Skip to main content

Advertisement

SpringerLink
Log in

Towards a Smart Population: A Public Health Framework for Cognitive Enhancement

  • Review Paper
  • Published:
Neuroethics Aims and scope Submit manuscript

Abstract

This paper presents a novel view of the concept of cognitive enhancement by taking a population health perspective. We propose four main modifiable healthy lifestyle factors for optimal cognitive functioning across the population for which there is evidence of safety and efficacy. These include i) promoting adequate sleep, ii) increasing physical activity, iii) encouraging a healthy diet, including minimising consumption of stimulants, alcohol and other drugs including nicotine, iv) and promoting good mental health. We argue that it is not ethical to promote or sanction the use of pharmaceutical drugs as putative cognitive enhancers without acknowledging the adverse effects on population cognitive health of failing to encourage the pursuit of healthy behaviours. We conclude with recommendations to increase the public health relevance of bioethical analyses of the cognitive enhancement debate.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. DeSantis, A., E.M. Webb, and S.M. Noar. 2008. Illicit use of prescription ADHD medications on a college campus: A multimethodological approach. Journal of American College Health 57(3): 315–324.

    Article  Google Scholar 

  2. Teter, C.J., S.E. McCabe, K. LaGrange, J.A. Cranford, and C.J. Boyd. 2006. Illicit use of specific prescription stimulants among college students: Prevalence, motives, and routes of administration. Pharmacotherapy 26(10): 1501–1510.

    Article  Google Scholar 

  3. Sahakian, B., and S. Morein-Zamir. 2007. Professor’s little helper. Nature 450(7173): 1157–1159.

    Article  Google Scholar 

  4. Outram, S.M., and E. Racine. 2011. Examining reports and policies on cognitive enhancement: Approaches, rationale, and recommendations. Accountability in Research 18(5): 323–341. doi:10.1080/08989621.2011.606734.

    Google Scholar 

  5. Greely, H., B. Sahakian, J. Harris, R.C. Kessler, M. Gazzaniga, P. Campbell, and M.J. Farah. 2008. Towards responsible use of cognitive-enhancing drugs by the healthy. Nature 456(7223): 702–705.

    Article  Google Scholar 

  6. Harris, John, and Anjan Chatterjee. 2009. Is it acceptable for people to take methylphenidate to enhance performance? British Medical Journal 338: 1532–1533.

    Google Scholar 

  7. Forlini, C., and E. Racine. 2009. Autonomy and coercion in academic “cognitive enhancement” using methylphenidate: perspectives of key stakeholders. Neuroethics 2(3): 163–177. doi:10.1007/s12152-009-9043-y.

    Article  Google Scholar 

  8. British Medical Association. 2007. Boosting your brainpower: Ethical aspects of cognitive enhancement. London: British Medical Association.

    Google Scholar 

  9. Commission de l’Ethique de la Science et de la Technologie. 2009. Psychiatric Drugs and Expanded Uses: An Ethical Perspective.

  10. Lucke, J.C., S. Bell, B. Partridge, and W.D. Hall. 2011. Deflating the neuroenhancement bubble. AJOB Neuroscience 2(4): 38–43.

    Article  Google Scholar 

  11. Partridge, B.J., S.K. Bell, J.C. Lucke, S. Yeates, and W.D. Hall. 2011. Smart drugs “As Common As Coffee”: Media hype about neuroenhancement. PLoS One 6(11): e28416. doi:10.1371/journal.pone.0028416.

    Article  Google Scholar 

  12. de Jongh, R., I. Bolt, M. Schermer, and B. Olivier. 2008. Botox for the brain: Enhancement of cognition, mood and pro-social behavior and blunting of unwanted memories. Neuroscience Biobehavioural Reviews 32(4): 760–776.

    Article  Google Scholar 

  13. Kumar, Raminder. 2008. Approved and investigational uses of modafinil: An evidence-based review. Drugs 68(13): 1803–1839.

    Article  Google Scholar 

  14. Minzenberg, M.J., and C.S. Carter. 2008. Modafinil: A review of neurochemical actions and effects on cognition. Neuropsychopharmacology 33(7): 1477–1502.

    Article  Google Scholar 

  15. Repantis, D., O. Laisney, and I. Heuser. 2010. Acetylcholinesterase inhibitors and memantine for neuroenhancement in healthy individuals: A systematic review. Pharmacological Research 61(6): 473–481. doi:10.1016/j.phrs.2010.02.009.

    Article  Google Scholar 

  16. Repantis, D., P. Schlattmann, O. Laisney, and I. Heuser. 2009. Antidepressants for neuroenhancement in healthy individuals: A systematic review. Poiesis und Praxis 6(3–4): 139–174. doi:10.1007/s10202-008-0060-4.

