In the Creyos Health Assessment I send clients, there’s a Grammatical Reasoning task. You need to work out the meaning of verbal statements, and then determine if they are true or not. The score provides a scientific measure of how well you combine verbal abilities with reasoning skills to solve problems. Some people find the task simple, but for others, the task can be quite challenging. Changes to nutrition, sleep, fitness and stress can improve your score however.
The Grammatical Reasoning task was first developed to measure the mental capabilities of divers. Divers often show signs akin to drunkenness after swimming to extreme depths. In fact, you can observe impairments in Grammatical Reasoning from depths of around 30 metres. In an interesting twist, it would appear that it isn’t only depth or compressed air responsible for impairment, but the stress of being at sea as well. Click here to watch Adrian Owen, chief scientific officer – Creyos Health, explain the science behind Grammatical Reasoning.
Ocean Brain Coral
Why Test Grammatical Reasoning?
Verbal reasoning is associated with mental health factors, like stress, and extends to anxiety and depression. Recently, Goodall et al. (2018) found that depressed youth consistently scored lower in verbal reasoning tasks. The conclusion: “the findings support the need to consider neurocognitive functioning when treating youth with depression.” Poorer attention, verbal memory, visual memory and verbal reasoning skills are also identified in youth with depression.
We all have a subjective idea of how our brains are doing. For instance, what’s your definition of ‘fine’ compared to mine? Some days you might experience “brain fog” but, on other days, feel like you can conquer the world. Just how much better are we on those good days? Can health and lifestyle changes making a difference? That’s where the Creyos Health Assessment is really useful, it helps quantify those subjective feelings. It enables us to determine what is supporting us on the good days so that we can have more of them.
Where does this fit with Nutrition?
We don’t pay much attention to our brain but our cognitive health affects all areas of life. Every second of every day. When our brain is performing, every activity in our daily life is just easier. Such as remembering where you put your mobile phone or planning the layout of your new room. What’s more, the brain and bowel (‘The Second Brain’) are in constant dialogue, they are intrinsically linked. For me, the CBS Health Assessment is a useful indicator also of your underlying gut health.
Scientifically-validated, the measures help me assess, monitor, and manage core areas of cognition to tailor every nutrition programme. What’s more, you get a fuller appreciation of how changes in nutrition, exercise, movement, sleep, social engagement can improve your overall health.
Stress management, reduced stigma around obesity, healthy intakes of selenium, vitamin D and zinc, and a healthy gut microbiota… These were all highlighted as potential contributors to the fight against the effects of COVID-19 by expert scientists at the British Nutrition Foundation (BNF)’s virtual conference: Nutrition and COVID-19. The conference took place on Tuesday 24th November 2020.
Eminent speakers working in the field of nutrition science discussed new and emerging research on the role nutrition plays – both in protecting against COVID-19 infection and in reducing the severity of associated health complications.
With the need for everyone to be more proactive about taking greater care of their own heath, I share some of the more interesting discussion points and conclusions.
Nutrients and Immunity
Prof Philip Calder at The University of Southampton explained that a well-functioning immune system is key to providing strong defence against infections such as COVID-19. He highlighted vitamin D, zinc and selenium as being important for anti-viral immunity:
Zinc Calder emphasised the various roles zinc plays in the immune system and its specific function in preventing multiplication of single-strand RNA viruses, like Coronavirus, by inhibiting the enzymes they require to spread. Meat, poultry, cheese, shellfish, nuts, seeds and wholegrains provide natural sources of zinc.
Selenium Selenium-deficiency can impair immune responses; increase susceptibility to viral infection; permit viruses to mutate; and allow weak viruses to become stronger. Calder shared previous research that suggests selenium supplementation in humans can help prevent viral mutation. Poultry, fish, eggs, nuts, seeds and organ meats provide natural sources of selenium.
