Do Crossword Puzzles Prevent Dementia?

Crossword blog: the truth about crosswords and dementia

Do Crossword Puzzles Prevent Dementia?

It’s official: crosswords are a waste of time.

A waste of time, that is, if you’ve ever justified your hobby by insisting that it’s insurance against dementia.

The notion of crosswords as a cerebral prophylactic has been around for years, despite the little problem of there being no research to back it up. Until recently, the only study that I’d seen was from the Journal of Experimental Psychology, and it found no evidence …

… to suggest that amount of crossword puzzle experience reduces age-related decreases in fluid cognition or enhances age-related increases in crystallized cognition.

In plainer language, puzzles don’t help us (a) to remember the words we need to fill in the blank squares, or (b) to reason our way through cryptic clues’ wordplay.

Last week, newspapers reported a new study, with headlines variously stating and denying an effect of crossword-solving on Alzheimer’s disease (trudge through the coverage yourself, if you can bear it). As is often the way, the title of the original paper – Effect of Intellectual Enrichment on AD Biomarker Trajectories Longitudinal Imaging Study – does not, in fact, mention crosswords.

And, well, nor does the paper itself. Crosswords seem to have appeared somewhere between publication and press release. But if we take “crosswords” as journalistic shorthand for “using your noddle”, there is something of interest hiding in the coverage.

What is termed “high midlife cognitive activity” – which is how I’m going to refer to the Guardian quiptic from now on – doesn’t do anything to prevent dementia for most people.

But it is “associated with lower amyloid in APOE4 carriers”, for which read: if you have a gene variant (that’s the APOE4 bit) which increases your risk of developing Alzheimer’s disease, get yourself doing some cognitive activity and get rid of those sticky protein fragments (that’s the amyloid bit).

But …

what if you don’t know whether you’re an APOE4 carrier or not? Perhaps a more cheering way of looking at negative results is to conclude that there is no evidence that doing crosswords causes any mental disorders, or indeed any kind of suffering beyond frustration, which is pretty much what a solver signs up for anyway. Just because you don’t have a specious justification for something doesn’t mean you can’t do it.

I’m not a doctor. But my advice is: carry on solving, and find yourself another excuse.

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Is It a Myth That Doing Crossword Puzzles Prevent Dementia?

Do Crossword Puzzles Prevent Dementia?

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Puzzles are frequently touted as being good for our brains. They keep us mentally active and challenge us. But, is it true that puzzles prevent dementia or even improve our memory?

Research conducted in nursing homes in 2011 found that puzzles, combined with physical activity, practicing activities of daily living and a spiritual element (such as the singing of a hymn or discussion about happiness) prevented a decline in the residents' cognitive abilities for twelve months. The other residents received care as usual and demonstrated a cognitive decline over twelve months.

Another research study involved 448 participants who were living in the community (not a facility) and were cognitively intact at the start of the study. The researchers measured the participants' cognitive functioning every 12-18 months and noted their frequency of doing crossword puzzles.

Researchers determined that, the participants who eventually developed dementia, those who frequently did crossword puzzles demonstrated a much slower decline in memory. On average, crossword puzzles provided about a two and a half year delay in memory decline compared to those who did not do crossword puzzles.

A third study found that doing crossword puzzles, along with multiple other mental activities such as reading, board games, playing cards, musical instruments, and other hobbies, was associated with a decreased risk of dementia.

However, not all research supports doing crossword puzzles.

One study compared completing computerized crossword puzzles- specifically, ones that don't progress to a more difficult level- to a structured computerized cognitive training program.

The study found that the cognitive training group maintained or even improved their cognitive functioning over the course of a year, while the crossword puzzle group declined.​

Stay mentally active. There's some support in research for crossword puzzles, but the bigger theme behind it is to continue to challenge yourself mentally to reduce your risk of dementia.

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  • American Journal of Alzheimer's Disease and Other Dementia. 2010 August; 25(5): 432–438. Engagement in reading and hobbies and risk of incident dementia: The MoVIES Project.
  • BMC Medicine 2011, 9:129. Non-pharmacological, multicomponent group therapy in patients with degenerative dementia: a 12-month randomized, controlled trial.
  • Journal of the International Neuropsychological Society. 2011 Nov;17(6):1006-13. Association of crossword puzzle participation with memory decline in persons who develop dementia.
  • Neurology. September 15, 2009 vol. 73 no. 11 854-861. Leisure activities and the risk of dementia in the elderly: Results from the Three-City Study.
  • Neurology. Volume 73, pages 356-361, August 2009. Cognitive Activities Delay Onset of Memory Decline in Persons Who Develop Dementia.
  • PLOS ONE. Published: May 01, 2013. A Randomized Controlled Trial of Cognitive Training Using a Visual Speed of Processing Intervention in Middle Aged and Older Adults.