    Article  Google Scholar 

  17. Smith, M.E., and M.J. Farah. 2011. Are prescription stimulants “smart pills”? The epidemiology and cognitive neuroscience of prescription stimulant use by normal healthy individuals. Psychological Bulletin 137(5): 717–741. doi:10.1037/a0023825.

    Article  Google Scholar 

  18. Academy of Medical Sciences. 2008. Brain science, addiction and drugs. United Kingdom. ISBN No: 1-903401-18-6

  19. Lanni, C., S.C. Lenzken, A. Pascale, I. Del Vecchio, M. Racchi, F. Pistoia, and S. Govoni. 2008. Cognition enhancers between treating and doping the mind. Pharmacological Research 57(3): 196–213.

    Article  Google Scholar 

  20. Outram, S.M. 2010. The use of methylphenidate among students: The future of enhancement? Journal of Medical Ethics 36(4): 198–202.

    Article  Google Scholar 

  21. Repantis, Dimitris, Peter Schlattmann, Oona Laisney, and Isabella Heuser. 2010. Modafinil and methylphenidate for neuroenhancement in healthy individuals: A systematic review. Pharmacological Research 62(3): 187–206.

    Article  Google Scholar 

  22. Belenky, G., L.J. Wu, and M.L. Jackson. 2011. Occupational sleep medicine: Practice and promise. Progress in Brain Research 190: 189–203. doi:10.1016/B978-0-444-53817-8.00012-8.

    Article  Google Scholar 

  23. Gruber, R., S.T. Wiebe, S.A. Wells, J. Cassoff, and E. Monson. 2010. Sleep and academic success: Mechanisms, empirical evidence, and interventional strategies. Adolescent Medicine: State of the Art Reviews 21(3): 522–541.

    Google Scholar 

  24. Killgore, W.D. 2010. Effects of sleep deprivation on cognition. Progress in Brain Research 185: 105–129. doi:10.1016/B978-0-444-53702-7.00007-5.

    Article  Google Scholar 

  25. Morin, C.M., and R. Benca. 2012. Chronic insomnia. Lancet 379(9821): 1129–1141. doi:10.1016/S0140-6736(11)60750-2.

    Article  Google Scholar 

  26. Lund, H.G., B.D. Reider, A.B. Whiting, and J.R. Prichard. 2010. Sleep patterns and predictors of disturbed sleep in a large population of college students. The Journal of Adolescent Health 46(2): 124–132. doi:10.1016/j.jadohealth.2009.06.016.

    Article  Google Scholar 

  27. Skaer, T.L., and D.A. Sclar. 2010. Economic implications of sleep disorders. PharmacoEconomics 28(11): 1015–1023. doi:10.2165/11537390-000000000-00000.

    Article  Google Scholar 

  28. Marks, Bonita L., Laurence M. Katz, and J. Keith Smith. 2009. Exercise and the aging mind: Buffing the baby boomer’s body and brain. The Physician and Sportsmedicine 37(1): 119–125.

    Article  Google Scholar 

  29. Esch, Tobias, and George B. Stefano. 2010. The neurobiology of stress management. Neuro Endocrinology Letters 31(1): 19–39.

    Google Scholar 

  30. Etnier, J. 2009. Physical activity programming to promote cognitive function: Are we ready for prescription? In Enhancing cognitive functioning and brain plasticity, ed. W. Chodzko-Zajko, A.F. Kramer, and L.W. Poon, 159–175. Champaign: Human Kinetics.

    Google Scholar 

  31. Khan, K.M., A.M. Thompson, S.N. Blair, J.F. Sallis, K.E. Powell, F.C. Bull, and A.E. Bauman. 2012. Sport and exercise as contributors to the health of nations. Lancet 380(9836): 59–64. doi:10.1016/S0140-6736(12)60865-4.

    Article  Google Scholar 

  32. Sallis, R.E. 2009. Exercise is medicine and physicians need to prescribe it! British Journal of Sports Medicine 43(1): 3–4. doi:10.1136/bjsm.2008.054825.

    Article  Google Scholar 

  33. Tomporowski, P.D., K. Lambourne, and M.S. Okumura. 2011. Physical activity interventions and children’s mental function: An introduction and overview. Preventive Medicine 52(Suppl 1): S3–9. doi:10.1016/j.ypmed.2011.01.028.

    Article  Google Scholar 

  34. Macniven, R., A. Bauman, and M. Abouzeid. 2012. A review of population-based prevalence studies of physical activity in adults in the Asia-Pacific region. BMC Public Health 12: 41. doi:10.1186/1471-2458-12-41.

    Article  Google Scholar 

  35. Bauman, A., F. Bull, T. Chey, C.L. Craig, B.E. Ainsworth, J.F. Sallis, H.R. Bowles, et al. 2009. The International Prevalence Study on Physical Activity: Results from 20 countries. International Journal of Behavioral Nutrition and Physical Activity 6(1): 21. doi:10.1186/1479-5868-6-21.