Vitamin D Data suggests that low levels of vitamin D are associated with increased risk of COVID-19 infection, as well as hospitalisation. Calder stressed that this is an association and so does not provide evidence of causation and that there is currently not enough data available to recommend vitamin D for prevention of COVID-19.
Prof Susan Lanham-New at The University of Surrey, who reviewed the evidence on vitamin D, concurred but highlighted the importance of vitamin D for bones and muscles in the context of widespread low vitamin D status in the UK. Lanham-New emphasised that all members of the public should take the recommended daily vitamin D supplement of 10 micrograms between October and March as a precaution to ensure good bone and muscle health.
“Maintaining a healthy, balanced diet, including foods from all the main food groups, is the best way to help ensure you get all of the nutrients you need for a healthy immune system. However, everyone should consider taking a vitamin D supplement especially during the winter months and also during the summer months if they are spending more time indoors than usual.”
Sara Stanner, Science Director – BNF
The Effect of Probiotics and Prebiotics on COVID-19 Symptoms
Prof Glenn Gibson at The University of Reading presented the “Emerging evidence for the role of the human gut microbiome in COVID-19 infection outcomes” . He explored the potential for probiotics and prebiotics to support the gut microbiome in fighting COVID-19.
The gut microbiome is a harbouring site for COVID-19 and clinical outcomes can be governed by the type of gut microbiome the patient has. If numbers of ‘good bacteria’ in the gut are low it can be more difficult for that individual to fight off the virus.
Gibson shared promising results from a recent Italian study into the effect of probiotics on the recovery of patients with COVID-19. The study involved two groups of people. The control group was given hydroxychloroquine, antibiotics, and tocilizumab, alone or in combination. The second group was given the same treatment but with a specific formulation of probiotics added. Within 72 hours, nearly all patients treated with probiotics showed remission of diarrhoea and other symptoms. This compared to less than half in the control group and there was also reduced admission to ICU and fewer deaths. More research is needed to confirm these findings.
The Mental Health Impact of Obesity and COVID-19 Risk
In the talk ‘Obesity as a risk factor for COVID-19’ , Prof Jason Halford at The University of Leeds, presented evidence to show that people living with obesity have an increased risk of contracting the virus, hospitalisation, ICU admission and dying from COVID-19.
The European Coalition for People Living with Obesity conducted a survey which Halford shared. The survey revealed that 73 percent of respondents are concerned about COVID-19 due to their weight. However, 43 percent have also been comfort or binge eating since the beginning of the pandemic; 60 percent are experiencing low levels of motivation; and 60 percent are struggling daily with their mental health.
Halford emphasised the negative impact that unusual life events can have on weight gain. Events like quarantine and being under lockdown. He highlighted that many weight management services have been de-prioritised due to the pandemic. As such, stigma around obesity, particularly on social media and in the press, is unhelpful in improving public health. Instead, strategies for supporting good mental health are needed to help the weight loss efforts of those living with obesity.
“This year we have all faced a plethora of new challenges, and mental health issues are often the silent symptom of this pandemic. It’s therefore important for us all to recognise that we are living through an extremely stressful time, not to be too hard on ourselves, to look for support in finding ways to manage stress and to eat as healthily as we can”
Sara Stanner, Science Director – BNF
A growing number of resources with information and advice on diet and COVID-19 can be found on the BNF’s website.
To complete an online Cambridge Brain Sciences Health Assessment and organise an in-depth personal nutrition consultation with Charlotte Fraser Naturopathic Nutrition, email: enquiries@naturopathic-nutrition.com.
Are you glass half full or half empty? It might sound like a slightly odd question but it’s one that I ask my nutrition clients in their initial 90-minute nutrition consultation. Do you generally have a positive or negative outlook on life? The answer provides just one of a series of ‘compass readings’ which help guide me down the various vitamin, mineral and disease pathways on every client’s individual health road map. Depending on the answer, I might ask other questions, such as ‘do you hoard or throw away?’, and ‘do you find yourself thinking about the past, or more about the present or the future?
