Crossword Puzzles Beat Cognitive Computer Video Games
By COLUMBIA UNIVERSITY IRVING MEDICAL CENTER
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| According to a new study, doing crossword puzzles has an advantage over computer video games for memory functioning in older adults with mild cognitive impairment. |
In a randomized, controlled trial, researchers determined that participants (average age 71) trained in doing web-based crossword puzzles demonstrated greater cognitive improvement than those who were trained on cognitive video games. The study was led by D.P. Devanand, MD, professor of psychiatry and neurology at Columbia, with Murali Doraiswamy, MD, professor of psychiatry and medicine at Duke.
“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 Dr. 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 have not
been studied systematically in mild cognitive impairment, which is associated
with a high risk for dementia, including Alzheimer’s disease.
To conduct their study, researchers at Columbia and Duke randomly assigned 107 participants with mild cognitive impairment (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 up to 78 weeks. Both interventions were delivered via a computerized platform with weekly compliance monitoring.
The most striking findings of the trial were:
- Crossword puzzles were superior
to cognitive games on the primary cognitive outcome measure, ADAS-Cog, at
both 12 weeks and 78 weeks. Crossword puzzles were superior on FAQ, a
measure of daily functioning, at 78 weeks.
- Crossword puzzles were superior
for participants at a later disease stage but both forms of training were
equally effective in an earlier stage.
- 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,” Dr. Devanand said.
The research 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.
Two strengths of the trial are the 28%
participation rate of individuals from racial and ethnic minority groups and
the low drop-out rate (15%) for such a lengthy home-based trial. A study
limitation was the absence of a control group that did not receive cognitive
training.
While these results are highly encouraging, the
authors stress the need for replication in a larger controlled trial with an
inactive control group.
“The trifecta of improving cognition, function,
and neuroprotection is the Holy Grail for the field,” said Dr. Doraiswamy.
“Further research to scale brain training as a home-based digital therapeutic
for delaying Alzheimer’s should be a priority for the field.”
Reference: “Computerized Games Versus Crosswords
Training in Mild Cognitive Impairment” 27 October 2022, NEJM Evidence.
DOI: 10.1056/EVIDoa2200121