The brain health product

Yesterday’s Doonesbury has Mike (Doonesbury) and (his wife) Kim (Rosenthal) listening to a mock Prevagen® commercial in which the dietary supplement is openly hawked as a useless (but expensive) placebo for treating mild forgetfulness (with a digression in the 5th panel on a secret ingredient in it derived from the fabulously memorious jellyfish):

(#1)

The testimonials in Prevagen ads pretty much scream placebo effect. You take Prevagen in the belief that it will improve your memory — the ads say that it does —  and then in a while you perceive that your memory has indeed sharpened.

Then I’d been noticing recently how the people offering testimonials in Prevagen ads don’t actually claim that their memory has improved or that the product has reversed their memory loss, which is what they’d  say if the placebo effect was all that was going on. Instead, they merely testify, more indirectly, that they feel that things have improved, that it seems to them that their memories have sharpened. This is an extremely careful choice of wording.

Prevagen’s advertising is heavily focused on testimonials from real people who have used the product. Interviews present them in their home environments and develop brief sketches of their lives, turning quickly to health concerns, among them worries about failing memory.

Two recent interviews of couples. The first shows the placebo effect, the second the careful choice of indirect wording.

First, retired teachers and official North Pole residents Steve and Lea (video from iSpot.tv). In the video, they

explain their health issues that begun to worsen with age, specifically how troubling Steve’s problems with memory were. After taking Prevagen, Steve simply didn’t have to work so hard to remember things.

(Side note: people’s perceptions of decline in memory are not necessarily accurate; if you expect that memory declines greatly with age, Confirmation Bias leads you to see evidence of that. Some notes below on the ordinary, fairly modest, declines in certain kinds of memory with aging.)

The (from the Prevagen site), Norm and Szasz from Columbia MO:


(#2) “after about 30 days of taking [Prevagen], we noticed a clarity we didn’t notice before” — rather than something more direct, like “our memories were clearer than they were before”

(Meanwhile, the image says, baldly and directly, “Prevagen improves memory”. And note that the couple have been enrolled as “Prevagen Content Contributors” — which presumably gives the company the right to craft details of the wording the couple use in their interview.)

Significantly, the jellyfish do not appear in these two recent commercials. Apparently, there’s some history here. In fact, the commercials used to be bolder.

Some history. From the Harvard Health site, “FBA curbs unfounded memory supplement claims” by Robert H. Shmerling, MD, on 5/31/19, updated 9/29/20:

I must have seen the commercial for Prevagen 50 times. Perhaps you’ve seen it, too: “You might take something for your heart… your joints… your digestion. So why wouldn’t you take something for the most important part of you… your brain? With an ingredient originally found in jellyfish! Healthier brain, better life!”

Like many heavily-advertised supplements, this one makes many claims. The bottle promises it “improves memory” and “supports: healthy brain function, sharper mind, clearer thinking.” Never mind that the main ingredient in jellyfish (apoaequorin) has no known role in human memory, or that many experts believe supplements like this would most likely be digested in the stomach and never wind up anywhere near the brain. Oh, and the commercial doesn’t mention any risks of treatment or cost (though I found it online for $1 to $2/day).

But does this supplement actually do what it says? If it doesn’t, how can the manufacturer make these claims? And if apoaequorin is so great, why aren’t jellyfish smarter, as a colleague of mine wonders?

… As “proof” of power, a bar graph shows a rise from 5% to 10% to 20% over 90 days in “recall tasks.” But there’s no way to know what these numbers refer to, how many people were studied, or other important details. And no information is provided about effects on memory after 90 days. The fine print under the graph says that the supplement “improved recall tasks in subjects” without explaining what this means. While a company-sponsored study reported improvements in memory after people took apoaequorin, the published version demonstrated minimal improvement (summarized here).

The US Federal Trade Commission wasn’t convinced of the supplement’s benefits. It charged the supplement maker with false advertising back in 2012. In the legal filings, the company was accused of selectively reporting data and misleading the public by claiming that Prevagen is “clinically proven” to improve cognitive function. The lawsuit has not yet been decided.

But it appears that the company has trimmed its sails considerably, and moderated its claims. The jellyfish seem to be gone, and the dubious clinical studies too. And the wording of the testimonials has gotten a lot more cautious.

Background notes on memory. From the American Psychological Association site on “Memory and Aging”, the section on “What Brain Changes Are Normal for Older Adults?”:

Although new neurons develop throughout our lives, our brains reach their maximum size during our early twenties and then begin very slowly to decline in volume. Blood flow to the brain also decreases over time. The good news is that many studies have shown that the brain remains capable of regrowth and of learning and retaining new facts and skills throughout life, especially for people who get regular exercise and frequent intellectual stimulation. Although there are tremendous differences among individuals, some cognitive abilities continue to improve well into older age, some are constant, and some decline.

Some Types of Memory Improve or Stay the Same

A type of memory called semantic memory continues to improve for many older adults. Semantic memory is the ability to recall concepts and general facts that are not related to specific experiences. For example, understanding the concept that clocks are used to tell time is a simple example of semantic memory. This type of memory also includes vocabulary and knowledge of language. In addition, procedural memory, your memory of how to do things, such as how to tell time by reading the numbers on a clock, typically stays the same.

Some Types of Memory Decline Somewhat

Do you sometimes arrive at the grocery store and have trouble remembering what you are there to get? Do you occasionally have trouble remembering where you left your car in the parking lot? Or do you have difficulty remembering appointments such as what time you’re supposed to meet your neighbor for coffee? Episodic memory, which captures the “what,” “where,” and “when” of our daily lives, is to blame. Both episodic and longer term memory decline somewhat over time.

Other types of brain functions that decrease slightly or slow down include:

– information processing and learning something new

– doing more than one task at a time and shifting focus between tasks

[Then a section on “Possible Causes of Memory Problems”, beginning:] If you or a loved one is having memory problems that are more bothersome than you would normally expect, don’t assume that Alzheimer’s or another form of dementia is the culprit. Glitches in memory can be caused by many physical and psychological conditions that are reversible…

The section goes on the inventory these briefly.

There’s also a section on “Tips for Maintaining and Improving Your Memory”, including a subsection on “Don’t buy into ageist stereotypes about memory decline”.

 

2 Responses to “The brain health product”

  1. Stewart Kramer Says:

    Prevagen capsules contain lactose as an ingredient.  That’s a great example of white privilege, where 90 percent of adults of northern European ancestry can digest lactose, but less than half of the rest of the world can.

  2. julianne taaffe Says:

    If Prevagen were to use a secret extract from Octopuses, now, they might have something. By any measure, and I’m sure there aren’t any, your average Octopus has it all over the jellyfish in the cognitive gifts department!
    (I’m not sure why I capitalize Octopus. Just out of respect for a clever species, I guess.)

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