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Experts say crossword puzzles tend to require more cognitive effort than other games. Bianca Loðbrók/Stocksy
  • For people with mild cognitive impairment, stimulating mental tasks can slow the symptoms of cognitive decline.
  • In a new study, crossword puzzles were more effective than other “brain games” after a year and a half.
  • Experts say the familiarity with crosswords as well as their more challenging cognitive demands may be factors.

About 1 in 9 adults in the United States reports experiencing worsening symptoms of confusion or memory loss associated with cognitive decline.

This is especially true of older adults. Some 5.6 million Americans aged 65 and over have some form of dementia, which includes Alzheimer’s disease.

Dementia often affects not only the individuals experiencing its symptoms but also the people closest to them, causing a significant societal impact.

Anything that can be done to slow the progression of cognitive impairment is welcome news.

A “brain game” industry has developed over the past two decades, with web-based and app-based programs providing a variety of cognitively stimulating puzzles.

But how do these types of games stack up against a classic: the crossword puzzle?

To find out, researchers from Columbia University in New York and Duke University in North Carolina collaborated on a study, published recently in the journal NEJM Evidence.

What they found surprised them.

In this study, researchers recruited 107 participants (45 male, 62 female) between the ages of 55 and 95 years (average age of 71) with mild cognitive impairment (MCI).

MCI increases the risk of dementia.

Of note, all participants were required to be English speakers due to the nature of crossword puzzles and other word games.

Participants were then split randomly into two groups: those who would play crosswords (56) and those who would play other cognitive games (51).

Both groups completed their tasks electronically after receiving 12 weeks of training, with additional training sessions up to a year and a half later.

Participants were assessed for cognitive impairment and functional ability. They also underwent functional MRI scans to measure their hippocampal volume. This part of the brain is involved in long-term memory storage.

At the end of the study’s 78 weeks, the researchers reported that the participants who played crossword puzzles didn’t experience as much decline in cognitive or functional ability as those who played other games.

Additionally, the MRI scans revealed less brain shrinkage for the group that played crossword puzzles.

Does this mean crossword puzzles are definitely better than other games at preventing cognitive decline?

Stella Panos, PhD, a neuropsychologist and director of neuropsychology for the Pacific Neuroscience Institute at Providence Saint John’s Health Center in California, told Healthline, “While this was a surprising finding when I read it (and to the authors themselves as they noted), there may be other reasons for this.”

She noted, for example, that crossword puzzles have been around for longer than most other specifically-designed cognitive games, so it’s possible that participants were simply more familiar with crossword puzzles to begin with.

“Computer games may also have stimulated a broader range of cognitive functions which may possibly not have been captured as well with their primary outcome measures,” said Panos.

Dr. Emer MacSweeney, the chief executive officer and consultant neuroradiologist at Re:Cognition Health, told Healthline, “The more the brain is exercised the better it will be able to function. And the better the quality of the brain exercise the more effective the result is likely to be.”

“It is the process of learning new information that is most important for the brain. Overall, I suspect the people doing crosswords were continually learning new information, compared to those doing the games, practicing the same or similar processes repetitively,” MacSweeney added.

Crossword puzzles may have been more engaging, encouraging participants to look up new words and definitions.

Other games may not have inspired learning and brain growth in the same way.

Does this mean cognitive games don’t have any value, or that you shouldn’t bother playing games such as the Jumble?

Not necessarily.

“I’m not certain Wordle and Sudoku will be as effective as crosswords as they do not require looking up and learning new information. But certainly [they’re] very likely to be better than not doing them at all,” said MacSweeney.

“In general, if cognitive tasks are stimulating, they may have a positive effect, though different games likely have different cognitive burden and may impact the brain differently. [For example,] Wordle is also about strategy and cognitive burden is lessened once there’s a strategy,” said Panos.

It’s also possible that people who become familiar with cognitive games may experience different results. Larger studies will be needed before we know for sure.

Panos suggests seeking medical care if you — or a loved one — notices an increase in symptoms of cognitive impairment.

These can include:

  • repetitively asking the same question
  • forgetting words, phrases, or ideas when speaking
  • using the wrong words during conversation (like saying “couch” instead of “chair”)
  • taking longer to complete common tasks
  • misplacing things around the house
  • getting lost while walking or driving in relatively familiar areas
  • having sudden or unexplained changes in mood, personality, or behavior