Crosswords and puzzles do not prevent mental decline, study says

Do Crossword Puzzles Prevent Dementia?

(CNN)Tackling a tricky crossword or a challenging Sudoku puzzle will not fend off age-related mental decline, new research has shown.

Scientists have, in recent years, argued that brain-training exercises, such as completing puzzles or learning another language, can reduce the risk of developing dementia. But that may not be the case after all, according to a team of Scottish researchers whose research was published in the BMJ.

The study's authors argue that such pursuits will not necessarily act as a preventative, but they could still provide a “higher cognitive point” from which to decline.

The study considered 498 participants, all born in 1936 and who took a group intelligence test when they were 11 years old. Those records were kept by the Scottish Council for Research in Education.

Then, at about 64 years old, they were tested for the current study and followed up with several more times for memory and mental processing over the next 15 years.

The research was led by Roger Staff, honorary lecturer at the University of Aberdeen and head of medical physics at Aberdeen Royal Infirmary.

The researchers stressed that their work is an observational study, so it is “impossible for a causal effect to be inferred.”

James Pickett, head of research at the UK's Alzheimer's Society, said that other factors should also be taken into consideration.

“Of all the diseases in the UK, dementia is now the biggest killer, so exploring potential factors which could reduce the risk of developing this devastating condition is fundamental to beating it,” he said.

“Although playing 'brain games' such as Sudoku may not prevent dementia, is has been shown that regularly challenging yourself mentally seems to build up the brain's ability to cope with disease.”

“We know that what is good for the heart is good for the head, and there are other ways we can reduce our risk of developing dementia,” he added, “by taking steps towards a healthy lifestyle, eating a balanced diet, avoiding smoking and heavy drinking, and exercising regularly.”

The Alzheimer's Society recently launched a brain game app called GameChanger “which won't reduce the risk of dementia,” Pickett said, “but through playing it, it can help build an understanding of cognitive changes and the difference between cognitive decline and dementia.

Eventually, he said, “the GameChanger project could find people who are showing early signs of cognitive decline and get them involved in studies and trials to hopefully stop them developing dementia.”

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Regular crosswords and number puzzles linked to sharper brain in later life

Do Crossword Puzzles Prevent Dementia?

Older adults who regularly take part in word and number puzzles have sharper brains, according to the largest online study to date.

The more regularly adults aged 50 and over played puzzles such as crosswords and Sudoku, the better their brain function, according to research in more than 19,000 participants, led by the University of Exeter and King's College London.

The findings emerge from two linked papers published today (May 16th) in the International Journal of Geriatric Psychiatry. The researchers have previously presented their findings on word puzzles at the Alzheimer's Association International Conference in 2018. The new research builds on these findings and also reports the same effect in people who regularly complete number puzzles.

Researchers asked participants in the PROTECT study, the largest online cohort in older adults, to report how frequently they engage In word and number puzzles and undertake a series of cognitive tests sensitive to measuring changes in brain function. They found that the more regularly participants engaged with the puzzles, the better they performed on tasks assessing attention, reasoning and memory.

From their results, researchers calculate that people who engage in word puzzles have brain function equivalent to ten years younger than their age, on tests assessing grammatical reasoning and eight years younger than their age on tests measuring short term memory.

Dr Anne Corbett, of the University of Exeter Medical School, who led the research, said: “We've found that the more regularly people engage with puzzles such as crosswords and Sudoku, the sharper their performance is across a range of tasks assessing memory, attention and reasoning. The improvements are particularly clear in the speed and accuracy of their performance. In some areas the improvement was quite dramatic — on measures of problem-solving, people who regularly do these puzzles performed equivalent to an average of eight years younger compared to those who don't. We can't say that playing these puzzles necessarily reduces the risk of dementia in later life but this research supports previous findings that indicate regular use of word and number puzzles helps keep our brains working better for longer.”

The study used participants in the PROTECT online platform, run by the University of Exeter and Kings College London. Currently, more than 22,000 healthy people aged between 50 and 96 are registered in the study, and the study is expanding into other countries including Hong Kong and the US.