These questions are helpful for the purpose of differential diagnosis: are you just feeling a bit down at the moment or are you suffering from depression? And, if it is depression, how severe is it, and might it be symptomatic also of another health condition? Is it a symptom of mental health, or is it more of an emotional symptom, or is it a combination of both?
Various emotional, physiological, mental, nutritional, environmental and lifestyle factors contribute to the rich fabric of your health, and YOU as an individual. That’s why it’s so important to consider symptoms within the context of the whole person, not in isolation. Nowadays, I see more and more people prescribed antidepressants for symptoms not even related to depression. And yet, antidepressants can disrupt gut health and studies show that the ‘Gut/Brain Axis’ is integral to preventing anxiety and depression. So the vicious circle starts, but this is where nutritional interventions can help.
A recent study found that persistently engaging in negative thinking patterns may raise the risk of Alzheimer’s disease. The study published in Alzheimer’s & Dementia, found that people who exhibited higher repetitive negative thinking (RNT) patterns experienced more cognitive decline over a four-year period. They also experienced declines in memory (an early sign of Alzheimer’s disease), and they were more likely to have amyloid and tau deposits in their brain.
About the Alzheimer’s and Dementia Study
For the Alzheimer’s Society-supported study, the research team from UCL, INSERM and McGill University studied 292 people over the age of 55 who were part of the PREVENT-AD cohort study, and a further 68 people from the IMAP+ cohort. Over the course of two years, the study participants responded to questions about how they typically think about negative experiences, focusing on repetitive negative thinking patterns like rumination about the past and worry about the future. The participants also completed measures of depression and anxiety symptoms. They assessed cognitive function, measuring memory, attention, spatial cognition, and language. Some (113) of the participants also underwent PET brain scans, measuring deposits of tau and amyloid; these two proteins cause the most common type of dementia, Alzheimer’s disease, when they build up in the brain.
Positive Findings
The study found depression and anxiety were associated with subsequent cognitive decline but not with amyloid or tau deposition. Thus suggesting that chronic negative thinking could be the main reason why depression and anxiety contribute to Alzheimer’s disease risk.
The researchers say RNT should now be further investigated as a potential risk factor for dementia. And that psychological tools, such as mindfulness or meditation, should be studied to see if these could reduce dementia risk.
“Depression and anxiety in mid-life and old age are already known to be risk factors for dementia. Here, we found that certain thinking patterns implicated in depression and anxiety could be an underlying reason why people with those disorders are more likely to develop dementia.” Said Lead author Dr Natalie Marchant (UCL Psychiatry).
“Taken alongside other studies, which link depression and anxiety with dementia risk, we expect that chronic negative thinking patterns over a long period of time could increase the risk of dementia. We do not think the evidence suggests that short-term setbacks would increase one’s risk of dementia.”
The researchers suggest that RNT may contribute to Alzheimer’s risk via its impact on indicators of stress such as high blood pressure. Other studies have found that physiological stress can contribute to amyloid and tau deposition.
“Taken alongside other studies, which link depression and anxiety with dementia risk, we expect that chronic negative thinking patterns over a long period of time could increase the risk of dementia. We do not think the evidence suggests that short-term setbacks would increase one’s risk of dementia.” Says Dr Marchant.
“Our thoughts can have a biological impact on our physical health, which might be positive or negative. Mental training practices such as meditation might help promoting positive while down-regulating negative-associated mental schemes.” Said co-author Dr Gael Chételat (INSERM and Université de Caen-Normandie)
“Looking after your mental health is important, and it should be a major public health priority, as it’s not only important for people’s health and well-being in the short term, but it could also impact your eventual risk of dementia.”
The researchers hope to find out if reducing RNT, possibly through mindfulness training or targeted talk therapy, could in turn reduce the risk of dementia.
