The Crossword Conundrum- Helpful for Cognition?

Researchers showed that solving crossword puzzles delayed the onset of accelerated memory decline (the “change point”) in individuals who developed dementia by a full 2 ½ years. However, after crossing that point, the rate of deterioration among the puzzlers was more rapid.¹ They believe this supports the “cognitive reserve” hypothesis, which suggests that mentally stimulating activities delay the start of clinically observable deficits by building up a supply that can partially compensate for pathological brain damage.

Investigators examined how cognitive exercises such as deciphering mind-benders, reading, playing board games, or using a computer at least once per week were protective against MCI.⁴ To distinguish between physical and mental activity, they focused on tasks that were done while the seniors were sitting down – or CASs (Cognitive Activities while in a Sitting position). While physical movements are beneficial for cognitive function, many seniors lead sedentary lifestyles. By counting CASs, the researchers were able to focus on differences between non-stimulating inactive behaviors (e.g., sleeping or passively watching television) and challenging seated actions such as solving crossword puzzles.

Another study found that working on brain teasers was associated with less decline in cognitive function overall and with less memory loss from age 70 to 79.⁶ The scientists believe that the results provide a nudge for people to be more engaged in mentally stimulating games throughout their lives.⁷

Although these studies primarily involved cognitively healthy individuals, the results hold promise for those already experiencing brain-health decline.  The outcomes have prompted the start of a new trial on crossword puzzles and computer-based cognitive training for individuals with MCI, which is now underway. Findings should be available next year.⁸

Even as researchers continue to puzzle out the pieces of MCI, physicians encourage these patients to engage in these and other brain-challenging activities as often as they can—not as a cure-all—but as part of a healthy and happy lifestyle. Because wordplay provides a demanding mental stimulation, experts suggest that they should be at a reasonable level of difficulty, whether the player is trying to prevent future cognitive decline or is already experiencing MCI. More complex games often cause frustration.⁹

There are many sources of these puzzles—from newspapers, to online, to large-print books,  which can be helpful for many seniors.

Solving crosswords entails searching for words that, in turn, trigger memories. Reflections about favorite topics could be helpful. There are themed puzzles based on one’s special interests such as baseball, music, WWII, U.S. history, or Broadway musicals.

Much research indicates that working crosswords may help ward off memory loss in older adults and may benefit those who already have MCI.

1. Pillai JA, et al. Association of crossword puzzle participation with memory decline in persons who develop dementia. J Int Neuropsychol Soc. 2011;17(6):1006-1013. doi: 10.1017/S1355617711001111.
2. Schultz SA, et al. Participation in cognitively-stimulating activities is associated with brain structure and cognitive function in preclinical Alzheimer’s disease. Brain Imaging Behav. 2015;9(4):729-736. doi: 10.1007/s11682-014-9329-5.
3. Verghese J, et al. Leisure activities and the risk of amnestic mild cognitive impairment in the elderly. Neurology. 2006;66(6):821-827. doi:10.1212/01.wnl.0000202520.68987.48.
4. Kurita S, et al. Association of physical and/or cognitive activity with cognitive impairment in older adults. Geriatr Gerontol Int. 2020;20(1):31-35. doi: 10.1111/ggi.13814.
5. Lizuka A, et al. Can cognitive leisure activity prevent cognitive decline in older adults? A systematic review of intervention studies. Geriatr Gerontol Int. 2019;19(6):469-482. doi: 10.1111/ggi.13671.
6. Altschul DM, et al. Playing analog games is associated with reduced declines in cognitive function: a 68-year longitudinal cohort study. J Gerontol B Psychol Sci Soc Sci. 2020;75(3):474-482. https://doi.org/10.1093/geronb/gbz149.
7. Sandoiu A. Board games may stave off cognitive decline. https://www.medicalnewstoday.com/articles/327153.
8. D’Antonio J, et al. Cognitive training and neuroplasticity in mild cognitive impairment (COG-IT): protocol for a two-site, blinded, randomised, controlled treatment trial. BMJ Open. 2019;9(8):e028536. doi: 10.1136/bmjopen-2018-028536.
9. Mehta S. April 22, 2019. https://www.medscape.com/answers/1136393-157428/which-activity-modifications-are-used-in-the-treatment-of-mild-cognitive-impairment-mci. Accessed February 17, 2021.