The online platform enables researchers to conduct and manage large-scale studies without the need for laboratory visits. PROTECT is a 25 year study with participants being followed up annually to explore how the brain ages and what might influence the risk of dementia later in life.

PROTECT is funded by the National Institute for Health Research (NIHR) Bioresource, including through its NIHR Clinical Research Network (CRN).

In addition to taking part in vital research, participants in the PROTECT study have access to a brain training programme that has already been shown to benefit brain function, as well as having the opportunity to take part in exciting new research studies into brain health and dementia prevention.

Clive Ballard, Professor of Age-Related Diseases at the University of Exeter Medical School, said: “PROTECT is proving to be one of the most exciting research initiatives of this decade, allowing us to understand more about how the brain ages and to conduct cutting-edge new studies into how we can reduce the risk of dementia in people across the UK. If you're aged 50 or over, you could sign up to take part in research that will help us all maintain healthy brains as we age.”

PROTECT receives funding from the Wellcome Trust, the JP Moulton Foundation, and Alzheimer's Society. Partners include South London and Maudsley NHS Foundation Trust, the Royal Devon & Exeter NHS Foundation Trust and Devon Partnership Trust.

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Materials provided by University of Exeter. Note: Content may be edited for style and length.

Journal References:

  1. Helen Brooker, Keith A. Wesnes, Clive Ballard, Adam Hampshire, Dag Aarsland, Zunera Khan, Rob Stenton, Maria Megalogeni, Anne Corbett. The relationship between the frequency of number‐puzzle use and baseline cognitive function in a large online sample of adults aged 50 and over


Crosswords do NOT prevent dementia but can make your brain sharper

Do Crossword Puzzles Prevent Dementia?

  • Experts believed doing puzzles slowed the rate of cognitive decline  
  • Now, a study shows it creates a 'higher cognitive point' from which to decline 
  • It suggests puzzles are still worth doing, but will not totally protect you

By Ben Spencer Medical Correspondent For The Daily Mail

Published: 23:30 BST, 10 December 2018 | Updated: 00:25 BST, 11 December 2018

Doing crosswords or Sudoku puzzles throughout your life does not slow mental decline in old age, researchers have found.

But the activities do boost mental ability, so when the brain does start deteriorating there is a 'higher cognitive point' from which to decline.

Experts have long believed in the neurological theory of 'use it or lose it' – which suggests people who have complex jobs or do intellectual puzzles that tax the brain are protected against mental decline.

Puzzles such as crosswords or Sudoku do not slow the rate of cognitive decline, but create a 'higher cognitive point' from which decline can start from, a study found

They believed that exercising the brain throughout a lifetime slows the speed at which the brain deteriorates in old age.

Now, however, scientists from the University of Aberdeen have found this is not quite the case.

The team recruited 498 people at the age of 64 and tracked them for the next 15 years, monitoring their mental abilities throughout the period.

They found those who had engaged in intellectually stimulating activities on a regular basis had higher mental ability at the start of the study – but there was no difference in the speed at which they declined over the next 15 years.

The scientists, writing in the British Medical Journal, said: 'These results indicate that engagement in problem solving does not protect an individual from decline, but imparts a higher starting point from which decline is observed and offsets the point at which impairment becomes significant.'

The team said this supports the theory of 'cognitive reserve' – the ability that some people have to maintain their memory and IQ despite the impact of ageing.

This is because regularly using the brain for complex tasks creates a greater number of connections between brain cells.

So when the wiring of the brain starts the break down with age, or if dementia starts to attack, the brain has 'backup' networks to use instead.

The scientists wrote: 'This association suggests that engagement adds to an individual's cognitive reserve – that is, individuals who engage in regular problem solving activities might require greater age related neuropathological burdens before clinical thresholds of impairment are crossed and symptoms of cognitive decline are reported.' 

Scientists have unveiled diet and lifestyle tips that maintain brain health in old age. 

According to researchers from around the world 'what's good for the heart is good for the brain'.

They add that no single food acts as a 'silver bullet' for improving or maintaining brain health.

The experts have put together the following diet and lifestyle advice to help people preserve their brain health as they age.

