David Williams: This is David E. Williams, co-founder of MedPharma Partners and author the Health Business Blog. I’m speaking today with Laura Fay. She is CEO of HAPPYNeuron. Laura, thanks for joining me.
Laura Fay: My pleasure.
David: Laura, I understand from an article that you wrote that all 72 million Baby Boomers are slated to be 65 or over in the next 20 years. Clearly that’s going to have a major impact on health care needs and health care costs. I’m wondering: can you give me a sense of how many of those folks are likely to be affected at some point along the way by dementia or Alzheimer’s disease?
Laura: Yes, the Alzheimer’s Association produced facts and figures for 2009 and they do a pretty nice job of capturing the statistics. Today there are 5.3 million Alzheimer’s sufferers. It’s expected that the Boomer population, about 10 million of them, will be afflicted with it. Even a bigger number if you include the lesser condition of Mild Cognitive Impairments. So overall we’re looking at pretty big numbers.
David: Can you tell me about this Mild Cognitive Impairment and what the relationship is between that and Alzheimer’s? Is Mild Cognitive Impairment just from normal aging or is it something different?
Laura: There are a whole bunch of different types of memory loss or cognitive impairment. Normal memory loss —is really normal. Everybody’s brain ages and the connections and chemicals in the brain alter with time. So from time to time you may forget things, but it’s fairly normal and it doesn’t automatically lead to deterioration if a person is leading a brain-healthy lifestyle over all.
One in five people over the age of 70 will actually have some form of Mild Cognitive Impairment. Some of those people may develop Alzheimer’s Disease later on, but others may not. It’s not an automatic assumption that if somebody has Mild Cognitive Impairments that they will later develop Alzheimer’s.
David: Have there been attempts to measure what the economic impact of Alzheimer’s and Mild Cognitive Impairment is? I know there are direct medical costs, but also I imagine there are going to be a lot of indirect costs of people not able to take care of themselves and affecting productivity and so on.
Laura: Absolutely. The answer is yes. Costs can be assessed both from a health care provider standpoint, from the Medicare perspective, from an individual perspective, and also from a corporate or business perspective in terms of loss of productivity and so forth.
The numbers are pretty staggering. I can comment on a few of them. Right now it’s estimated that the average lifetime cost of care for an individual with Alzheimer’s taking an average number of years of treatment is around $175,000, which is quite sizable. Today the Medicare treatment costs for treating Alzheimer’s disease is $148 billion, which is also pretty staggering. The cost to businesses is almost $25 billion. The caregiver cost to business is actually around $36 billion. That’s really the cost to business where individuals who are in the role of a caregiver for somebody with Alzheimer’s through absenteeism and other issues.
So when you look at the cost for individuals, for the health care system, for businesses overall, it’s very staggering. And of course all of these numbers are expected not just to increase, but to accelerate as the demographic ages.
David: It’s pretty clear that we already have enough of a problem with health care costs and with Medicare. Looking into the future the solvency of the Medicare system is in doubt.
What sort of strategies are being put in place to keep those costs under control and what’s HAPPYNeuron’s role in that?
Laura: On the government level there’s been some initiative with the growing awareness in Washington that this is something that really needs to be looked at. One example I can think of is the Healthy Workforce Act, which is being pushed through Congress to encourage incentives to engage in healthy behavior. Some of those things include cognitive training and some of the things that really can lead to a healthy brain.
There are other things that are going on within the health care industry itself. Some fairly progressive health plans and health insurance companies are really taking a proactive, preventative type of approach. It ranges from ones that are involved with proactive preventative medicine in general and encouragement of healthy lifestyles overall all the way to those that say, “We don’t really see why this may be that important.”
HAPPYNeuron is trying to be an educator within the industry to say the good news is what’s good for your heart is good for your brain. A heart-healthy lifestyle is also a significant contributor to a healthy brain. The missing component is continuous cognitive stimulation. One can get that through a wide variety of cognitive activities. But it needs to be cross-functional in nature, it needs to be consistent and it needs to be done on a fairly regular basis in order for it to have sustained effects. So obviously the programs that we offer for cross-training are scientifically validated to make a difference for consistent participants. It’s something that we’re building awareness of over time.
