Crossword puzzles can be used by people with mild cognitive impairment

Crossword puzzles can be used by people with mild cognitive impairment


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For years, scientists have been trying to find out whether “brain exercises” like puzzles and online cognitive games can strengthen our minds and slow down the aging process.

Now, a a study published in the New England Journal of Medicine found that regularly trying crossword puzzles can help slow the decline in some people with mild cognitive impairment, an early stage of poor memory that can sometimes progress to dementia.

While the study didn’t investigate whether crossword puzzles benefit younger adults who aren’t facing cognitive decline, it suggests that keeping your mind active as you age can benefit your brain. The research gives hope to those diagnosed with mild cognitive impairment that they can prevent further declines in memory, language and decision-making that are hallmarks of the condition.

The American Academy of Neurology estimates that mild cognitive impairment affects about 8 percent of people aged 65 to 69; 10 percent of people aged 70 to 74; 15 percent of people aged 75 to 79; 25 percent of those aged 80 to 84; and about 37 percent of people 85 and older.

The research, funded by the National Institute on Aging, involved 107 adults aged 55 to 95 with mild cognitive impairment. Over 12 weeks, everyone was asked to play one of two types of games, four times a week – spending 30 minutes on Lumosity, a popular platform for cognitive training, or a 30-minute attempt at a digital crossword puzzle. After 12 weeks, participants were reassessed and given “booster” doses of game play six more times during the 78-week experiment.

By the end of the study, participants were given standard assessments used to measure cognitive decline, and friends and family reported on their daily functioning. MRI scans were also used to measure brain volume changes.

The researchers discovered this in key measurements — scores on cognitive decline, functional skills and brain volume changes — regular crossword puzzle players fared better than game players.

The discovery surprised the scientists behind the study who expected that challenging web-based brain games specifically designed to boost cognitive function would offer the most benefits.

“Our study shows quite convincingly that in people with mild cognitive impairment, crossword puzzles beat computer games on multiple metrics,” said Murali Doraiswamy, a professor at Duke University and co-author of the study. “So if you have mild cognitive impairment, which is different from normal aging, then the recommendation would be to keep your brain active by solving crossword puzzles.”

People with higher degrees of cognitive impairment appeared to benefit the most from solving the crossword puzzle, which was designed as a moderately difficult puzzle comparable to the New York Times Thursday game.

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The study has limitations. Some of the participants may have just been more familiar with crossword puzzles and therefore responded better to the puzzles than to Lumosity’s computer games. More years of follow-up are also needed to determine whether interventions like crossword puzzles “can truly prevent dementia,” Doraiswamy said.

“We’ve known for almost 30, 40 years that keeping mentally active is really important,” Doraiswamy said. “But we haven’t really translated that into a medical-level intervention.”

DP Devanand, a professor at Columbia University and lead researcher on the study, said the finding needs to be replicated in a larger study with more participants and a control group that does not play any game.

“We can’t say beyond a certain point why people do better at crosswords, but it suggests that doing crosswords helps you,” Devanand said.

Doraiswamy said he hopes future studies can build on the findings to investigate the optimal level of difficulty and time spent solving puzzles for people with mild cognitive impairment.

Some researchers remained skeptical. Zach Hambrickprofessor of cognition and neuroscience at Michigan State University, said the study did not investigate why a crossword puzzle might offer more benefits than a computer game.

In 1999, Hambrick was a co-author study who found no evidence to suggest that people who do crossword puzzles more than twice a week have less cognitive decline.

Hambrick said completing the crossword puzzle, which requires the ability to memorize words and esoteric knowledge gathered through experience, tests a person’s “crystallized cognitive abilities.” He said people with mild cognitive impairment have the most trouble with “fluid cognitive abilities” such as remembering a list of words or solving a logic problem. Crossword puzzles don’t challenge the type of ability associated with mild cognitive impairment, Hambrick said.

Lumos Labs, the company behind the computer games in the experiment, provided access to both the crossword puzzles and their game suite, but was not involved in the design or publication of the study. Doraiswamy is a consultant to Lumos Labs.

Laurie Ryanchief of clinical interventions at the National Institute on Aging, said the agency funded the research because it is important to find treatments that reduce the risk of Alzheimer’s disease and other types of dementia.

“We’re probably going to need multiple interventions for different people,” Ryan said. “We’re trying to fund as many things as we can.”

Most researchers agree that keeping both your body and mind active as you age likely benefits your brain. Ronald C. Petersendirector of the Mayo Clinic Alzheimer’s Disease Research Center, said that in addition to regular exercise, he recommends that patients spend time on intellectually challenging tasks such as watching a documentary or attending a lecture.

Look for activities that “take you out of your comfort zone,” it said Sylvia Belleville, professor of neuropsychology at the University of Montreal. Try different “stimulating” tasks or increase the difficulty of a particular task over time. “If you’re very good at solving crossword puzzles and you just keep doing that, you’re still in your comfort zone and you’re not picking up new strategies, new brain networks,” Belleville said.

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