By Amy Norton
Health Day Reporter
WEDNESDAY, November 2, 2022 (HealthDay News) — Older adults looking to slow memory loss may find help in a classic brain teaser: the crossword.
That’s the suggestion of a small study that tracked older adults with mild cognitive impairment – problems with memory and thinking that can progress to dementia over time. The researchers found that those who were randomly assigned to do crossword puzzles for 18 months showed a small improvement on tests of memory and other mental abilities.
This was in contrast to study participants assigned to a more modern brain exercise: computer games designed to activate different mental abilities. On average, their test scores dropped slightly over time.
Experts warned that the study was small and had other limitations. For one thing, there was no “control group” of participants who didn’t do brain exercises. So it’s not clear if doing crosswords or playing games is significantly better than doing nothing.
“This is not definitive,” said lead researcher Dr. Davangere Devanand, Professor of Psychiatry and Neurology at Columbia University in New York City.
He said larger studies, including a control group, are still needed.
According to Devanand, the current results are unexpected. Early in the process, the researchers hypothesized that computer games would be superior. Previous studies have shown that such games can help older adults without cognitive impairments sharpen their mental acuity.
It’s not clear why crosswords were the winner in this process. But, according to Devanand, there is evidence that the puzzles are more effective specifically for people in the “late” stage of mild cognitive impairment – which may indicate that crossword puzzles are easier for them to handle.
The results were recently published online in the journal NEJM proof.
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, an estimated 10 to 20% of adults age 65 and older with such disabilities will develop dementia within a year.
Researchers want to find ways to delay or prevent this progression to dementia, and mentally stimulating activities are one avenue being explored.
Some research has found that brain games can help people with mild cognitive impairment improve their memory and thinking skills — although studies have found many differences 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 older adults with mild cognitive impairment and randomly assigned them to one of the two types of brain exercises. All participants received instruction on how to log in and use the games or puzzles.
Although the crosswords were online, Devanand noted, they were otherwise the same as old-fashioned paper-and-pencil puzzles. They were moderate — at level a New York Times Puzzles on a Thursday.
After 18 months, investigators found, the crossword group had improved on average by about 1 point on a standard scale used to assess cognitive decline — primarily on memory and language skills.
In contrast, people in the games group dropped by half a point on average.
However, the people were different. About a quarter of the game group improved their score by at least 2 points.
And when the researchers looked closer, the difference between the two brain exercises was particularly noticeable in people in the later stages of mild cognitive impairment.
It’s possible, Devanand said, that crosswords might be easier for older people with more severe disabilities.
An expert not involved in the study said “limited conclusions” can be drawn from the results – in part because there was no control group.
“However, the results open the door for follow-up experiments to directly examine the possibility of the utility of computer-assisted crosswords,” said Claire Sexton, senior director of scientific programs and outreach for the Alzheimer’s Association.
However, she stressed that it is unlikely that a single measure – crossword puzzles 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 study called US Pointer testing this possibility. It’s investigating whether a combination of tactics — including physical activity, brain exercises and better control of high blood pressure and diabetes — may benefit older people at increased risk of cognitive decline.
Right now, there is at least a small risk of picking up a crossword puzzle habit.
“We have a saying about the brain in this area,” Devanand said. “Use it or lose it.”
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 City; Claire Sexton, DPhil, Executive Director, Scientific Programs and Outreach, Alzheimer’s Association, Chicago; NEJM proof, October 27, 2022, online