    Article  Google Scholar 

  36. le Coutre, J., and J.A. Schmitt. 2008. Food ingredients and cognitive performance. Current Opinion in Clinical Nutrition and Metabolic Care 11(6): 706–710. doi:10.1097/MCO.0b013e32831394a5.

    Article  Google Scholar 

  37. Benton, D., P. Winichagoon, T.P. Ng, E.S. Tee, and M. Isabelle. 2012. Symposium on nutrition and cognition: Towards research and application for different life stages. Asia Pacific Journal of Clinical Nutrition 21(1): 104–124.

    Google Scholar 

  38. Snel, J., and M.M. Lorist. 2011. Effects of caffeine on sleep and cognition. Progress in Brain Research 190: 105–117. doi:10.1016/B978-0-444-53817-8.00006-2.

    Article  Google Scholar 

  39. Heatherley, S.V. 2011. Caffeine withdrawal, sleepiness, and driving performance: What does the research really tell us? Nutritional Neuroscience 14(3): 89–95. doi:10.1179/147683011X13019262348785.

    Article  Google Scholar 

  40. Fernandez-Serrano, M.J., M. Perez-Garcia, and A. Verdejo-Garcia. 2011. What are the specific vs. generalized effects of drugs of abuse on neuropsychological performance? Neuroscience and Biobehavioral Reviews 35(3): 377–406. doi:10.1016/j.neubiorev.2010.04.008.

    Article  Google Scholar 

  41. van Holst, R.J., and T. Schilt. 2011. Drug-related decrease in neuropsychological functions of abstinent drug users. Current Drug Abuse Reviews 4(1): 42–56.

    Article  Google Scholar 

  42. Luksys, G., and C. Sandi. 2011. Neural mechanisms and computations underlying stress effects on learning and memory. Current Opinion in Neurobiology 21(3): 502–508. doi:10.1016/j.conb.2011.03.003.

    Article  Google Scholar 

  43. Millan, M.J., Y. Agid, M. Brune, E.T. Bullmore, C.S. Carter, N.S. Clayton, R. Connor, et al. 2012. Cognitive dysfunction in psychiatric disorders: Characteristics, causes and the quest for improved therapy. Nature Reviews. Drug Discovery 11(2): 141–168. doi:10.1038/nrd3628.

    Article  Google Scholar 

  44. Wallace, T.L., T.M. Ballard, B. Pouzet, W.J. Riedel, and J.G. Wettstein. 2011. Drug targets for cognitive enhancement in neuropsychiatric disorders. Pharmacology Biochemistry and Behavior 99(2): 130–145. doi:10.1016/j.pbb.2011.03.022.

    Article  Google Scholar 

  45. Walsh, R. 2011. Lifestyle and mental health. American Psychologist 66(7): 579–592. doi:10.1037/a0021769.

    Article  Google Scholar 

  46. Carek, P.J., S.E. Laibstain, and S.M. Carek. 2011. Exercise for the treatment of depression and anxiety. International Journal of Psychiatry in Medicine 41(1): 15–28.

    Article  Google Scholar 

  47. Pack, A.I., and G.W. Pien. 2011. Update on sleep and its disorders. Annual Review of Medicine 62: 447–460. doi:10.1146/annurev-med-050409-104056.

    Article  Google Scholar 

  48. Bostrom, N., and A. Sandberg. 2009. Cognitive enhancement: Methods, ethics, regulatory challenges. Science and Engineering Ethics 15(3): 311–341. doi:10.1007/s11948-009-9142-5.

    Article  Google Scholar 

  49. Avitzur, O. 2010. Will a pill boost your brain power? Consumer Reports 75(3): 12.

    Google Scholar 

  50. Farah, M.J., J. Illes, R. Cook-Deegan, H. Gardner, E. Kandel, P. King, E. Parens, B. Sahakian, and P.R. Wolpe. 2004. Neurocognitive enhancement: What can we do and what should we do? Nature Reviews Neuroscience 5(5): 421–425.

    Article  Google Scholar 

  51. Sahakian, B.J., and S. Morein-Zamir. 2010. Neuroethical issues in cognitive enhancement. Journal of Psychopharmacology. doi:10.1177/0269881109106926.

Download references

Acknowledgments

This research was funded by the Australian National Health and Medical Research Council. The authors would like to thank Professor Wayne Hall for comments on an earlier draft of this paper.

Author information

Authors and Affiliations

  1. The University of Queensland, UQ Centre for Clinical Research, Herston, QLD, 4029, Australia

    Jayne Lucke & Brad Partridge

Authors
  1. Jayne Lucke
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Brad Partridge
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Jayne Lucke.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Lucke, J., Partridge, B. Towards a Smart Population: A Public Health Framework for Cognitive Enhancement. Neuroethics 6, 419–427 (2013). https://doi.org/10.1007/s12152-012-9167-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12152-012-9167-3

Keywords

Search

Navigation