What’s better for your brain, crosswords or computer games?

By Amy Norton

health day reporter

WEDNESDAY, Nov. 2, 2022 (HealthDay News) — Seniors looking to slow memory loss may find help in a classic puzzle: the crossword puzzle.

That’s the suggestion of a small study that followed older people with mild cognitive impairment – problems with memory and thinking that can progress to dementia over time. Researchers found that people randomly assigned to do crossword puzzles for 18 months showed small improvements in memory tests and other mental skills.

This contrasts with study participants who were assigned a more modern brain exercise: computer games designed to engage various mental abilities. On average, their test scores declined slightly over time.

Experts cautioned that the study was small and had other limitations. For one thing, it lacked a “control group” of participants who didn’t perform brain exercises. So it’s not clear whether doing crosswords or playing games is significantly better than doing nothing.

“It’s not definitive,” said lead researcher Dr. Davangere Devanand, a professor of psychiatry and neurology at Columbia University in New York.

He said larger studies, including a control group, are still needed.

As things stand, the current results were unexpected, according to Devanand. Going into the lawsuit, the researchers suspected that computer games would reign supreme. Previous studies have shown that such games can help older people without cognitive impairment sharpen their mental acuity.

It is unclear why the crossword won this lawsuit. But, Devanand said, there was evidence that the puzzles were specifically more effective for people in the “late” stage of mild cognitive impairment – which may suggest that the crosswords were more manageable for them.

The results were published online recently in the journal NEJM testimonial.

Mild cognitive impairment is common with age and does not always progress to dementia. But in many cases, it is. It’s estimated that among adults 65 and older who have such impairments, 10 to 20 percent develop dementia over a one-year period, according to the US National Institute on Aging.

Researchers want to find ways to delay or prevent this progression to dementia, and mental stimulation activities are one avenue being explored.

Some research has shown that brain games can help people with mild cognitive impairment improve their memory and thinking skills – although studies have found many variations in the types of improvements seen.

And one question, according to Devanand, is whether certain types of brain exercises are better than others.

So his team set out to compare the effects of web-based computer games and web-based crossword puzzles.

The researchers recruited 107 elderly people with mild cognitive impairment and randomly assigned them to one or another type of brain exercise. All participants received lessons on how to connect and use the games or puzzles.

Even though the crosswords were online, Devanand noted, they were otherwise the same as the old-fashioned paper-and-pencil ones. They were moderately difficult – at the level of a New York Times puzzle on a Thursday.

After 18 months, investigators found that the crossword puzzle group had improved by about 1 point, on average, on a standard scale assessing cognitive decline – focusing primarily on memory and language skills.

In contrast, those in the games group fell by half a point on average.

Individuals varied however. About a quarter of the gaming group, for example, improved their scores by at least 2 points.

And when the researchers took a closer look, the difference between the two brain exercises was specifically seen in people in the later stages of mild cognitive impairment.

It’s possible, Devanand said, that for older adults with more significant disabilities, the crossword may be easier to manage.

An expert not involved in the study said “limited conclusions” can be drawn from the results – partly because there was no control group.

“However, the results open the door to follow-up trials to directly examine the potential benefit of computerized crossword puzzles,” said Claire Sexton, senior director of science and outreach programs for the Alzheimer’s Association.

She pointed out, however, that a single measure — crossword or otherwise — is unlikely to make a big difference in progression to a complex disease like dementia.

Instead, Sexton said, the greatest potential may be in “multidomain interventions that target many risk factors simultaneously.”

Sexton noted that the Alzheimer’s Association is funding a trial, called US Pointer, that is testing this possibility. The aim is to determine whether a combination of tactics – including physical activity, brain exercises and better control of high blood pressure and diabetes – can benefit older people at increased risk of cognitive decline.

For now, there is at least little risk in getting into the habit of crossword puzzles.

“We have a saying in this area about the brain,” Devanand said. “Use it or lose it.”

More information

The Alzheimer’s Association has advice on protecting brain health.

SOURCES: Davangere P. Devanand, MD, professor of psychiatry and neurology, Columbia University Medical Center, New York; Claire Sexton, DPhil, senior director, science programs and outreach, Alzheimer’s Association, Chicago; NEJM testimonial, October 27, 2022, online

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