By Amy Norton
Health Day Reporter
WEDNESDAY, Nov. 2, 2022 (HealthDay News) — Older adults looking to reduce memory loss may find some help in a classic brain teaser: the crossword puzzle.
That’s the suggestion of a small study that followed older adults with mild cognitive impairment — problems with memory and thinking that can progress to dementia over time. Researchers found that people who were randomly assigned to do crossword puzzles for 18 months showed little improvement on tests of memory and other mental abilities.
This was in contrast to a study of participants who were assigned to a more advanced brain exercise: computer games designed to engage different 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 do the brain exercises. So it’s not clear whether doing a crossword puzzle or playing a game is significantly better than doing nothing.
“It’s not conclusive,” said Dr. Davangere Dewanand, a professor of psychiatry and neurology at Columbia University in New York City.
He said that larger studies including control groups are needed.
As it is, according to Devanand, the present results were unexpected. Going into the trial, the researchers doubted that computer games would rule the roost. Past studies have found that such games can help older adults with no cognitive impairments to sharpen their mental acuity.
It is not clear why crosswords were the winners in this trial. But, Devananda said, there was evidence that puzzles were particularly effective for people in the “late” stages of mild cognitive impairment — which might suggest that crosswords were easier for them to manage. .
The findings were recently published online in the journal NEJM Records.
Mild cognitive impairment is common with age, and does not always progress to dementia. But in many cases it does. According to the US National Institute on Aging, it is estimated that 10% to 20% of adults aged 65 and older with such disorders develop dementia within a year.
Researchers want to find ways to delay or prevent this progression of dementia, and mentally stimulating activities are one avenue being studied.
Some research has found that brain games can help people with mild cognitive impairment improve their memory and thinking skills – although the types of improvements found vary greatly across studies.
And one question, according to Devananda, is whether certain types of mental exercises are better than others.
So his team set out to compare the effects of web-based computer games and web-based crossword puzzles.
Researchers recruited 107 older adults with mild cognitive impairment and randomly assigned them to either type of brain exercise. All participants received tutorials on how to log in and use the games or puzzles.
Although the crossword puzzles were online, Devananda noted, they were otherwise the same as the old-fashioned paper-and-pencil. They were moderately difficult — at the level of a The New York Times Thursday puzzle.
After 18 months, the investigators found, on average, the crossword group had improved by about 1 point on a standard scale assessing cognitive decline — which focused primarily on memory and language skills.
In contrast, people in the games group lost an average of half a point.
However, individuals were different. About a quarter of the games group, for example, improved their scores by at least 2 points.
And when the researchers looked closely, the difference between the two brain exercises was especially noticeable in people in the later stages of mild cognitive impairment.
It’s possible, Devananda said, that crossword puzzles were easier for older people with more significant impairments.
An expert involved in the study said “limited conclusions” could be drawn from the findings – in part because there was no control group.
“However, the results open the door to follow-up trials to directly test the potential benefit of computerized crossword puzzles,” said Claire Sexton, senior director of scientific programs and outreach at the Alzheimer’s Association.
He stressed, however, that it is unlikely that any single measure – crosswords or otherwise – will make a big difference in the progression of a complex disease like dementia.
Instead, Sexton said, the greatest potential may lie in “multidomain interventions that target many risk factors simultaneously.”
Sexton noted that the Alzheimer’s Association is funding a trial called US Pointer, which is testing this possibility. It is looking at whether a combination of strategies – including physical activity, mental exercises and better control of high blood pressure and diabetes – can benefit older people at increased risk of cognitive decline.
For now, there is minimal risk in taking up the crossword puzzle habit.
“We have a saying in this field about the mind,” Devananda said. “Use it or lose it.”
The Alzheimer’s Association has advice on protecting mental health.
Sources: Davangere P. Devanand, MD, Professor, Psychiatry and Neurology, Columbia University Medical Center, New York City; Claire Sexton, D.Phil., senior director, scientific programs and outreach, Alzheimer’s Association, Chicago; NEJM Records, 27 October 2022, online