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Review by expert Dr. Alice Saperstein, Ph.D., Assistant Professor of Medical Psychology, Columbia University Medical Center

PROS:

  • Lumosity provides an accessible, affordable, flexible, and engaging user experience so that routine cognitive practice can be easily integrated into any individual’s plan to sustain good cognitive health.
  • Lumosity includes a number of features that make it simple for an individual to create and follow a personalized cognitive training plan including: a survey assessing cognitive needs, access to repeatable online assessments of cognitive abilities, tracking of relative cognitive strengths, weaknesses and changes over time, and a personalized schedule of training reminders, progress and program updates.
  • The research and development team behind Lumosity partners with a network of researchers in the U.S. and abroad to study factors underlying improvement in game performance and cognition. Research data inform ongoing product development. Randomized controlled trials investigating the efficacy of Lumosity exercises for use in cognitive rehabilitation are underway.

CONS:

  • Cognitive improvements achieved within the web-based program may have limited applicability to cognitive functioning in real-world contexts.
  • Relative to other web-based cognitive rehabilitation programs, Lumosity offers less opportunity for systematic skill building across exercises. Without the aid of a trained therapist, generalization of cognitive gains may be limited.
  • At this time, it is not known whether training with Lumosity can result in clinically meaningful improvement in cognitive functioning for people with severe cognitive impairments such as those associated with psychiatric illness.

Description

Lumosity provides a suite of engaging exercises that is commercially available to the general public for the purpose of providing practice with a range of cognitive skills. Lumosity can be accessed via internet, or iOS or Android mobile application. Those who seek to integrate Lumosity into an intensive “brain training” routine may take advantage of the program’s online assessment tool, which provides the user with a snapshot of cognitive abilities, and a schedule of recommended exercises to target select cognitive domains. Each cognitive domain includes several exercises from which the user may choose, providing multiple options to target cognitive skills including speed, attention, working memory, visual-spatial memory, selective and divided attention, inhibitory control, mental flexibility, and reasoning/problem solving. Lumosity exercises were developed with the intention to challenge and, potentially, improve the way the brain works to process information. The end-goal for Lumosity users is to improve neurocognition across a range of domains. Lumos Labs is currently collaborating with researchers from academic institutions across the U.S. and abroad to study the effects of Lumosity in people with psychiatric and neurological conditions. Evidence about the efficacy of Lumosity exercises to yield clinically significant change in cognition is not yet determined, although research is underway.

Ease of Use and User Experience

User Interface

Lumosity is a user-friendly website that is easy to navigate. The website and mobile application use colorful graphics that offer a simple but engaging platform. Exercises vary with respect to use of the mouse or keyboard, depending on the type of response required. New exercises are added fairly frequently and graphics for older exercises are periodically updated. All exercises are designed as “games”, using sound effects to maintain users’ attention, and points to reward performance achievements. Lumosity’s design provides a fun context for cognitive training.

Appropriateness of Content

When a new account is created, users are asked to choose which types of cognitive skills need improvement, using simple language to describe the different types of cognitive abilities people use in everyday life. New users are guided through a brief personalization process that allows for training preferences to be specified. Content can also be adjusted to account for special circumstances such as color-blindness or for when English is not the user’s primary language. The account setup ensures that the training content will be appropriate to each individual’s learning needs. During the training, exercise instructions are simple and easy to follow. Each exercise offers a tutorial to walk the user through the instructions and practice examples before beginning each trial. The language used is appropriate for the vast majority of users and there is a good balance between verbal and non-verbal exercises.

Appropriateness of Feedback

Lumosity provides users with feedback after each exercise trial. Feedback includes points as well as data on accuracy and response speed. Bonus points are awarded for optimal performance on many exercises. For some exercises bonus points are meant to reinforce the use of information processing strategies, such as optimal planning on a problem solving exercise (e.g. Route to Sprout), or remembering more detailed information in a memory exercise (e.g. Familiar Faces). However, for many exercises, it is unclear how bonus points are calculated, or what aspect of performance is meant to be reinforced. Additional feedback is collected based on users’ performance over time including a record of training days, and a performance index that illustrates relative strengths and weaknesses across the different areas of cognition.  This information is presented graphically, allowing the user to their progress at a glance.