I wish the researchers every success in the next phase of their study. I’m so delighted that more research is going into adopting a more multi-therapeutic, holistic approach to treating and preventing Alzheimer’s and Dementia. Of course, we live in particularly testing timings with Covid, but the advice to stay positive is a good prescription for us all.
To book an online Cambridge Brain Sciences Health Assessment and an in-depth nutrition consultation with Charlotte Fraser, contact: enquiries@naturopathic-nutrition.com.
After six months of homeschool and two days back at school, my 9 year old put in an impressive 90 minutes of homework last night… developing a cough.
“I have a cough Mummy. EHH… KKHHH.. KKUHGH… I will need to quarantine for two weeks at home,” he announced. This was all accompanied by a lot of grunting, like he was trying to swallow a rubber.
I resorted to the first line in my ‘Differential Diagnosis’ manual and recommended he take a spoonful of honey and go to bed early. This provoked an immediate recovery much to everyone’s relief. Of course, the symptoms just happened to coincide with the launch of a new season on his Xbox. Enough said!
The whole ‘back to school’ is extra challenging for teachers and parents this year. September is the start of cold and flu season and now we have Covid-19 to contend with. With everyone on high alert for Covid-19 symptoms, how do you differentiate between these and an ordinary cough and cold? The answer is you can’t easily, especially with diarrhoea and vomiting now also reported as a Covid symptom in children. These symptoms are all part and parcel of school life at this time of year.
While we sadly can’t magic Covid-19 away, we can build our natural defences to benefit our overall physical, emotional and mental wellbeing.
Prevention is Better than Cure
We all need to do as much as we can to build our immune defences to protect our community and bubbles. There is only so much that the Government, the NHS and our schools can do. Ultimately, everyone has to take more responsibility for their own health and I wish this message of self-care was integrated more into Government strategy. There needs to be a more preventative national health policy, one that extends beyond hand washing, mask wearing and social distancing. There are some early steps to address the UK’s high obesity levels evidenced in higher Covid complications and death rates. Again, however, making more gastric band surgery available on the NHS isn’t the solution, let’s do more to prevent obesity.
Back to School Basics: Ways to Strengthen your Immune System
As well as protecting yourself from viruses on the outside, you can build up your body’s defences from the inside by strengthening your immune system. What you eat is pivotal to this as 70% of your immune system is in your gut. Here are some tips:
Make sure your diet is as varied as possible. Variety and balance are integral to optimal health and building up your immune system. So don’t go crazy for one fruit or vegetable that is particularly high in a certain nutrient. Aim to have 5-7 different plants a day at a ratio of 1 fruit for every 4 vegetables ideally. Ensure you have more vegetables than fruits, go for a rainbow of colours on the plate. The more varied your diet, the more you feed the good bacteria in your gut microbiome – your natural defence system. You are also more likely to get the full spectrum of nutrients and micronutrients that you need.
Eat foods which contain microbiome-enriching good bacteria such as kefir, natural bio yoghurt, certain cheeses and fermented foods. For a more in-depth analysis as to the important role of probiotics in strengthening our immune system click here. There is also a list of good bacteria-friendly foods.
Keep an eye on your Zinc levels. This mineral helps develop white blood cells, the immune cells that fight off foreign bacteria and viruses. Zinc also helps protect the mucous membranes that coat the nose, throat, lungs and digestive tract – the entry points for Covid-19. I especially look out for zinc deficiency around puberty as Zinc is involved in numerous aspects of cellular metabolism that influence growth and maturation. Puberty pulls on your Zinc reserves more. Look out for possible signs of deficiency: white spots on the nails, spotty skin, acne, constipation, IBS, obsessive or stuck behaviour, and a more ‘glass half empty’ outlook.
