What the latest research says about puzzles and brain health

While puzzles may seem like a simple way to keep your brain in shape, studies suggest the reality is more nuanced. A 2022 study published in NEJM Evidence found that individuals with mild cognitive impairment (MCI) who did crossword puzzles over 12 weeks showed cognitive improvement. Still, it’s important to note that while the results were impressive because they occurred in a very specific group of people already experiencing cognitive decline, the improvement was also modest.

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A 2024 study also showed a link between puzzles and better cognitive abilities. It studied the lifestyle choices of more than 9,000 people and concluded that board games and puzzles were the strongest predictors of reasoning skills and a top predictor of memory and verbal ability (video games ranked just as high).

While studies like these are encouraging for puzzle enthusiasts, there’s a catch: the link between puzzles and brain health may be correlation instead of causation. And while puzzles may have some benefits, the research is much stronger in support of other lifestyle interventions for boosting brain health.

Exercise and other proven ways to protect your brain

So, what does move the needle when it comes to brain health? In his book Outlive: The Science and Art of Longevity, physician Peter Attia says exercise is “the single most powerful item in our preventive tool kit,” especially for reducing the risk of Alzheimer’s disease and cognitive decline.

Regular exercise improves glucose control, which benefits the brain and helps increase blood flow. It’s even been shown to increase the volume of the hippocampus, a critical brain region for learning and memory.  According to Niotis, it also boosts neuroplasticity (i.e., helps the brain form new connections) and produces brain-derived neurotrophic factor (BDNF), a protein essential for healthy cognitive function.

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“Exercise is tricky because we don’t really understand the optimal dose or type or frequency of exercise,” she explains. “But it’s very clear that cardio exercise helps boost cognitive function.” Studies also show that older adults who exercise have better cognitive performance than those who aren’t active.

Beyond exercise, the 2024 report of The Lancet Commission on Dementia prevention, intervention, and care identified 13 additional modifiable risk factors at different stages during the life course. These include hearing loss, traumatic brain injury (TBI), hypertension, heavy drinking, obesity, smoking, depression, social isolation, physical inactivity, type 2 diabetes, air pollution, high cholesterol, untreated vision problems, and lower levels of education in early life. Notably absent from that list? Crossword puzzles.

Why puzzlers seem to stay sharper with age

If the research suggests that several other lifestyle interventions play a stronger role in brain health, then why does it appear to the general public that those who do puzzles stay sharper in old age? One possibility: puzzle enthusiasts may already be doing many of the right things. They’re often more educated—a factor the Lancet identifies as a key modifiable risk for dementia—and they may be more likely to follow other brain-healthy habits, like staying socially engaged and physically active.