Cognitive Challenge

Lumosity is designed to provide practice on a range of cognitive skills. The beginning level of challenge is appropriate for the vast majority of users; for those who need additional guidance, there is a tutorial offered for each exercise that users may find useful for instruction and practice. Most exercises are progressive in the level of challenge, based on the user’s real-time performance. For example, following successful recall of 3 items in a visual-spatial display, the next trial will contain 4 items, and so on. Alternatively, some exercises offer different levels of game play, which can be selected by the user from one trial to the next. Level of cognitive challenge typically varies with respect to the number of items held in memory, or the addition of distractors in attention tasks, or the complexity or number of steps needed to solve a problem. Of those exercises that provide different levels, some require a certain degree of performance before a new level may be accessed. Once a new level is available, users have the flexibility of choosing whether to remain at the current level to gain mastery over the basic skill, or to move up to take on an additional degree of cognitive challenge.

Ease of Account Management

One Lumosity account includes access to the assessments and all cognitive exercises. The home page allows users to view training history and progress, or to navigate to the assessments or games straight away. There is a variety of account management options. Users can select if and when to receive training reminders, as well as notifications of when new exercises are available, availability of promotional offers, and a newsletter. Users can select training preferences to prioritize areas of cognition to work on, training type, and game options available for special conditions such as color blindness or for users less fluent in English. There is an option to track mood and sleep habits if users are interested in how cognitive performance relates to lifestyle.

Scientific Basis

Lumos Labs is the scientific team behind the creation and ongoing development of Lumosity exercises. The tests of cognitive abilities and some of the exercises themselves are based on common neuropsychological and cognitive tasks that have been used by doctors and researchers to examine different cognitive abilities and, in turn, how the brain works. There is current, promising research evidence that the “Brain Performance Test”, provided online by Lumosity, is a reliable assessment of cognitive performance that captures multiple cognitive abilities and is sensitive to change with cognitive training. This assessment provides a benchmark for cognitive performance and is a useful tool with which the user can independently track changes in cognitive ability over time. This is an important element of Lumosity given that many users subscribe to Lumosity without the guidance of a therapist. The Lumosity exercises are designed to improve cognitive abilities based on what is known about how the brain adapts and can improve its ability to function when challenged. For example, most exercises automatically adjust the level of difficulty as performance improves so that the user is consistently challenged. Because exercises are brief, they can be repeated within and between training sessions for continued practice. In addition, because cognitive challenges are presented in the form of enjoyable “games”, users may feel motivated to train frequently and over a longer period of time. Currently, the majority of research on Lumosity (a part of an organized effort called “The Human Cognition Project”) is focused on how people use the program, and how cognitive performance relates to age, general health and lifestyle factors. Completed research has been presented at scientific conferences, and some research on training outcomes has been published in peer-reviewed journals.
There is preliminary evidence on how regular training with Lumosity exercises impact cognitive abilities in healthy adults, in elderly patients with Mild Cognitive Impairment, in individuals who have had chemotherapy, and in individuals with medical conditions associated with cognitive impairment. Cognitive change has been documented with regard to improved game performance, improvement on the Brain Performance Test, and there is some evidence to indicate that generalization to cognitive performance on independent standardized measures of neurocognition can occur. There is limited evidence to indicate perceived or actual change in cognitive functioning in the context of everyday life. Thus far, the populations that have been studied using controlled study designs vary considerably with respect to the type and magnitude of their impairments, as well as in the frequency and duration of training. In these studies, the effect of Lumosity training was compared to being on a wait-list (i.e. receiving no intervention) or training gains were examined relative to each individual’s pre-training cognitive performance. There is research underway to examine the cognitive impact of Lumosity in adults with psychiatric conditions such as schizophrenia. However there is no concrete evidence available to-date that recommends Lumosity as a stand-alone cognitive intervention for people with moderate to severe deficits in neurocognition.