As well as being important for respiratory and gut health, Zinc is also an important mineral for your brain; Zinc deficiency is often implicated in my cognitive health and depression cases. If you supplement with Zinc it is best to choose a supplement such as Cytoplan’s Zinc & Copper; Zinc and Copper compete for the same absorption sites and too much of one can deplete the other. Similarly, ensure you get sufficient iron from natural food sources such as lean meat, spinach, lentils, apricots and eggs. Natural food sources high in zinc are oysters and shellfish, lean meat, pumpkin and other seeds.
Watch your Vitamin D levels as this vitamin plays an important role in immune function. It is a common deficiency in the UK. Scientists are considering vitamin D supplementation as a preventive or therapeutic agent for severe COVID-19. They are researching Vitamin D deficiency as a possible risk factor. The body creates vitamin D from direct sunlight on the skin when outdoors. I recommend supplementation if you have dark skin which absorbs sunlight less easily or if you don’t get enough sunlight from October to March. Good natural food sources otherwise include: oily fish (salmon, trout, sardines, mackerel, herring, tuna and anchovies) and egg yolks.
Oily fish is important for brain and heart health. It is rich in omega-3 polyunsaturated fatty acids, which have been shown to reduce inflammation.
Vitamin C is water-soluble: you don’t store it in your body and so you need to factor this into your daily diet. It is a common supplement but I encourage clients to get their Vitamin C in natural food sources. Bioflavonoids naturally accompany vitamin C in fruit and vegetables. Vitamin C contributes to normal immune system function, and, as an antioxidant, the protection of cells from oxidative stress. It’s also important for bone and tooth formation, collagen production, Iodine conservation, wound healing , red blood cell formation, and infection resistance. Natural food sources include citrus fruits, kiwi fruit, Honeydew melon, potatoes, green peppers, broccoli, papayas, strawberries, rosehips, blackcurrants and tomatoes.
Do I Need to Supplement?
Nutrient shortfalls are caused by a number of different factors. Most people aren’t getting the essential nutrients they need for health and protection on a daily basis.
The following contribute to the nutritional ‘bank balance’ of our bodies and need to be factored into the equation:
Individual food choices
Food growing, processing and preparation methods
The actual nutrient content of the food you eat
The ability of you body to assimilate these nutrients
Lifestyle factors, such as stress and medications etc.
Activity levels and energy-expenditure
Certain life-stages, e,g. puberty where there is increased hormonal activity and growth
It isn’t always easy to determine what your child is eating in school dinners. And, a lot of school pack lunches lack the important variety factor so essential for good health. That’s when supplementation may be helpful.
Nutri-Bears is a good all-round wholefood supplement for primary school children who are fussy-eaters. For teenagers and young adults, Little People is a good option if you are looking for an additional layer of baseline support during the colder months.
All products referenced are available at www.cytoplan.co.uk. They supply science-based Food State and Wholefood nutritional supplements.
Please note that supplements aren’t a substitute for a healthy, varied diet. Keep introducing new plants and wholefoods to the mix and have fun experimenting with different textures and flavours. This really is the best recipe for optimum health.
If you have an underlying health condition or are on medication, I will be happy to provide more tailored advice for you. You should also consult your GP.
I often allude to the microbiome, the colony of trillions of bacteria, fungi and viruses in our gut, as our internal rainforest. This analogy resonates more as we recognise the importance of ensuring plant diversity in the natural world to safeguard the future wellbeing of our planet.
Scientific studies show that we can boost our good gut bacteria by eating as diverse a diet as possible, and in consuming as many different plants especially. The more diverse the diet, the more diverse the gut microbiome. Conversely, a loss in species diversity is a common finding in several disease states.
Though invisible to the naked eye, our good bacteria play an important role in maintaining our overall physical, emotional and mental wellbeing. The gut and the brain are in constant communication and dynamic exchange determines metabolism, immune system function and appetite.
Our thirst for nature and the great outdoors became especially pronounced during lockdown. It isn’t just humans however who crave a change of scene and fresh air… our gut bacteria also relish diversity and new company!
The journal Science of The Total Environment recently published a new theory called “the Lovebug Effect.” This theory suggests that our gut microbiome may actually be driving our increased desire for nature holidays and woodland walks.
