will require fairly large samples to tease out the cognitive,
environmental, disease, and genetic factors that make an individual more or
less susceptible to the benefits of cognitive training.
Methodological rigor and replication. Scholars have
leveled a variety of criticisms against studies that report evidence of
transfer of training from video games and brain-training programs to other
tasks. These criticisms should be addressed before practitioners make strong
recommendations that individuals engage in these activities. In addressing the
potential of placebo effects, expectations for improvement on transfer tasks
can be assessed upon completion of the intervention,16 or in a
separate group of individuals.39 When expectations for improvement
are equal for intervention and control groups, but actual transfer effects
differ, placebo effects are unlikely. In addition to addressing methodological
concerns, researchers should also note that the brain-training literature
contains few direct replications. This is understandable because these types of
studies are difficult and expensive to run. However, replication studies would
be of tremendous value in answering the question of whether reliable transfer
gains can be expected to result from any specific type of training. These types
of studies should be incentivized.
Meaningful Measures, Outcomes,
It’s a no-brainer that individuals purchase and engage in
brain-training programs because they wish to perform better on certain tasks
that are meaningful to them. Yet the majority of studies in the literature use
relatively simple, process-pure laboratory tasks to assess transfer of benefit.40
Few studies assess performance on simulated everyday tasks (for example,
through a driving simulation), and far fewer assess real-world outcomes (e.g., automobile
crash rate, loss of independence, or loss of wealth due to fraud). These types
of important and meaningful outcomes can be assessed only in large-scale
longitudinal studies that follow cognitively trained individuals over a decade
Other important questions relate to when cognitive training
should begin, how much an individual should train, and how long training gains
might last. If brain training is judged to be effective, should it begin when
someone is in his 20s? In her 60s? Should individuals train every day? Most
days of the week? Is it better to engage in long, spaced-out training sessions
or fewer, shorter training sessions? Does an individual need to continue
training in order to maintain gains, or do training gains persist long after
training has ceased? Is there a point of diminishing returns at which the
training task becomes so automated that it no longer exercises the abilities it
was designed to improve? Can people enhance the potential benefits of cognitive
training if they pair it with physical activity and/or social interaction? Only
a handful, if any, studies have addressed these important issues.
These are only some of the unanswered questions regarding
brain training. What, if anything, can today’s doctors recommend to those who
wish to enhance (or to maintain) their cognitive abilities? At this point, any blanket
endorsement of a certain brain-training program would be premature. Yet there
appears to be enough accumulated evidence that being cognitively inactive is
not a good strategy for maintaining cognitive health. Doing something to remain
active and engaged is likely an investment worth making. Cognitive activity
takes many forms, and there is currently little evidence suggesting that any
particular software package is best at improving cognition, or that any brain-training
product is better than other engaging activities, such as learning a new
language or instrument, creative writing, or learning to dance.
These latter alternatives have the advantages of being inexpensive
being especially enjoyable, and providing a useful and valuable skill—even if
there were no general cognitive benefits associated with them. Aerobic exercise
may be one of the safest bets for those wishing to improve their cognition, as
animal models and human cross-sectional and intervention studies all indicate
benefits to brain function, structure, and cognition.41 This option
may be particularly beneficial because it also comes with a host of physical
health benefits. Exercise would be a worthwhile investment even if it had no
effect on cognition.
In the future, more precise recommendations will be possible
as more evidence accumulates and the methodological rigor of intervention
studies continues to advance. Large-sample studies that include real or
simulated performance on important everyday tasks, extended post-training
testing and observation periods (similar to those used in the ACTIVE study),
and large individual-difference batteries (cognitive, genetic, neurophysiological)
that assess moderators of transfer effects will be especially valuable in
informing these recommendations.
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