Working crossword puzzles may improve memory, helping people who have mild cognitive impairment.
That’s according to a study just published in NEJM Evidence that compared crossword puzzles with computer video games that target cognition.
Mild cognitive impairment can be a precursor to dementia. In the study, people who have mild cognitive impairment were randomly assigned to 12 weeks of “intensive, home-based computerized training with Web-based cognitive games or Web-based crossword puzzles, followed by six booster sessions,” the study said.
Per Prevention, “Scientists noted that both crossword puzzles and brain games positively impacted the early stages of cognitive decline.”
The Centers for Disease Control and Prevention says 1 in 9 adults in the U.S. have worsening self-reported symptoms of confusion or memory loss associated with cognitive decline. Among those 65 and older, the share climbs to 11.7%. Self-reported cognitive decline is more common among men than women, 11.3% vs. 10.6%. It is somewhat more common for Black people, then Hispanics, then whites, Asians and Pacific Islanders.
The Washington Post noted numbers from The American Academy of Neurology showing that “mild cognitive impairment affects about 8 percent of people ages 65 to 69; 10 percent of people ages 70 to 74; 15 percent of people ages 75 to 79; 25 percent of those ages 80 to 84; and about 37 percent of people 85 and older.”
The study design
The researchers, running the trial of puzzle vs. game at Columbia University/New York State Psychiatric Institute and Duke University Medical Center, found that among 51 patients assigned to the games and 56 assigned to the crossword puzzles, scores worsened slightly for games and improved for crosswords by Week 78. The noted improvements were also slight.
The study reported that 6 of the 56 individuals assigned to the crosswords group and 8 of 51 in the games group progressed to dementia during the study. But 17 in the crossword group and 12 in the games group reverted from mild cognitive impairment to normal cognition, it said.
They measured cognitive changes using the Alzheimer’s Disease Assessment Scale-Cognitive score, which is a 70-point scale. Higher scores mean increased impairment. they also used the University of California San Diego Performance-Based Skills Assessment Score and the Functional Activities Questionnaire, administered at 78 weeks.
The loss of hippocampal volume and cortical thickness — both indicators of decline for cognition that were measured by MRI — was greater in the game group than in the crossword group, as well.
The study concludes that “if these effects are replicated and expanded in future trials with the inclusion of a control group that does not receive cognitive training, crossword puzzle training could become a home-based, scalable, cognitive enhancement tool for individuals” who have mild cognitive impairment.
All of the study participants were English speakers. The researchers said larger studies are needed to confirm the results.
Studies with different findings
In other studies over the years, crosswords haven’t fared as well as certain cognition-targeting video games.
Stella Panos, 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, there may be other reasons for this.”
She said crossword puzzles could be a more familiar tool to the study participants. And “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.”
The CEO of Re:Cognition Health, Dr. Emer MacSweeney, told Healthline that over weeks of doing the same video game processes, the processes could become familiar, so crosswords might have better presented new information. “It is the process of learning new information that is most important to the brain,” he said.
Other studies have suggested that crossword puzzles do not impact cognitive decline. For example, as The Washington Post reported, one by the University of Michigan in 1999 didn’t find crossword puzzles impact cognitive decline.
That study author, Zach Hambrick, told the Post that doing a crossword puzzle, “which requires the ability to remember words and esoteric knowledge gathered through experience, tests a person’s ‘crystallized cognitive abilities.’”
He explained that those with mild cognitive impairment struggle most with fluid, not crystalized, cognitive abilities like remembering a list of words or working a logic problem. Crossword puzzles don’t address those or build those skills.
Experts emphasize the new information aspect of reducing cognitive decline. Different tasks, near information and getting away from what’s simply comfortable and familiar are important, they say.