The Lovebug Effect
The Lovebug Effect theorises that gut-brain communication drives our nature-seeking behaviour. When our gut microbes are starved of contact with their country cousins (environmental microbiota), they hijack the neural pathways between the brain and gut to make us venture outdoors to find them. Microbes intercept the gut-brain ‘switchboard’ by activating the vagus nerve and sympathetic neurons through the release of neurotransmitters including serotonin, dopamine and GABA.
Certainly, being in nature can have a very tangible feel-good, stress-relieving effect. There have been numerous scientific studies also linking gut microbiome imbalances to increased depression and anxiety. However, what else might be fuelling our need for nature?
Why does our gut microbiome love the great outdoors?
When we immerse in nature, we surround ourselves with environmental microbiota. Nature is teeming with trillions of microbes: this provides our gut microbiome with endless choice when it comes to selecting which microbes to propagate.
Fresh air offers a microbial diversity that avoids the build-up of harmful microbes. Exposure to soil microbes may boost the immune system. Just a single teaspoon of rich garden soil can hold up to one billion bacteria.
The role of the environment in the make-up of the gut microbiota has yet to be fully understood. Studies have shown children (ages 1 to 5) from rural communities have a more diverse gut microbiota compared to children from Western populations. Early-life exposure to microbe-rich environments may be beneficial for human health by increasing the gut bacterial species pool. Studies have also shown that individuals who grow up in city environments have a less diverse gut microbiome. And that City-dwellers are more prone to inflammatory disorders and allergies. Urbanisation can lead to increased sanitation and antibiotic use, separation from the outdoors, and land management practices that reduce soil microbial biodiversity.
‘Baths in the Forest’ for full nature-immersion
Preidlhof in South Tyrol, has made Forest Bathing a central component of their Integrated Health and Transformational Wellness programmes. They also offer microbiome testing to assess the state of your gut bacteria, and champion mindful and sensorial eating.
The ancient Shinrin-Yoku (literally “Bath in the Forest”) came to the fore in the 1980s. Japan made Forest Bathing part of a national health programme to tackle stress-related disorders. Studies showed that conscious contact with the forest brought benefits to body and mind. It bolstered the immune system, reducing stress and blood pressure levels.
Preidlhof’s Forest Bathing takes place on Monte Tramontana, a dense area, rich in biodiversity, with woods, streams and small lakes. Leading the sessions is Irmgard Mossmair, a 73-year-old official mountain guide. She found her source of healing in the wisdom of plants, trees and in the regenerating power of forests. Irmgard has studied aromatherapy and natural remedies through herbs and Chinese medicine.
Forest Bathing facilitates complete immersion in the woods, lights, scents, aromas, textures and pulsations of the earth. Sensory interaction with the forest helps to increase our frequency, and promote mental calm and awareness.
“Slowly, they open up to their surroundings and find themselves immersed in another world, in contact with nature and its secrets. The scents of the trees, the earth, the flight of birds and insects, the sound of the wind, the sunlight on the trees, the different shades of green… All these elements can facilitate a profound transformation.”
Patrizia Bortolin Spa Director and Transformational Health Coach – Preidlhof
We can so easily take our access to nature for granted. What’s more, we increasingly inhabit a virtual and digital universe which provides a further disruptor. However, what Covid 19 has reminded us is that we are still all very much part of the natural world. And our microbiome will act as a constant biological prompt to reconnect with us our ancient roots.
For further recommendations on how to boost your gut bacteria through natural food sources, click here.
Aside from feeling better, there is evidence of significant improvement in brain and cognitive health when you change your diet, improve sleep, and increase your fitness. Reducing symptoms associated with stress, anxiety or depression can also make a huge difference!
Working with Creyos Health, I provide clients with a science and evidence-based means of quantitatively measuring how changes to your diet, sleep, and fitness routine can positively impact brain and cognitive health.
