by Amy Norton
WEDNESDAY, November 2, 2022 (HealthDay News) — Seniors looking to slow memory loss may find some help with a classic brain teaser: a crossword puzzle.
This is the suggestion of a small study that followed older adults with mild cognitive impairment — problems with memory and thinking that may progress to dementia over time. The researchers found that those who were randomly assigned to solve crossword puzzles for 18 months showed little improvement in tests of memory and other mental skills.
This was in contrast to study participants who were assigned a more modern brain exercise: computer games designed to engage different mental abilities. On average, their test scores decreased 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 did not perform the brain exercises. So it’s not clear if doing a crossword puzzle or playing games is much better than doing nothing.
“It’s not definitive,” said lead researcher Dr. Davanger Devanand, MD, professor of psychiatry and neuroscience at Columbia University in New York City.
He said that larger studies, including a control group, are still needed.
As it stands, the current results were unexpected, according to Devanand. When starting the experiment, the researchers suspected that computer games would prevail. Previous studies have found that such games can help older adults without cognitive disabilities sharpen their mental acuity.
It is not clear why crossword puzzles win this trial. But Devanand said there was evidence that the puzzles were particularly more effective for people in the “late” stage of mild cognitive impairment — which may indicate that crossword puzzles were easier for them.
The results were recently published online in the journal NEJM Handbook.
Mild cognitive impairment is common with age, and it does not always progress to dementia. But in many cases it does. It is estimated that among adults age 65 and older with such disabilities, 10% to 20% develop dementia over the course of one year, according to the US National Institute on Aging.
Researchers want to find ways to delay or prevent this progression to dementia, and mental stimulating activities are one avenue being studied.
Some research has found that brain games may help people with mild cognitive impairment enhance their memory and thinking skills – although studies have found a lot of variation in the types of improvements observed.
And one question, according to Devanand, is whether certain types of brain exercise 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 older adults with mild cognitive impairment, and randomly assigned them to any type of brain exercise. All participants received lessons on how to log in and use games or puzzles.
Although crossword puzzles existed on the Internet, Devanand pointed out, they were unlike those of old paper-and-pencil puzzles. It was rather difficult – on a level The New York Times Thursday puzzle.
After 18 months, the investigators found that the crossword puzzle had improved by about one point, on average, on a standard scale for assessing cognitive decline — focused primarily on memory and language skills.
In contrast, people in the gaming group dropped by half a point on average.
Individuals vary, though. About a quarter of the gaming group, for example, improved their scores by at least two points.
And when the researchers looked closely, the difference between brain exercise was specifically noted among people in the later stages of MCI.
It’s possible that crossword puzzles may be easier to handle for older adults with significant disabilities, Devanand said.
An expert not involved in the study said “limited conclusions” can be drawn from the findings – in part because there was no control group.
“However, the findings open the door for follow-up trials to directly examine the potential for computerized crossword puzzles,” said Claire Sexton, director of science programs and outreach for the Alzheimer’s Association.
She stressed, however, that no single action – crossword puzzle or otherwise – is likely to make much difference in progression toward a complex disease such as dementia.
Instead, Sexton said, the greatest potential may be in “multi-domain interventions that simultaneously target multiple risk factors.”
Sexton noted that the Alzheimer’s Association is funding an experiment called US Pointer, which is testing this possibility. It’s looking at whether a range of tactics — including physical activity, brain exercise, and better control of high blood pressure and diabetes — can benefit older adults at increased risk of cognitive decline.
For now, there is at least little risk of acquiring a crossword puzzle habit.
“We have a saying in this area about the brain,” Devanand said. “You either use it or you lose it.”
The Alzheimer’s Association offers tips on protecting brain health.
SOURCES: Davangere P. Devanand, MD, Professor of Psychiatry and Neuroscience, Columbia University Medical Center, New York City; Claire Sexton, Senior Director, Scientific and Outreach Programs, Alzheimer’s Association, Chicago; NEJM guide, October 27, 2022, online