Evidence Base for Brain Stimulating Apps?

In my last post I discussed the 'Healthy Living Apps Guide' which had reviewed and scored a variety of health apps.  The effectiveness of most of these apps was found to be fairly poor.

In this context, I have had a number of discussions in regards to brain training apps used for older people and those with cognitive impairment, as to whether we should be rating them for effectiveness, or assessing them for their evidence base.

My answer is, it depends.  It depends on the reason you are using an app and what you are claiming the outcome will be.  There are a number of apps available that claim to 'train your brain' or promote specific aspects of brain function i.e. memory.  Most of these apps have no evidence to support their claims.

An example is 'Brain Yoga Brain Training App' (free with In-App Purchases).  This app claims to train your memory, vocabulary, numeracy, spatial ability and pattern matching.  There is no evidence that the developer has undertaken any research in this area or has any experience with brain function in a professional capacity (other than enjoying puzzles!).  However, is some level of cognitive activity required to participate in the games? Certainly.  Can you say what level of stimulation occurs in the brain or how long it may last (particularly in an individual with some level of cognitive impairment)?  Certainly not.

Therefore it is only possible to say that these games offer cognitive stimulation in a variety of ways, while providing enjoyment and interaction.

On this basis 'Brain Yoga Brain Training App' is a highly enjoyable app with a whole variety games/puzzles to enjoy (shapes, patterns, words, number, memory).

We will have to wait for research results by people like Progessor Gazzaley (see blog posts from 6 October 2014-9 November 2014) before we can make claims about specific cognitive improvements in relation to participation in digital technology.  In the meantime it is possible to enjoy and engage in a wide variety of apps that can provide some level of brain stimulation to help keep our brains active.

Review of the"Healthy Living Apps Guide"

Last month the Victorian Government released the 'Healthy Living Apps Guide' (free) which provides an independent, evidence based review and score of more than 200 health apps.  The categories of apps assessed included; eating well, physical activity, quitting smoking, reducing alcohol consumption and improving mental well being.

The apps were rated on functionality and ability to favourably affect the users health behaviours.

The review found that many of the apps available were ineffective and poorly designed.  Particularly in relation to changing behaviours. Only five of the apps achieved a score of three out of five, which was the highest score!

These type of reviews can be invaluable in saving time (and money!) in finding good quality apps.  The 'Healthy Living Apps Guide' is available at www.vichealth.vic.gov/apps

The Apps rated as the top 5 were;

1. Freeletics - Workout and Training
2. Quit Now: My Quit Buddy
3. Get Some Headspace
4. Water Balance
5. UP - Tracker Required

Excellence Award

Feeling very overwhelmed after winning the Excellence Award at a Health Service Awards ceremony.    
This was particularly in recognition of my work in relation to the 'iPad for Activity and Leisure
In  Individuals with Cognitive Impairment Program'.  With over 9,400 employees I feel very humbled to receive this honour.

Free eBooks

Many eBooks are very inexpensive, costing as little as 99 cents.  However, when searching for free eBooks, there are many apps that are free, but require you to pay for books that are accessed through the app.

I have found an excellent app recently that contains 80 free iBooks!

'Top 80 Classic Books' (free).  This app contains 80 books by a number of well known authors, from Jane Austen's 'Emma' to Charles Dickens' 'Great Expectations', or Lewis Caroll's 'Alice in Wonderland' to Dostoevsky's 'Crime and Punishment'.

If the print is too small, turn the tablet to the landscape position (side on) and enlarge the print using the reverse pinch technique.

There are advertising 'pop ups' that intermittently appear, which can be closed by tapping the X on the screen.  Alternatively, turn off Internet access while reading and the 'pop ups' won't appear.

I have been thoroughly enjoying these books, hope you will too!

Digital Reminiscence

'House of Memories' (free) uses content from a program by the National Museums Liverpool U.K.  It is a very elegant app that aims to promote the use of both digital and physical memory and reminiscence aids.

There are detailed written and video instructions on how to use the app.  Objects from the museum are catalogued under headings with written and audio information, which can be viewed and saved to a memory tree or timeline.  You can browse topics using a search button.

There is a Carers Toolkit which gives clear explanations on memory activities, both physical and digital, including informative videos.  Memory displays can be saved under individual names to be accessed again later.

This is an excellent app for both education and creation of reminiscence activities.  Enjoy.

Let's Talk

There are a number of reminiscence apps that are now available.  The next few posts will look at some of  these.

'Let's Talk' (free) is by 'Many Happy Returns' with the Norfolk and Suffolk Dementia Alliance (U.K). It has a useful section which describes how to use an iPad in terms of how to swipe, tap and pinch the screen.  There are website links to a variety of dementia resources in the U. K.  Their are also some thoughtful communication tips when engaging with individuals with dementia.  The actual reminiscence section is limited to 1940's and 1950's with 6 sections in each, on everyday subjects in that time period.  There are photos, brief descriptions and questions to promote interaction.  Although it is limited in its content, it might still be a useful app to get some conversation started.

Next post- House of Memories!

The AVED Project

Mandy Salamon, a PhD student from the Swinburne University of Technology (Melbourne) ,with the help of Smart Services Cooperative Research Centre, has developed a pilot prototype app called the Applied Virtual Environment for Dementia (AVED).

The app creates a realistic virtual home environment, where the person can select options to set up a sitting room, kitchen or garden with period specific furniture, play individually selected music and have personalised pictures on the walls.

The creation of an individual's familiar home environment draws on the principles of reminiscence theory, bringing out the 'personhood'in someone with a diagnosis of dementia.  The development of the app was designed to include each users personal preferences, to enhance engagement and communication for people with dementia.  Mandy also has recognised that the goal of the app should be participation, rather than success or failure found in many digital games.

One of the wonderful aspects of this app, is that Mandy worked with 10 Residents from a residential care facility with moderate to advanced dementia.  They trialled the app utilising an iPad.  The feedback from these residents will be used to further develop the app.  By gathering information from these individuals, it is far more likely that the app will be highly engaging.  The brief examples I saw of the app looked really exciting.

I await the release of this app with great anticipation!