The false promise of brain games (and what actually works instead!)

If doing the New York Times crossword puzzle were the way to better brain health, we could cure Alzheimer’s tomorrow.

Unfortunately, it’s not.

That may come as a surprise to you. If so, you’ve got plenty of company. Millions of Americans spend countless hours — and some $1.3 billion a year — solving crossword puzzles, scribbling numbers into Sudoku grids and otherwise engaging in free and paid brain games under the misguided notion they’re protecting themselves against dementia.

Experts have been warning us otherwise for some time now.

“Brain games are bogus,” The New Yorker inveighed in 2013. “Brain-training games don’t work,” New York magazine echoed last year.

Not all criticism of brain games is quite that harsh. But even after many of the nation’s leading neurologists signed a consensus statement calling out the brain-game industry for exaggerated claims that aren’t backed by science, the American obsession with brain games endures.

If you’ve been diagnosed with mild cognitive impairment, you can do better. There are ways to protect the brain that really work.

And here’s the beauty of it. The answer can be almost anything, as long as it stimulates your mind in new and demanding ways.

So set your Sudoku aside for a moment and heed the advice of Jacquelyn James, co-director of the Sloan Center on Aging at Boston College.

“We used to think that doing crossword puzzles was the best way to keep our cognitive ability alive and developing, but we’re seeing that it takes more than that,” James told The Washington Post. “It’s much more important to do things that challenge the mind, like learning a new language, or learning a new technology.”

Here’s what you need to know about brain games and brain health, beginning with this basic question:

I like brain games, and they keep my mind active. What’s so bad about that?

Let’s make this clear: there’s nothing wrong with brain games. They’re a pleasant pastime enjoyed by millions of people, including me. They’re engaging and relaxing. And when you play a challenging game often enough to get really good at it, the sense of mastery can be quite satisfying.

So how can that not be good for my brain?

It’s not bad for your brain. As the neurologists like to say, “Use it or lose it.” Anything that keeps your mind active is better than doing nothing. And for someone who enjoys playing a particular game, that’s fine.

But for someone facing the threat of cognitive decline, here’s where brain games fall short. The benefit you get is limited to the game you play. You become better at that game, but there’s no cognitive halo effect.

As Dr. Richard Isaacson, director of the Alzheimer’s Prevention Clinic at Weill Cornell Medicine in New York, recently told me, “You can do all the Sudoku you want, but you’ll just get better at Sudoku. It won’t have a spillover effect that will help you over the long-term.’’

Yikes, that’s not good. I need something that really gives my brain a boost. What should I be doing instead?

Here’s the simplest way anyone ever explained it to me: be a cabbie and not a bus driver.

A few years back, British scientists studied the brains of taxi drivers in London, and compared them to people who drove city buses. They found that the taxi drivers had greater gray matter volume in the hippocampus, the portion of the brain associated with memory and spatial navigation.

Here’s why. Bus drivers have a fixed route. Once they learn that route, it becomes routine and requires little thought. Cabbies, on the other hand, never know where they’re headed next. Every passenger and destination varies. They’re constantly making mental calculations on the best route based on traffic, construction and time of day. This challenge builds brainpower and helps them stay mentally sharp in a way that mindlessly repeating a fixed route doesn’t.

If you play brain games, the same concept applies. Once you’ve learned the game, you can continue to get marginally better at it. But you’ve essentially turned yourself into a bus driver. You’re not generating new neurons and neural pathways that can help fortify your brain against further cognitive decline.

OK, I get the concept. But I don’t happen to be a cab driver, so what do you suggest I do instead?

Almost any activity can be good, as long it seriously challenges your brain to figure out something it doesn’t already know how to do.

It can be as simple as occasionally trying a task with your left hand, if you’re right-handed. That’s the irony. Doing a crossword puzzle every day doesn’t help you, but doing that crossword puzzle with your left hand actually can.

That being said, certain activities have proven to be particularly beneficial. One of the most important studies yet was released by the Mayo Clinic earlier this year.

Researchers followed nearly 2,000 men and women over the age of 70 up to four years. They found people who kept their mind active – such as by using a computer, or doing a craft, such as pottery – had a much lower risk of cognitive decline.

For example, the risk went down by:

• 30 percent with computer use
• 28 percent with crafting activities
• 23 percent with social activities

The researchers said the best results seemed to occur with activities that require you to use your mind to figure something out, and then manipulate objects to get some desired result.

Sounds great. So I should just pick one of those and go for it, right?

That would be a good start, but there’s a little more to it.

First, make it something you enjoy. If you’re having fun with it, you’re not only getting a genuine cognitive benefit but also enriching the quality of your life. Plus, if you like it, you’re more likely to stick with it.

But here is what’s even more important. Don’t just settle into one thing. Study after study has shown that we get greater protection against Alzheimer’s when do a variety of cognitively stimulating activities. One is good, but several is better.

So try to mix it up over the course of a week. See a play. Read a great book. Join friends for a game of bridge. Learn how to fix a leaking faucet. Try your hand at fantasy football. Take a gourmet cooking class. Keep it fun and fresh and interesting.

Those all sound good, but I’m really concerned about doing the very best I can for my brain. Are some of those better than others? What do the studies say about that?

When I talk to the experts, they usually don’t single out any particular activity. Just make sure it’s new and challenging, they say. “If anything helps, it probably doesn’t so much matter what it is,” Dr. Deborah Blacker, a Harvard geriatric psychiatrist, recently told me. “There’s no evidence that activity one is better than activity two.”

