Generation Expectation

Over at Disruptive Demographics, Joseph Coughlin, Director of the Massachusetts Institute of Technology AgeLab, talk about Generation Expectation as part of a forum on “What’s Next? How Technology will Revolutionize the Boomer Generation”.  Coughlin’s video argues that it is not the baby boomers numbers, not their wealth, not their experiences, nor their education that are worth paying attention to, but how these factors converge together to contribute to create Generation Expectation, composed of people who expect to live longer and to live better. Notice that he does not think that they expect to live forever (i.e. they are not transhumanists) nor does he think that they will want to pursue radical enhancements.  However, they will be amenable to using technology to improve their lives. The ability of this generation to drive trends in North America has been a defining feature of the last 50 years; it is likely that they will continue to do so, with everything from cognitive enhancers (writ large) to social media.  As Coughlin says, “the new expectations of the next generation of old will drive markets and demand innovations in products, services and public policy.”

Link to Disruptive Demographics.

2011 Sharp Brains Summit

Registration is now open for the 2011 Sharp Brains Summit (full disclosure – I am a speaker this year). Sharp Brains is an organization that follows the business of brain fitness software and is primarily dedicated to promoting the business model of selling software.  At the same time, Alvaro and his team are quite serious about highlighting the best ways that we can improve our brains (non-pharmacologically, that is), and the information that Sharp Brains provides is not only intriguing but often practical. If you are at all interested in the latest and greatest in this rapidly growing field, by all means attend.

Even better, you don’t have to go anywhere!!  This is a virtual conference, so all that you need is a computer (you need to be  able to run Flash, but if you can watch YouTube videos, you are all set) to attend from the comfort of your own home or office.  I attended the 2010 Summit, and it was remarkably effective – not only did it save travel expenses and time for me (not to mention that it was environmentally responsible), but it turned out that the virtual conference had an advantage over in-person conferences in one way. Most people have had the experience that some of the most valuable discussions at conferences occur not from the podium but in the hallway. The virtual conference software allows for hallway conversations, but the bulk of that conversation occurs as a public comment stream. Getting to hear what many people are saying in the ‘hallway’ is much better than hearing only one person, and if you like what they say, you can send them a note and continue your conversation as a private one.

For the full list of speakers, go here.

For a brief intro to virtual conferences, go here.

Physician Attitudes towards Pharmacological Cognitive Enhancement

Yemi Banjo, Roland Nadler and I have a new paper out today in PLoS One entitled “Physician Attitudes towards Pharmacological Cognitive Enhancement: Safety Concerns Are Paramount.  Here is the abstract:

The ethical dimensions of pharmacological cognitive enhancement have been widely discussed in academic circles and the popular media, but missing from the conversation have been the perspectives of physicians – key decision makers in the adoption of new technologies into medical practice. We queried primary care physicians in major urban centers in Canada and the United States with the aim of understanding their attitudes towards cognitive enhancement. Our primary hypothesis was that physicians would be more comfortable prescribing cognitive enhancers to older patients than to young adults. Physicians were presented with a hypothetical pharmaceutical cognitive enhancer that had been approved by the regulatory authorities for use in healthy adults, and was characterized as being safe, effective, and without significant adverse side effects. Respondents overwhelmingly reported increasing comfort with prescribing cognitive enhancers as the patient age increased from 25 to 65. When asked about their comfort with prescribing extant drugs that might be considered enhancements (sildenafil, modafinil, and methylphenidate) or our hypothetical cognitive enhancer to a normal, healthy 40 year old, physicians were more comfortable prescribing sildenafil than any of the other three agents. When queried as to the reasons they answered as they did, the most prominent concerns physicians expressed were issues of safety that were not offset by the benefit afforded the individual, even in the face of explicit safety claims. Moreover, many physicians indicated that they viewed safety claims with considerable skepticism. It has become routine for safety to be raised and summarily dismissed as an issue in the debate over pharmacological cognitive enhancement; the observation that physicians were so skeptical in the face of explicit safety claims suggests that such a conclusion may be premature. Thus, physician attitudes suggest that greater weight be placed upon the balance between safety and benefit in consideration of pharmacological cognitive enhancement.

Link to the full paper (open access)

Virtual Mentor November Issue: Neuroethics in the Twenty-First Century

The American Medical Association has a lovely little journal focused on ethics called Virtual Mentor.  Tthe title for this month’s issue is “Gray Matters: Neuroethics in the Twenty-First Century”, and it has a number of articles that are likely of interest to readers of this blog (full disclosure: the issue includes an article by me).

