May 13, 2009
Anya Martin

Consumers and retirement homes have made brain-fitness games and exercises a commercial hit, but now some insurers and employers are incorporating them into wellness programs that promote health not just for the body but also for the mind.

When OptumHealth, Inc., a subsidiary of UnitedHealth Group Inc. which develops wellness programs for 2,500 U.S. employers, launched an in-house pilot study of a Web-based cognitive function test in January, Danna Lipton, a care advocate, was quick to sign up. Lipton’s father was diagnosed with Alzheimer’s disease at age 62, and while she is just 31 she was looking for ways to start early to maintain her brain health.

Lipton scored fine on memory in the 40-minute assessment, but the licensed clinical social worker was surprised to learn that she did not do so well on some abilities that were key to her job, such as reading emotional and verbal cues. Since then she has played brain games on the Web site which is trademarked MyBrainSolutions and feels that she has seen some improvement.

“It showed me some of those little things about yourself that might otherwise be hard to learn,” Lipton said. “It was like having therapy without having a therapist there.”

The U.S. brain-fitness-software market generated $265 million in revenues in 2008, an 18% increase from $225 million in 2007, and up from $100 million in 2005, according to a report this month by SharpBrains, Inc., a San Francisco-based firm that tracks the cognitive-fitness industry.

So far sales have been driven mostly by consumers doing programs on their home computers or visiting brain gyms and retirement homes, over 700 of which offer computerized cognitive training programs today, said Alvaro Fernandez, SharpBrains’ co-founder and CEO.

However, the fast-growing sector is expected to skyrocket to between $1 billion to $5 billion by 2015, with future growth amplified by insurers, employers and even governments seeking to reduce direct and indirect health-care costs. Staying engaged on the job

OptumHealth rolled out MyBrainSolutions first to employee assistance programs to help identify mental-health issues such as depression that may accompany other health problems such as diabetes or obesity, said Dr. Eugene Baker, vice president, EAPs for OptumHealth’s Behavioral Solutions division. The test is three-quarters brain function, and one-quarter psychological, he added.

The company then rolled it out as a new wellness feature this year and hopes to position itself as a leader in the brain-health space for employers, Baker said.

“Improving brain health can result in less presenteeism, the tendency to be at work but be distracted and not able to focus,” he added. “If you look at disability costs, absenteeism and presenteeism account for most of the medical costs, and that’s a good reason for employers to be focused on brain health.”

Nationwide Auto Insurance Company added MyBrainSolutions to its EAP last September and started offering it as part of its wellness program for all its 35,000 associates on April 28.

That employee interest in brain health is high could be seen in the swift response — in just the first two hours after sending an introductory email, 150 people signed up, and 500 have taken the test and started completing modules, said Kathleen Herath, associate vice president, health and productivity for Nationwide.

“We have programs for weight loss and smoking cessation, but we also need something for people who are healthy and on top of their game,” she added. “This is a nice fit for those folks as well.”

Humana, Inc.  also has dabbled with brain fitness for several years and recently partnered with brain-fitness firm HappyNeuron, Inc., a subsidiary of French company Scientific Brain Training, to add five brain games to its Humana Games for Health Website.

The site, which can be accessed by anyone, not just health plan members, also includes games that focus on good nutrition and physical fitness.

Insurers join the program

Its goals was to use videogames not only as a consumer-friendly, fun way of motivating healthy behavior to reduce medical costs but also as a marketing tool, said JoAnna Darst, project manager for Humana’s Innovation Center, a division charged with searching the latest consumer trends for new ways to encourage healthy lifestyles.

“We think that adults, no matter what age, will find it beneficial to work different areas of their brain, not just to improve memory,” she added.

Humana also added brain games specifically because a growing volume of scientific research suggests that cognitive activities can improve brain function, Darst said.

San Francisco-based Posit Science Corporation is exploring partnerships with a variety of health, long-term-care and auto insurers about offering its brain-fitness software program to their members, said Jeff Zimman, its chairman and co-founder.

Penn Treaty American Corp. reported a reduction in claims after offering Posit Science exercises to long-term-care-insurance members, he added. Last fall Allstate Corporation offered Posit Science software targeted at improving driving-related cognitive and visual skills to 100,000 auto-insurance customers in Pennsylvania age 50 to 75 in a pilot study to see how that group’s accident rates compare to a control group who does not play.

Dakim, Inc., a brain fitness provider in Santa Monica, Calif., also is in discussions with insurers, said its CEO and Founder Dan Michel. Holding down health-care costs

While health insurers and employers currently say their brain games are more about improving overall cognitive health for employees, the potential impact on health care costs of delaying Alzheimer’s disease would be even more substantial and could represent the next big boost for the brain fitness industry, Fernandez said.

Approximately 10 million baby boomers will develop Alzheimer’s disease and many more will experience mild cognitive impairment (MCI), an early stage of memory loss that may indicate the development of Alzheimer’s, according to the Alzheimer’s Association. The health-cost impact could top $100 billion.

“It’s a major health care crisis that has the medical world looking down the barrel of a gun,” Michel said.

Still, it remains unclear if brain games really do improve cognitive health.

According to an April 28 article in Scientific American, while 50 studies have researched the benefits of brain training for people, only a few have explored whether game-score improvements endure or pass on to daily living.

A randomized, controlled trial by the Mayo Clinic reported in the April issue of the Journal of the American Geriatrics Society is the largest to yield some positive results.

Researchers divided 487 adults age 67 to 93 into two groups, one which used Posit Science’s brain-fitness program and another control group which watched educational videos on art and history for 40 hours over eight weeks.

The brain-training cohort showed significant increases in measures of overall cognition and memory, which translated to improvements in their daily activities, but both brain trainers and the control group had improvement. Mapping the brain

Exercise, a healthy diet, stress reduction and social activity all also have been linked by researchers to reduced risks of cognitive decline.

For this reason, the most exciting aspect of OptumHealth’s program may be the assessment component that could provide a baseline for identifying any future decline in a variety of brain functions whether due to stroke, injury, MCI or other cognitive disorders, said Dr. James Lah, associate professor of neurology at Emory University School of Medicine in Atlanta.

For example, last year the U.S. Army started requiring soldiers to complete a computer-based cognitive baseline assessment before leaving for overseas duty to be able to track any brain-function loss due to brain trauma.

Currently routine brain-health exams are not covered by insurance or Medicare and, at 40 to 60 minutes in length, are too time-consuming for primary-care doctor visits that average 15 minutes, Lah said.

That’s why he and other Emory researchers are developing a paper-and-pencil test that takes three minutes or less, which combined with a questionnaire for a family member or friend can help identify individuals with MCI.

As for computerized brain games, he remains both skeptical that they are any more valuable than say, completing a crossword puzzle, and encouraged that insurers, employers and individuals are so jazzed about stimulating people’s cognitive abilities, he added.

“The best you can say is that they are not going to do harm and they might do some good,” Lah said. “But it’s going to take years and decades to study the differences between people who participated in these activities and those who didn’t.”