Eating plenty of berries helps maintain people's brain health as they get older

Eat plenty of:

  • Berries
  • Fresh vegetables, particularly leafy greens
  • Healthy fats, such as extra-virgin olive oil
  • Nuts
  • Fish and seafood

Include the following in your diet:

  • Beans and other legumes
  • Fruit
  • Low-fat dairy
  • Poultry
  • Grains

Red meat consumption should be limited

Limit intakes of:

  • Fried food
  • Pastries
  • Processed foods
  • Red meat
  • Full-fat dairy
  • Salt

Other tips:

  • Stay active
  • Avoid overeating
  • Eat at least one meal a week with fish that is not deep fried
  • Watch out for salt levels in pre-made food
  • Use lemon, vinegar, herbs and spices to flavour food over salt
  • Snack on raw, plain, unsalted nuts
  • Eat vegetables with a range of different colours
  • Prepare meals from scratch 

Eleven researchers from the Global Council on Brain Health, including experts from the University of Exeter, met on September 12-to-13 2017 to discuss the impact of diet on the brain health of adults over 50. 

Their recommendations are the evaluation of studies investigating the impact of nutrients on the cognitive function of older adults. 


Can a puzzle a day keep dementia at bay?

Do Crossword Puzzles Prevent Dementia?

The National Poll of Healthy Aging conducted by the University of Michigan surveyed adults between the ages of 50 to 64 about their concern for developing dementia and the steps they are taking to reduce their risk [1].

Only 5% of respondents reported speaking with their doctor about strategies to minimize dementia risk, with most instead resorting to the use of brain puzzles and/or supplements in the hope that they can stave off dementia.

While both the World Health Organization and Global Council on Brain Health have concluded that supplements are not effective for preventing dementia, numerous studies have reported associations between engaging in mentally stimulating activities and resistance to later cognitive decline.

However, this does not imply that all types of brain games are equally effective or that they can actually prevent the eventual onset of dementia.

Computerized brain training games have become increasingly popular in recent years, but simple crossword puzzles and number puzzles are still the most common activities used by older adults.

While speed of processing training was shown to provide long-lasting cognitive protection in the ACTIVE study [2], the long-term benefits associated with the general use of common mentally-stimulating activities in everyday life are less clear.

A recent observational study examined the association between cognition and word or number puzzle use in 19,078 cognitively healthy adults in the UK between the ages of 50 and 93 enrolled in the online PROTECT study on brain aging [3; 4].

Cognitive function was assessed using 14 measures from two different battery assessments covering a range of cognitive functions including spatial working memory, verbal reasoning, reaction time, and attention.

Participants were ranked into 6 groups according to their self-reported frequency of word or number puzzle use ranging from never to more than once per day.

Those who did word or number puzzles at least once a month showed significantly better performance across all cognitive domains compared to those who never used them, and measures of attention were highest in the people who did puzzles most frequently.

Participants who did word puzzles had higher scores on measures of grammatical reasoning, while those who did number puzzles had higher scores on measures of executive functions, which includes activities such as organizing and planning.

Since the magnitude of overall cognitive improvement was similar for either type of puzzle, participating in a brain engaging activity on a regular basis may be more important than the specific type of activity.

Since this is an observational study, it did not determine cause and effect.

It is not clear whether using puzzles can boost cognitive performance, or if people with higher baseline cognition are more ly to engage in mentally stimulating activities, such as solving puzzles.

Another caveat is that the study did not determine whether there is a difference between people who have engaged in cognitively stimulating activities throughout their lives compared with those who started later in life.

The Bronx 20-year longitudinal Aging Study found that self-reported crossword puzzle use was associated with a 2.

54 year delay in dementia onset [5], which suggests that similar to education, mentally stimulating activities may help delay the onset of symptoms, but on their own they cannot prevent dementia.

However, in contrast to the use of supplements, there are no health risks associated with puzzle use. Therefore, brain puzzles may be considered as part of a more comprehensive dementia prevention program that also involves exercise and healthy eating.

  1. University of Michigan (2018) Thinking About Brain Health. National Poll on Healthy Aging. 
  2. Willis SL, Tennstedt SL, Marsiske M et al. (2006) Long-term effects of cognitive training on everyday functional outcomes in older adults. JAMA 296, 2805-2814.
  3. Brooker H, Wesnes KA, Ballard C et al. (2018) An online investigation of the relationship between the frequency of word puzzle use and cognitive function in a large sample of older adults. International Journal of Geriatric Psychiatry 0. 
  4. Brooker H, Wesnes KA, Ballard C et al. (2019) The relationship between the frequency of number-puzzle use and baseline cognitive function in a large online sample of adults aged 50 and over. International Journal of Geriatric Psychiatry 0. 
  5. Pillai JA, Hall CB, Dickson DW et al. (2011) Association of crossword puzzle participation with memory decline in persons who develop dementia. J Int Neuropsychol Soc 17, 1006-1013.

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