There is also was previously an ethics poll on the website which tells readers that “Modafinil is a drug that is FDA-approved for treatment of narcolepsy.”  The poll goes on to state “In widespread off-label use, it has been found to restore memory in older people who have age-associated memory loss (AAMI). Now the FDA is testing modafinil for that use.”  To the best of my knowledge, there is neither data nor compelling anectodal information which demonstrates that modifinil restores memory in older or younger individuals [Update I:  An early report suggested that modafinil improved performance in selected cognitive tasks in young individuals, but a recent meta-analysis holds that there are modest effects on attention, and that “the effects were not unequivocal for people in a normal state of wakefulness.”  Restorative effects on memory in older individuals have not been seen.] Moreover, the FDA does not test drugs, but rather acts as regulator, evaluating drugs for claims of safety and efficacy.  If any readers know of information which would suggest otherwise, please share it with us in the comments section.

Update II: Virtual Mentor has modified their ethics poll, dramatically improving it.  I recommend that readers participate.

Full table of contents are listed below the fold.  Continue reading

Call for Abstracts: An interdisciplinary conference on cognitive enhancement for young scholars

Call for Abstracts: An interdisciplinary conference on cognitive enhancement for young scholars

21 February – 1 March 2011

University of Mainz, Germany

The conference will provide a forum for young scholars, post-docs and Ph.D. students from Europe and Canada interested in medical, societal and ethical issues of cognitive enhancement. This event is sponsored by the German Federal Ministry of Education and Research (BMBF).

During the conference, 15 participants from different disciplines will have the opportunity to present their work and to discuss issues related to cognitive enhancement with renowned international experts.

The scientific programme will consist of oral presentations by the 15 participating young scholars, keynote lectures and a panel discussion. In addition, a hands-on day will be held at the Psychiatric Clinic, University Medical Center, Mainz.

Who should apply?

Young scholars, post-docs and Ph.D. students from disciplines such as neurosciences, medicine, psychology, theory of medicine, philosophy, biomedical ethics, neuroethics, law, theology and the social sciences, interested in an interdisciplinary debate on cognitive enhancement.

Accommodation and travel expenses will be provided.

Participants will receive an additional expense allowance of 300 € for preparing and submitting their manuscript for inclusion in the conference proceedings. In order to allow for a timely publication, it will be necessary that the participants submit their manuscripts within four weeks after the conference.

Please send your application with an abstract of your presentation (max. 500 words), a short curriculum vitae and a list of publications to

PD Dr. Elisabeth Hildt

Department of Philosophy, University of Mainz

Jakob Welder-Weg 18, 55099 Mainz, Germany

Mail: hildt@uni-mainz.de

Deadline for submission of abstracts: 30 November 2010

Outcome of review: 15 December 2010

Regulatory environment tightens for cognitive enhancers

A spate of recent activity at the FDA seems to indicate that the bar for approval of bona fide cognitive enhancers will be quite high, at least if one considers the balance between risk and benefit.  The latest in a series of advisory committee recommendations came on Thursday when the weight loss drug lorcaserin was voted down 9-to-5 [These advisory committee recommendations are different than FDA rulings, but they are influential and it is rare for the FDA to go against the advice that it receives from these expert panels.]  The safety issue was quite modest, and given the seriousness of obesity as a health issue in the USA, the setback is all that much more surprising.  Writing about the vote in the New York Times, Andrew Pollack points out that,

“the F.D.A. is very safety conscious in this area since the drugs will be taken by millions of people”.

Perhaps the biggest sticking point was that the drug met only one of two FDA benchmarks for weight-loss drugs and it did so by only a small margin. In July, again citing safety concerns, the same committee voted against approval of another weight loss drug, Qnexa, even though that drug produced a much greater weight loss than lorcaserin.  A different committee voted unanimously against approval of flibanserin, a drug that was being developed for hypoactive sexual desire disorder in women, once again citing the thin benefit even though side effects were modest.

What is most relevant to the development of cognitive enhancers is that both in the case of weight loss and hypoactive sexual desire disorder the FDA has put out guidance for industry to provide clarity about the kinds of evidence it would find compelling, thereby hastening the efficiency of drug development.  The FDA has not issued any guidance on cognitive enhancement, and this makes the regulatory environment even more challenging for the pharmaceutical industry.

There may be relevant compounds in the pipeline, and new targets that pop up on a regular basis, but without some  encouragement from the regulatory authorities, the likelihood of a new cognitive enhancer being approved for use seems further off than ever.

Link to New York Times article on lorcaserin

Prosocial enhancement

Over at The Atlantic website, they have a special section called The Ideas Report which is chock full of interesting thoughts about ‘the themes that shape our times’. Chris Good, a staff editor at the Atlantic.com recently posted a piece entitled, “Give Scientists Performance-Enhancing Drugs”.  The ideas in the article are, to put it delicately, a bit problematic. There are many issues that Chris raises which I disagree with, but I will limit my comments to a few choice items.

The essential message of the piece is that sometimes it might be good for society as a whole to have a subset of people take cognitive enhancers. Chris trots out the ‘unfair advantage’ argument, but then dismisses it with the following logic:

“But for scientists and researchers, particularly those working on medical advancements, things are different. They’re working for the public good. Fairness matters less. If one biochemist or physicist “cheats” to gain an edge over a rival research lab, university department, or grant competitor, it may be unethical, but we should be willing to forgive if it means one less day on earth with incurable cancer or massive emissions of carbon gas.”

