Brain training and dementia

Brain training includes activities to challenge the brain, such as crosswords, Sudoku puzzles and bespoke computer games. Here we discuss the evidence and the claims made by commercial game providers.

Will brain training prevent dementia?

Some studies have found that cognitive training can improve some aspects of memory and thinking, particularly for people who are middle-aged or older.

So far, no studies have shown that brain training prevents dementia. However, this is a relatively new area of research and most studies have been too small and too short to test any effect of brain training on the development of cognitive decline or dementia.

Evidence suggests that brain training may help older people to manage their daily tasks better, but longer term studies are needed to understand what effect, if any, these activities may have on a person’s likelihood of developing dementia.

What are the claims about brain training and reducing dementia risk?

Many people engage in brain training in the hope that keeping their brains active will maintain or improve their cognitive abilities as they get older.

The idea of brain training is based on the concept of 'use it or lose it'. The popular theory goes that the more you regularly challenge your brain the less likely you are to experience cognitive impairment (a reduction in someone’s ability to remember or learn things) or dementia in your later years.

The theory is based on an observation made by some that people who have complex jobs or who regularly participate in activities such as crosswords, puzzles or learning new hobbies throughout life appear to have lower rates of dementia.

Computer-based brain training games have been developed that challenge brain functions such as memory, problem solving and reasoning, abilities that can slow down or worsen with age.

What studies have looked at brain training and dementia?

Observational and interventional studies have looked at the role of brain training activities in older people.

Observational studies

Observational studies collect data about a group of people and look for an association between two or more factors.

The results from several observational studies have indicated that people who do cognitively stimulating activities may have a lower risk of cognitive decline and dementia. This has been reported for people who do the activities in both middle age and in later life. However, this type of study cannot tell us that brain training activities are directly responsible for lower rates of dementia.

Interventional studies

Interventional studies, sometimes called clinical trials, ask groups of people to start doing a new activity and follow them over time to see what effect it has on their brain function.

There have not been any interventional studies looking at the effects of crosswords or Sudoku on cognition and dementia risk in older people but a number of studies of this type have tested computer brain training games.

Most of these studies have been small or have only followed participants over a short time frame so there is a lack of robust evidence to show that brain training games can bring long term cognitive benefits in older people over several years.

A recent study analysed the results of 51 interventional studies. The review indicated that brain training could lead to a small improvement in thinking and memory in older people during the duration of the study. However, the analysis also found that thinking and memory was not improved in older people who used the brain training unsupervised.

The largest study conducted to date testing computer brain training was funded by Alzheimer's Society and involved almost 7,000 people over the age of 50. The brain training package tested in this study challenged people's reasoning and problem solving skills.

The results showed that using this brain training package resulted in improvements in reasoning and remembering words after six months. The more the exercises were completed, the more likely participants were to see improvements in these brain functions.

The study was a randomised controlled trial. This means that some people in the study acted as 'controls', taking cognitive tests but not trying out the brain training games. This type of study is considered rigorous because the researchers can compare the results of those who did brain training with those who didn’t to discover whether the brain training was having an effect.

People over 60 who participated in this study reported that using the brain training packages also improved their ability to get on with their daily activities such as managing a household budget, preparing meals, shopping and navigating public transport.

The PROTECT study

PROTECT is a major UK research study that aims to understand how healthy brains age and why people develop dementia.

It will also investigate which factors in mid-life affect our risk of dementia, such as exercise and diet. This knowledge will help develop better approaches to prevent and treat dementia in the future.

It is run by the University of Exeter and Kings College London, in partnership with the NHS.

Commercial brain training games

There are a large number of commercial brain training games or products on the market, some of which have been tested in research studies but the majority have not. It is not possible to apply the results of studies that test a particular training package to all brain training games because they may be designed to challenge a different kind of brain function.

People should be cautious if they find commercial packages that claim they can prevent or delay cognitive decline as the evidence for this is currently lacking. Recently, one of the leading providers of commercial brain training games was fined for making false claims about the benefits of their product.