Fundamentally we believe that we will get to a place in time where taking care of your brain is a commonplace accepted thing.
David: Before you talked about differences in health plans. Some of them are taking more of a preventative approach and others saying this isn’t really a fit. I can understand why some health plans might choose not to participate, because if you’re going to do something for somebody now that’s going to cost money, the impact isn’t going to be felt until it’s Medicare’s problem. It seems like on the other hand some of the firms are moving faster. I know that HAPPYNeuron is working with Humana, which I assume is more in that first category.
David: Can you tell me about that relationship and how it started and what’s involved with it?
Laura: Humana definitely takes a preventative approach to health care and wellness. We’ve been talking with Humana for a long time about the role of cognition and healthy brain lifestyles. That fits with Humana’s approach of looking at games for health in general across a number of different areas, not just for cognitive training, but for education for kids about healthy eating choices or disease management and so forth. Those two thing combined have really put them into a place where they get it. They understand the importance of the role.
Our relationship has started off in a number of different ways. We have the Humana Games for Health initiative. They offer some of the cognitive training games to that audience. We have just launched a Humana Brain Fitness Store powered by HAPPYNeuron. It essentially offers discounts to Humana members on all cognitive training products.
So those are the two timely areas today. We’re working on a number of other projects that I can’t talk about now because they’re not announced.
David: You mentioned before that the games you have are validated. Can you tell me about the nature of the validation and how robust that validation is?
Laura: Yes. We have a number of validation points that have been done both in Europe and here. Essentially what’s been analyzed is really looking at the individuals who have participated in the program over a period of 12 – 18 weeks and who have performed at least 40 minutes a day, three times a week across a cross-functional selection of exercises.
When I say “cross-function” I mean a minimum amount in each of the five main cognitive areas of: memory, language, attention, visual/spatial skills and executive function. What we have seen is that when that combination or that formula is adhered to, cross-functional consistency in the amount of time over a sustained period, the improvement level in each of those areas has been measured with a very high statistical significance between 12% and 18% improvement.
David: You mentioned a couple of times the importance of having cross-functional activities, which I can understand. But I wonder: do some people have weaknesses in particular areas that they need to work on more or do you essentially recommend that everybody go through the same set of exercises?
Laura: No. It’s very personal. Some people may have more or less strength in one area over another. I can really just talk to this about the HAPPYNeuron program because the experience is personalized and the cross-functional workout recommendations are really designed around a balanced workout that is the optimal set of exercises at various levels that are appropriate for a particular individual and take into account the individual’s strengths and weaknesses and how they’ve been performing over a period of time. That’s designed through a series of scientific algorithms based on the user’s activity and performance.
So for example let’s say I’m participating and my visual/spatial skills are weak in comparison to my attention skills or memory skills. So when the online virtual coach that implements the scientific algorithms is going to recommend a balanced workout for me, it’s probably going to have a little bit more of the visual/spatial exercises in there than it would for somebody who has a strength in that area.
The cross-functional component – the analogy I’ve given to many people – it’s like a very large nest made of twine. These neural networks in the brain become frayed and weak with age over time. So really the best insurance against brain decline is to make sure they’re all pretty strong and pretty good. If I have a weakness in one area, I’m only going to be as effective as that weak link.
David: You talked before about how you’ve recorded in scientific studies the 12% – 18% improvement in performance. What about if people aren’t participating in a study? Are they able to track their progress over time?
Laura: Oh absolutely. Yes the system keeps a highly personalized record of accomplishments both overall as well as a drill down within each of the five main cognitive areas and the functions and 25 sub-functions. So there’s a continual ongoing track record on how one is progressing in each of the areas with feedback, both written and graphical feedback with charts and graphs. So someone can see how they are progressing over time.
David: I’ve been speaking with Laura Fay, CEO of HAPPYNeuron. Laura, thank you very much.
Laura: Thank you.May 11, 2009