Qualitative Review of Program Efficacy

Lumosity offers a web-based platform of game-like cognitive exercises that provide practice on cognitive skills including speed of information processing, selective and divided attention, response inhibition, visual-spatial, verbal, and working memory, mental flexibility, reasoning, planning, and problem solving. Lumosity is commercially available to any person with internet access on a computer or mobile device. Individuals can therefore subscribe to Lumosity without the guidance of a professional therapist. Because Lumosity is not exclusive to professionals or rehabilitation clinics, the program offers user-friendly assessment tools in order to create a personal profile of cognitive ability. Users can also select from a menu of options precisely which aspects of cognition they would like to improve. Based on assessments and/or users’ preferences, Lumosity offers a training program that will suggest exercises to address areas of particular weakness. Users can independently track performance on exercises over time and retake the assessments to see if cognitive performance has improved. Users can also freely choose among the exercises within each domain without following a recommended plan. Lumosity advises users to train at least 3 to 5 times per week over 10 weeks; repeated, consistent, and varied practice is highly recommended in order to improve cognitive performance.
An advantage of Lumosity is that each cognitive domain can be exercised in different ways. There are at least 40 exercises in total. Each cognitive domain includes between 8 and 12 exercises which vary in focus (e.g. visual-spatial memory versus verbal memory) and game context (e.g. remembering faces or remembering shapes and colors). Users can therefore select exercises that are most enjoyable and motivating, while continuing to practice the same set of cognitive skills. It is important to consider that, while all exercises utilize cognitive skill in some way, they may vary in the degree to which improvement in game performance will likely translate into sustained improvement in cognitive abilities that are meaningful for everyday life. For example, exercises that simulate real-life scenarios (e.g. Familiar Faces) have more real-life applicability for the use of cognitive skills than other exercises (Penguin Pursuit). To optimize the potential for cognitive gain, users should take advantage of the varied exercises within each domain as well as the different levels of difficulty within each exercise. Users who do so stand to gain greater cognitive benefit than those who limit their practice and remain at lower levels of cognitive challenge. Few exercises prompt users to employ strategies to aid cognitive processing, although this may be a drawback of using the program without the guidance of a therapist more so than a disadvantage of the program itself.
Overall, Lumosity users can expect improved game performance and may experience improved confidence and ability to perform real-world tasks that are similar in nature to the exercises used. Independent training with Lumosity may therefore be a helpful component of maintaining general cognitive health. However there is no available research yet to inform how improving game performance within Lumosity will help people with severely impaired cognition (i.e. due to injury or serious psychiatric conditions) improve to the level of pre-illness ability, nor how improved performance within the program will translate to meaningful improvement in cognitive functioning in everyday life.

Estimate of efficacy relative to similar products

Lumosity is accessible to a wide audience and was designed for general population use. Because of this, users may find Lumosity exercises more game-like than other programs designed specifically for cognitive rehabilitation. The cognitive domains included in the suite of Lumosity exercises are similar to those in other web-based rehabilitation products (e.g. processing speed, attention, memory, reasoning and problem solving), thereby allowing users to practice similar skills in fun, engaging ways. Lumosity exercises are fairly streamlined with respect to the cognitive focus of each exercise and with respect to the properties of the exercise that change to increase the level of difficulty from one trial or level to the next. Other web-based programs designed for rehabilitation purposes employ tasks with more finely tuned exercise parameters so that, from one trial to the next, the user is increasingly challenged along multiple dimensions. In addition, Lumosity offers less opportunity for systematic skill building across exercises. While cognitive skills may be practiced in different ways (e.g. working memory can be exercised using faces, shapes, or words), there is a less obvious progression between exercises such that a skill practiced in one exercise is then applied in a different way or in combination with a different skill in a new and more challenging context. Sequences of exercises to enhance generalization may be recommended by a trained therapist, but may be less intuitive to the independent user.
An advantage of Lumosity over other web-based cognitive training programs is the opportunity to complete repeatable online assessments of cognitive abilities. This allows users to independently track cognitive skill improvement, using change on cognitive tasks that are separate from the exercises themselves. Thus users can gauge the extent to which change in cognition is limited to or goes beyond improvement in game performance. To keep users engaged over the long-run, Lumosity is enabled to send training reminders and progress updates to the user. These features help the independent user to practice regularly, which is necessary for any meaningful gains in cognition to be made.

Cost

Lumosity offers a variety of affordable subscription plans. Online and mobile subscriptions are available for purchase on a monthly basis ($11.95), for 1 year ($5 per month) or 2 years ($3.75 per month). There is even a lifetime subscription which is paid in one installment ($299.95). Subscriptions are renewable. Each account provides complete access to all Lumosity features for one person. There is an additional option to purchase a family plan, such that 5 accounts may be used at one time for $8.33 per month. Lumosity often has promotions and discounts available. Prior to purchasing a subscription, individuals can try out a limited number of Lumosity exercises at no cost.

Reviewed August 2014

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