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Brett Arends’s ROI: Want to slow, delay or reverse dementia? Try this classic game.

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A couple of years ago I bought a big book of crosswords and started doing one every day. I found something peculiar. With each crossword, I would initially get stuck on many of the clues. But when I came back to it the next morning, or even a few hours’ later on the same day, I found they nearly all came easily. My brain had apparently been working on the clues, subconsciously, while I was doing other things.

So I’m cheered, but not totally surprised, by an exciting scientific discovery. Turns out, doing crosswords is good for our brains. It may delay the onset of aging. It may delay dementia. It may slow or delay cognitive decline. It may even—and this really is remarkable—throw cognitive decline into reverse.

Oh, and it turns out crosswords may well be better for our brains than the electronic “brain training” games you can get on your computer or that small device you carry in your pocket (and which seems to be turning everyone’s brain into mush, though that’s a story for another day).

This isn’t me talking: This is a new article in the journal NEJM Evidence, where NEJM is the artist formerly known as The New England Journal of Medicine.

15 medical researchers from Columbia, Duke and the City University of New York are reporting on a trial they recently conducted over 78 weeks—a year and a half—with over 100 participants.

The subjects were aged 55 to 95, with an average age of 76, and had either early stage or late stage mild cognitive impairment.

Over the initial 12 week period, half of the subjects did computer-based brain-training games over an initial 12 week period, including games that included “memory tasks, matching tasks, spatial recognition tasks, and processing speed tasks.” The other half did crossword puzzles (also on a computer) of supposed medium difficulty, which the researchers said were about the equivalent of the New York Times’ Thursday crossword. After the 12 week period there were a further six “booster” sessions.

The researchers then did follow-up studies over the next 60 months to see what differences, if any, the exercises had made.

Bottom line: Those who had done crosswords on average fared much better than those who had done the computer games. 

Read: So long, senior centers and nursing homes. Older adults don’t want to spend their time in places where they are seen as victims in decline.

“Crossword puzzles showed superior efficacy to games in the cognitive outcome…with a small-to-medium effect size,” the researchers report.

On a standardized test known as the “Alzheimer’s disease Assessment Scale Cognitive score,” they write, after the full 78 weeks those who had done the games showed a “small decline” on average while those who had done the crosswords showed an improvement.

Those who had done the crosswords were 50% more likely to show a significant improvement in cognitive scores (meaning more than 2 points on the scale, albeit out of a total possible range of 70 points). More than a third of those who did the crosswords showed an improvement of more than 2 points, compared to just a quarter of those who had done the games.

Those who did games were 50% more likely to progress to full-blown dementia during the period than those who did the crosswords, at a rate of 15.7% to 10.7% (though we are dealing with very small numbers).

Read: 4 things you can do to fight dementia and improve your memory

The differences even showed up in brain structure. After 78 weeks, MRIs showed those who had done crosswords showed smaller declines in the size of their hippocampus, and in the thickness of their cerebral cortex, than those who had done the games instead.

The researchers admit they were surprised by their findings.

“These results were unexpected and in opposition to the proposed hypotheses,” they note. “The choice of games was based on experience from a large data set of online games that was selected for feasibility and targeted to improve memory and executive ability.” They added that crosswords had one big advantage for those with later stage cognitive decline: They were much easier to do.  

The latest study is not the only one in its field and its results can hardly end the debate. It involved small numbers, barely 50 in each group. The researchers note that other studies have found that games also had a positive effect on cognitive functions. What scientists don’t know about the brain, aging and dementia is vastly greater than what they do know, and each new study barely scratches away at the coalface of ignorance.

But the latest adds to the growing signs that doing complex mental activities is good for your brain and may well lower your risk of dementia. The researchers note that a prior, systematic review of 22 studies had found that doing things like reading books, playing checkers, and doing crosswords or other puzzles “reduced overall incident dementia risk by 46% during a median 7-year period.”

How much will crosswords really help us ward off dementia? We still don’t know for certain. But unless someone is willing to argue that doing crosswords might be bad for you, the risks are simply asymmetrical. Lots of potential upside, no downside. If you have ever seen a loved one get dementia, you probably won’t need any other impetus to buy or just download some crosswords.

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