Crossword puzzles beat video games in slowing memory loss

It is known that exercising the brain can help slow memory loss, but what is the best tool to do so? A new study by researchers from Columbia University in New York and Duke University in North Carolina have found that doing crossword puzzles has an advantage over computer video games for memory functioning in older adults with mild cognitive impairment (MCI).

Psychiatry and neurology Prof. Davangere Devanand at Columbia and psychiatry and internal medicine Prof. Murali Doraiswamy of Duke have just published their findings in the journal NEJM Evidence under the title “Computerized Games versus Crosswords Training in Mild Cognitive Impairment.”

In the randomized, controlled trial, the researchers determined that participants with an average age of 71 trained in doing web-based crossword puzzles showed greater cognitive improvement than those who were trained on cognitive video games.

“This is the first study to document both short-term and longer-term benefits for home-based crossword puzzles training compared to another intervention,” said Devanand, who oversees brain aging and mental health research at Columbia. “The results are important in light of difficulty in showing improvement with interventions in mild cognitive impairment.”

Crossword puzzles are widely used, but until now, they have not been studied systematically in mild cognitive impairment, which is associated with high risk for dementia including Alzheimer’s disease. They randomly assigned 107 participants with MCI at the two different sites to either crossword puzzles training or cognitive games training with intensive training for 12 weeks followed by booster sessions for up to a year and a half.

Both interventions were delivered via a computerized platform with weekly compliance monitoring.

The most striking findings of the trial were that crossword puzzles were superior to cognitive games on a major cognitive-outcome measure at both 12 weeks and 78 weeks. Crossword puzzles were superior on a Functional Activities Questionnaire, a measure of daily functioning, at 78 weeks.

While crossword puzzles were superior for participants at a later disease stage, both forms of training were equally effective in an earlier stage.

Decreased brain shrinkage reported

Brain shrinkage (measured with MRI) was less for crossword puzzles at 78 weeks. “The benefits were seen not only in cognition but also in daily activities with indications of brain shrinkage on MRI that suggests that the effects are clinically meaningful,” Devanand said.

The study also highlights the importance of engagement. Based on remote electronic monitoring of computer use, participants at a later stage of impairment may have better engaged with the more familiar crossword puzzles than with computerized cognitive games.

While these results are highly encouraging, the authors stress the need for replication in a larger controlled trial with an inactive control group.

“The [threesome] of improving cognition, function and neuroprotection is the Holy Grail for the field,” concluded Doraiswamy. “Further research to scale brain training as a home-based digital therapeutic for delaying Alzheimer’s should be a priority for the field.”