An engaging and scientifically-validated cognitive assessment
As well as understanding how your brain is functioning, you will be able to track how the changes you are making are impacting your brain. Importantly, you will be able to visualise improvements with objective and quantifiable information, presented in an easy to understand format. Brain health integrates very much with gut health and provides a great indicator of your overall health and wellbeing.
You can take the Creyos Health cognitive assessment as a one-off to get a snapshot of your brain health in any point in time. However, you will get far deeper insight if you take the assessments over a series of weeks or months; this enables us to determine meaningful change.
Who benefits from doing this cognitive test?
Everyone can benefit. It is especially helpful to those who want to track whether making the smallest changes to their diet, their sleep routine, or increasing their fitness levels, makes a difference to their brain health and overall wellness.
The Creyos Health test facilitates a highly personalized approach to healthcare. It provides useful biomarkers to enable you to take a proactive and preventative approach to optimizing your health and wellbeing. I further support you with a nutritional and wellbeing programme tailored to your individual needs. We adapt this as required, during the course of the Cognitive Health programme and based on your test findings.
The Creyos Health Test is not a diagnostic tool. However, it may be useful to clients with ADHD, Autism, Depression, Dyslexia, and Cognitive Impairment who wish to monitor progress from nutritional and other lifestyle changes.
You can relax because this isn’t an IQ test. We aren’t measuring IQ!
The tasks assess aspects of cognition including reasoning, memory, attention and verbal ability.
You are anonymously assessed against a sample of healthy control subjects. We factor in your age and gender.
Creyos Health maintains a global normative database of more than 75,000 participants (built off of a larger database of 7 million+ completed tasks). This allows for detailed comparisons of individuals to specific populations.
On completion of the assessment, I share your individual Creyos Health report and we discuss nutritional and lifestyle strategies for improvement. We schedule further tests at agreed intervals to monitor progress and assess meaningful change.
About Creyos Health
The Creyos health tasks were developed in the laboratory of Professor Adrian Owen OBE, Canada Excellence Research Chair in Cognitive Neuroscience and Imaging (owenlab.org). Over 300 scientific studies have been run to date using the Creyos Health tasks, yielding numerous publications in leading academic journals.
The tasks were validated in studies of patients, brain imaging studies of healthy volunteers and in several large-scale public studies involving tens of thousands of volunteers. They have proven to be efficient and sensitive measures of baseline cognitive capacity. For example, in one study, the results of the 30-minute Creyos Health battery were comparable to those of a standard 2-3 hour (paper and pencil) neuropsychological battery (WAIS-R) (Levine et al., 2013). In another recent study of mental capacity in the elderly, the CBS battery outperformed a standard task of cognitive abilities (the MoCA) (Brenkel et al., 2017). Finally, performance on the CBS battery is highly predictive of reasoning and problem solving abilities, as indexed by “classic” tasks such as Raven’s Matrices and the Cattell Culture Fair task (Hampshire et al., 2012).
How do we measure Meaningful Change?
The Meaningful Change Indicator compares the difference in an individual’s performance on any given task between two time points to the variability in repeated measurements that would occur in the absence of meaningful change. The latter is estimated from a sample of healthy control subjects. The reliable change index uses the test-retest reliability and the standard deviation of scores (measured in a control sample) of a task to describe the range of possible differences that occur in repeat task completions. If an individual’s change in performance from one time point to another is much larger than what is expected due to chance, then one can conclude that there was meaningful change.
Assessing meaningful change requires data to be obtained in a control sample. Creyos Health has a database of over 8 million test scores, and their normative database consists of more than 75,000 individuals. The interval between self-administered repeated assessments ranges from less than a day, to more than a month. This massive database allows Creyos Health to characterize in the general population how performance on every task fluctuates naturally across a range of intervals. Creyos Health is therefore able to quantify the bounds of what constitutes a meaningful change for every task.