That’s sound advice, but at the same time, based on the research I’ve seen, I’d say some activities stand out for their association with better cognition.

One is doing volunteer work in your community. Two others are learning to play a musical instrument, or learning a new language. If you decided to try any of these, you’d be making a truly brain-healthy choice.

And if you’ve been diagnosed with mild cognitive impairment and you’re determined to do whatever you can to slow your memory loss, the other thing you really want to consider is a rigorous computer-based brain training program.

Hold on there. First you say playing brain games on my computer won’t help me, and now you say it will. What gives?

Computer brain games being sold by private companies and scientifically validated brain training are two different things. The latter is what you want.

There are tons of pseudoscientific computer brain games out there making fantastic claims about their ability to prevent dementia and keep your mind sharp. They’re raking in millions of dollars, but there’s no evidence they deliver the benefit they promise. Those are the ones you want to steer away from.

If you cut through all the hype, you’ll find there actually are a handful of legitimate, scientifically sound brain training programs that can improve cognition in a way that brain games don’t.

And here’s the single most important thing you ought to know about these select programs that have stood the test of science. They seem to work best on people with mild cognitive impairment. In other words, people like you.

OK, you’ve got my attention now. Tell me more about that.

A study published in the American Journal of Psychiatry last fall found the right kind of computerized brain training can improve global cognition, memory, learning and attention in people with MCI.

“Our research shows that brain training can maintain or even improve cognitive skills among older people at very high risk of cognitive decline,” says Amit Lampit, a research fellow at the University of Sydney’s Brain and Mind Centre. “And it’s an inexpensive and safe treatment.”

Lampit and his fellow researchers did a “meta-analysis” of randomized clinical trials involving more than 700 people over a period of two decades. Seventeen of those trials included people with mild cognitive impairment.

What they saw was that people with MCI who took part in individualized, mentally challenging brain training improved not only their memory, but also their mood and their perceived quality of life. People who’d already been diagnosed with Alzheimer’s dementia didn’t see the same improvement.

The brain training was most effective when done in a clinical setting. As these brain-training programs become more available online to individuals, the next step is to extend this opportunity to more people at home.

But I already do brain training at home. I use Lumosity or one of the other sites like that. So I’m good, right?

Lumosity, which has been around since 2007, is easily one of most recognized providers of online brain games. It has some 70 million users, and if you’re one of them, you’re welcome to enjoy its many popular games.

But you need to be aware that playing the games offered by Lumosity has not been proven to protect against dementia or reduce the risk of cognitive decline, and it was forced to stop making such claims after being fined by the federal government.

The FTC filed a complaint against Lumosity last year, accusing the company using unfounded claims to hawk its brain games. “Lumosity preyed on consumers’ fears about age-related cognitive decline, suggesting their games could stave off memory loss, dementia and even Alzheimer’s disease,” the FTC said. “But Lumosity simply did not have the science to back up its ads.” The company ultimately agreed to pay a $2 million fine.

More recently, a study published in the Journal of Neuroscience tested the mental performance of some 130 younger adults after they played either Lumosity games or regular video games, and found no improvements in memory, attention or other cognitive skills on the part of those who trained with Lumosity.

Uh-oh, that’s not good. Is there a brain-training program out there that’s actually lives up to its promises?

For now, yes, there’s one that stands out as being backed by the highest level of scientific scrutiny. It’s called Double Decision and it’s offered commercially on the BrainHQ brain training site.

Double Decision is a speed of processing exercise that came out of a decade-long study funded by the National Institute of Health. The study involved almost 3,000 adults between the ages of 74 and 84. They received either reason training, memory training or speed of processing training and then their cognition was measured over a period of 10 years.

At the end of the study, those who took the speed of processing training had a 33 percent lower rate of dementia than the control group. Some underwent follow-up training, and they showed a 48 percent lower rate of dementia.

“Every time you learn something new, you’re making connections between nerve cells, called synapses, and you’re strengthening the ones you have.”

The findings generated great fanfare and excitement when they were announced at the Alzheimer’s Association International Conference in Toronto last year. One leading neurologists who’s been a past critic of brain training programs called the results “spectacular.”

Time magazine later named the finding among the top 100 scientific discoveries of 2016. And in January, a research review of commercially available brain training programs called the BrainHQ program the “gold standard,” saying it’s the only one to demonstrate in rigorous studies that it can improve cognition in older adults.

You can learn more about BrainHQ by visiting its website at www.brainhq.com. A subscription costs $14 a month, or $96 annually. The BrainHQ program also is available for free at some libraries or senior centers, so you may want to check around your area for that.

(For the record, I need to state that I do not have a commercial relationship with BrainHQ and do not receive any compensation from them if you choose to use their service based on my recommendation.)

Dr. Rulolph Tanzi, a Harvard neurologist and longtime Alzheimer’s researcher, says it’s all about synaptic connections.

“Every time you learn something new, you’re making connections between nerve cells, called synapses, and you’re strengthening the ones you have,” Tanzi says in a video outtake for “Alzheimer’s: Every Minute Counts,” a documentary produced by Twin Cities PBS.

Tanzi says with Alzheimer’s, there’s a strong correlation between degree of dementia and the loss of synapses. So enhancing our “synaptic reserve” is crucial.

“Stay intellectually active,” he says. “It doesn’t mean playing brain games, which can just help focus, but not really make new synapses. You have to build up enough synapses so that as you lose them, you hang on, and don’t go down that slippery slope to dementia. And that really means learning new things.’’