New results from a clinical trial lasting over a year have shown playing crossword puzzles may be more effective at slowing age-related cognitive decline than modern video games specifically developed to improve memory.
The trial, led by a team of researchers from Columbia University and Duke University, recruited over 100 participants aged around 70 with mild cognitive impairment. The cohort was evenly split into either a cognitive video game group or a crossword-playing group.
For the first 12 weeks of the trial, the subjects were tasked with four 30-minute game sessions per week. They then completed "booster" sessions comprising a week of gaming sessions every few months for the next year and a half.
In findings that surprised the researchers, after 78 weeks cognitive scores for those in the crossword group had improved slightly while the same scores for those in the video game group had worsened slightly. According to D.P Devanand, who led the trial, the results were unexpected as the team has originally hypothesized the cognitive video games would lead to superior outcomes.
"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. "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."
Digging into the details of the findings, the researchers do note the difference in cognitive outcomes between the crossword and video game groups seemed to depend on how progressed each subject's cognitive impairment was at the beginning of the trial. Older subjects with more advanced cognitive impairment seemed to show greater improvements from crosswords compared to younger subjects at earlier stages of decline.
"Participants with late MCI may have found the games too difficult to comprehend and execute satisfactorily. In contrast, most older adults are familiar with crossword puzzles, which were of medium difficulty in the trial and allowed participants to set their own pace," the researchers speculate in the study. "It is possible that games are superior in cognitively intact individuals, especially in young adults who are familiar with games, but the more familiar and less technical crossword puzzles may be superior in cognitively impaired older individuals."
This crucial caveat suggests cognitive-enhancing video games could still be beneficial in the future for a generation more familiar with video games. However, crossword puzzles may be the superior brain training option for those older people who never engaged with computerized games.
The researchers indicate future trials will need to replicate these results in a larger cohort with a control group receiving no specific cognitive training. This will help affirm whether crossword puzzle games are an effective cognitive enhancement tool for those experiencing age-related cognitive decline.
“The trifecta of improving cognition, function and neuroprotection is the Holy Grail for the field,” added Murali Doraiswamy, another researcher working on the project. “Further research to scale brain training as a home-based digital therapeutic for delaying Alzheimer’s should be a priority for the field.”
The new study was published in NEJM Evidence.
