Brain Training Games Offer Specific But Limited Benefits

Crossword puzzles. Memory exercises. Video games. In the quest to stave off Alzheimer’s disease or other dementias, many people have been looking for ways to keep their brains active. This consumer desire for mental stimulation has even led to a multi-million-dollar brain-training industry.

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The concept that building a greater “cognitive reserve” is associated with a lower risk of dementia has a long history in the scientific literature. However, the extent to which cognitive tasks or games can improve this reserve has been a matter of some debate.

“It’s true the brain is like a muscle and the more you work out, the better you get,” said Neil Charness, Ph.D., the William G. Chase Professor of Psychology at Florida State University. “But there is no compelling evidence that the benefits extend beyond the limited skills of the game you are playing.”

In other words, if you spend hours a day doing crosswords, you can become very good at solving crosswords—a concept known as “narrow transfer.” However, crosswords—or any mind-stimulating activity for that matter—have shown no capacity for “far transfer,” such as improving working memory, attention, or other problem-solving skills.

Studies by Charness and others suggest that even the popular commercial brain-training applications that have taglines like “backed by neuroscience” fail to lead to improvements in these skills.

In a recent study, Charness and colleagues randomly assigned a group of 60 older, healthy adults to play a suite of “gamified” cognitive tests (designed to exercise inductive reasoning, speed of processing, task switching, and more) or common word and number puzzle games (crossword, word search, and Sudoku) on tablets for 30 sessions of 45 minutes each for one month. A battery of cognitive tests was administered to all participants before and after the training.

Both groups performed similarly when tested, with one exception. The participants in the cognitive-training group did marginally better in a block-swapping spatial memory task that was similar to one of the games included in the cognitive-training program.

“The cognitive game that focused on spatial memory happened to be the one the participants enjoyed the least,” Dustin Souders, a graduate student in Charness’ lab, told Psychiatric News. “They found it tedious.”

Studies such as the one by Charness and colleagues are not meant to imply that there is no benefit to brain-training games, noted former APA President Dilip Jeste, M.D., a distinguished professor and director of the Sam and Rose Stein Institute for Research on Aging at the University of California San Diego.

“I feel that brain activities of different kinds are potentially helpful if they are somewhat challenging but not too stressful either,” he told Psychiatric News.

“However, an expectation that the brain-training games alone can prevent dementia is probably unrealistic. A comprehensive lifestyle-based program with healthy diet, physical activity, social engagement, appropriate health care, and sleep hygiene combined with brain-training games—which the senior finds fun—can help keep the brain active longer.”

Linda Clare, Ph.D., Sc.D., a professor of clinical psychology and director of the Centre for Research in Ageing and Cognitive Health at the University of Exeter Medical School in the United Kingdom recently led a study that corroborates this idea.

She and colleagues analyzed the lifestyles and cognitive performance of over 2,000 older adults. They found some correlation between the levels of cognitive reserve (quantified based on years of education and occupational complexity) and cognitive test scores among the participants, but other factors such as physical activity, social activity, diet, and occupation likely influenced this association.

As with Jeste, Clare believes personal enjoyment is a critical consideration for anyone thinking of investing time and money into brain training.

“A key element of healthy aging is not to do things that you hate simply because they may decrease the probability of dementia,” she said. “Live a healthy lifestyle built around the things you enjoy.”

Clare also told Psychiatric News that while brain training may not prevent or delay dementia on its own, it might help people with existing dementia manage their daily lives better.

Charness said he agrees with that assessment, noting that brain-training games can have significant value if they are tailored to an individual’s specific needs, making the limited transfer of skills a strength and not a weakness.

“I think we need to drill down to the instrumental activities of daily living, such as driving or finances, that have the greatest risk of catastrophe from a mental error, and develop tasks to improve these core skills [in older adults],” he said. ■