Puzzles are Protective of Brain Power
By: Tracy Binius, MD,
Adjunct Assistant Professor in Psychiatry and Behavioral Medicine Medical College of Wisconsin
Your brain works like an orchestra, with many musicians playing their parts to create a symphony. The conductor sits in your frontal lobes, just behind your forehead, directing the brain's "executive function."
Executive function encompasses many skills that get us through our day, such as planning, problem solving, controlling impulses, and adapting to new information. Problems with executive function can be an indicator or warning sign of subsequent dementia.
One of the most famous medical cases in history helped doctors understand executive function and where it resides in the brain. Phineas Gage, a railroad construction worker, was the victim of a freak accident when a metal rod shot through his skull and destroyed much of his frontal lobe. Afterward, his memory, speech and motor skills were mostly intact, but his personality changed. He was irritable and impatient, and he was no longer able to complete tasks that required planning and organization.
When I test a patient's executive function, one of the screening tools I use is the clock draw test, which has been used for decades for early screening of dementia. We can’t see dementia on MRIs or diagnose it with lab tests, so this screening tool is one way I look inside someone’s brain.
The instructions are: “Draw a clock and make it say ten past eleven.” To draw the clock requires working memory, verbal fluency, planning, and impulse control to stay on task.
Here is an example showing evidence of early executive function changes. Notice the planning errors in number placement and clock hand placement.
In addition to using screening tools, I ask my patients about their daily activities, such as if they are having trouble driving, paying bills, scheduling doctor’s appointments, or using a computer or cell phone. These higher-level, executive function tasks will deteriorate over time in patients with dementia.
The good news is that brain exercise can protect against dementia. Ongoing research is showing that mental activities, such as reading, games and puzzles, reduce the risk of developing dementia. In some studies, crossword puzzles are being recognized as a hero for brain protection. For example, as part of the Bronx Aging Study, crossword puzzle activity was shown to delay the onset of memory decline by 2.54 years.
In recent research, a clinical trial at McGill University was the first study in humans to show that brain training using a game app for 10 weeks enhanced acetylcholine activity in the brain of older adults to levels seen in people 10 years younger. Acetylcholine is a chemical messenger in the brain that is involved in memory and attention, and is severely depleted in Alzheimer's disease.
Given the evidence, I recommend adding puzzles and games to my patients' routines. If you are new to puzzles, I suggest starting with easy 5x5 crosswords, or 5 minutes of games on a brain training app during brief downtime, such as standing in line. That's how I started integrating crosswords and games into my day. I found that doing larger, harder puzzles are fun to do with a friend or as a group.
Try this cognitive health morning routine
Meet a family member or friends
Share a MIND diet breakfast, such as avocado on whole wheat toast with soft boiled eggs, or oatmeal with raspberries
Collaborate on a 15x15 moderately hard crossword
Afterward, take a walk outside