This argument might stand as a nice little bit of consequentialist thinking, but for the naive notion that scientists are all working for the public good. It is true that many scientists do so (that is one reason why the public often holds them up as paragons of virtue), but it is hardly the case that arc of scientific progress is monolithic, or that every discovery leads inexorably towards a cure for cancer. But Chris is prepared to carry out an experiment, with scientists as the guinea pigs.  He concludes by suggesting:

Throw fairness out the window, and let’s see what happens.

I don’t even know what to say about that comment. Continue reading

Natural Selection on the web

As one measure of how quickly things move in the world of IT, consider this.  On Monday, I put up a post on the effects of hyperlinks on the brain, suggesting that we here at the Core were going to carry out an experiment in which we would not include hyperlinks in the body of blog posts.  Later in the day, Nick Carr wrote about our experiment ‘de-linkification’, and his post evoked a fistful of blog posts along with comments, sometimes enthusiastic, sometimes excoriating.  And now, at the end of the week, the folks over at Arc90, have modified their Readability bookmarklet to allow links to appear, magically, at the bottom of the page as a series of footnotes.  So here we are, five days later, and you can modify your web-surfing experience to conform to an experimental idea that was suggested on Monday.

The pace of such changes is what is both exciting and worrying about IT.  I very much appreciate the Arc90 team offering this solution, and they have wisely made it optional.  As with many downloadable enhancements to one’s environment on the web, this will either survive or not, depending upon user appetite (my guess is that a few enthusiasts will love it; most people will ignore it). In this way, the modern web is very much like evolution, with natural selection holding sway.

But in evolution, it is generally held that traits that increase fecundity – survival and reproductive success – are those that will persist.  On the web, what are the selection pressures?  At least in this instance, it is user experience.  This gets to the heart of the issue – just because your experience is more enjoyable hardly means that it is the best route to pursue.  One need only think about recreational drugs to understand the analogy.  The meme that Nick began with his Is Google Making Us Stupid article and continues in his new book The Shallows leads, inevitably to this insight: that as we (and the web) mature, we should also begin to make some intelligent choices about how we consume the bounty of information that the internet makes available to us.  Just because we can do it, or even just because we like to do it, hardly insures that it is worth doing.

Link to Arc90’s Readability Project and their blog post on the matter.

Hat tip to Nick Carr for alerting me to Readability’s update

Image credit

Massive study finds no support for generalizability of benefit from brain training software

In a powerhouse of a publication, Adrian Owen and his colleagues have taken a broadside at the field of brain fitness software.  Together with the BBC popular science program Bang Goes the Test, they recruited 11,430 people who completed an average of twenty-four 10 minute training sessions over the six weeks that the experiment was run.  All of these individuals underwent cognitive testing before and after brain training, and the results were pretty clear: brain training provided no benefit other than improvement on the task that people trained with.  In their words:

In our view these results provide no evidence to support the widely held belief that the regular use of computerized brain trainers improves general cognitive functioning in healthy participants beyond those tasks that are actually being trained.

There will be much debate about this study in the days and weeks to come, much of it focused on the details, which, as we all know, is where the devil habitually resides.   In particular, it will be very important for experts to examine the specific tests being employed and compare them to what has been previously published, especially for those brain training regimes that have reported improvements in fluid intelligence.  One thing is clear: the numbers of participants make it difficult to refute Owen et al.’s findings, and certain make replication a challenge.

Personally, I see Owen et al.’s study as a healthy development, indicating that the field is moving from adolescence into early adulthood.  Indeed, with pharmaceuticals of all stripes we are quite accustomed to optimistic early results only to find in later, larger trials (especially after the drugs are released into use by the general population) that a subtle effect is seen which was not observed in earlier clinical trials.  Moreover, it is likely to spur further investigation, which again can only be healthy. The results, and our interpretation of those results, are likely to change over time.

I will admit to being among those who had hoped that brain training would produce impressive effects.  But in the end, I am a slave to data.   Anything less would be wishful thinking.

For more about the study, see the following video from the Nature Video.

Image source: Nature Publishing Group and Rex Features

Hat tip to Sofia Lombera for alerting me to the video

The Singularity – What, Me Worry?

Image credit: Dog's Breakfast (http://www.miniurl.com/33703)

People have all sorts of reasons to both hope and worry about the presumptive singularity – that moment when computers magically develop so much computational power that they will begin outwit us in meaningful ways.  A score of science fiction stories have fed both dreams (“The answer is out there, Neo, and it’s looking for you, and it will find you if you want it to.”) and fears (“Dave. What are you doing Dave?”).  My mother-in-law recently sent me a link to a short graphic presentation that captures it pretty well.  Enjoy.