Boosting the Brain

News from earlier this year that a brain-boosting “game” called Double Decision could counter the cognitive decline associated with aging didn’t make much of a splash.

For one, the game itself is grueling to play. But more importantly, the recent explosion of new knowledge about brain health—how to boost it and how to improve modifiable risk factors—points to overwhelming benefits of activities that involve novelty, movement, and conversation.

In contrast, skills gained from doing any single exercise—from crossword puzzles to Angry Birds—don’t transfer or generalize well to daily life skills, such as memory and reasoning. Worse, spending time on anything sedentary and/or solitary goes against the ubiquitous advice to exercise and socialize. What has an impressively strong effect on brain health, starting with learning in early infancy, is conversation — with the unpredictability of another (human) speaker creating a barrage of novelty.

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When you try something new, your brain will attempt to rely on old networks that it already built, but when that doesn’t work, it will try to create new networks — the scientific theory of neuroplasticity, explains the University of Washington website rightasrain.com. Benefits increase with anything that involves a physical component, like dancing or playing a new sport. Adding novelty to activities you already enjoy is a good option, for example: if you love reading fiction, try another genre like poetry.

New activities also help build cognitive reserve, composed of “neural networks that are resilient and can maintain function even when there’s damage to brain cells,” according to Brownhealth.org. The chart on this site provides examples of activities that “target and train the different areas of the brain:” for attention/concentration, card games and Monopoly; for memory, Trivial Pursuit and Guess Who?; for language, Boggle and Scattergories; for visuospatial ability, word search and video games; and for executive functions, chess and Clue.

Crossword puzzles led to greater improvements in memory and brain health than other types of brain-training games in an 18-month study of adults with mild cognitive impairment, according to K2med. And researchers are currently studying those who regularly do jigsaw puzzles to see the effects on their cognitive abilities. In a large review of 22 studies, an array of “complex mental activities like reading books, playing checkers, or solving crosswords or other puzzles” reduced the risk of developing dementia by 46% over a 7-year period.

“Engaging in these activities is like a workout that helps keep the brain fit… just like you can work out different muscles,” according to NeuroGrow Brain Fitness Center neurologist Majid Fotuhi. In another study of 2,800 people older than 60 with no cognitive decline, a variety of brain games, including computerized games, led to “improvements in memory and thinking tests, with some improvements maintained after 10 years.”

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The success of the Double Decision computer game, developed at NIH, is “the strongest evidence yet that cognitive training can lead to lasting changes in the brain,” NYU cognitive neurologist Thomas Wisnieswki told NBC. Director of the Johns Hopkins Alzheimer’s Disease Research Center, Marilyn Albert, called the research results “very surprising,” and said she “would recommend [the game] to patients over 65.”

Part of the large ACTIVE (Advanced Cognitive Training for Independent and Vital Elderly) study, the Double Decision research involved 3,000 participants age 65 and older, a majority of whom were women — who develop dementia at “nearly twice the rate of men,” according to the NBC report. (Dementia is the umbrella term for several diagnoses, of which Alzheimer’s is the most common.) One group of participants worked on memory while another worked on reasoning.

The third group played Double Decision, designed to teach the brain how to process visual information more quickly and accurately. In the game, players must keep track of two items—for example, a car and a road sign—that change or move unpredictably around a screen in increasingly short flashes. This group played the game for 10 sessions, each lasting 60 to 75 minutes, twice a week for five weeks. Half received “booster training” of four additional sessions one to three years afterwards.

In a follow-up review 20 years later, only Double Decision players who had the booster sessions showed cognitive improvement—and a 25% decrease in the risk of a dementia diagnosis. One explanation, according to Albert, is the game’s reliance on implicit learning, used in learning to ride a bike, that can last a lifetime. (One example of explicit learning, by contrast, is using flash cards to build vocabulary.) Also potentially advantageous for the brain, Double Decision is adaptive, with difficulty—the speed of the flashing images—changing based on performance.

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“Repetitive to the point that it’s torture” is how retired research scientist psychologist Paula Williams described Double Decision, on a now-deleted Reddit post. “I hate it so much I will never use it again.” The developer of Double Decision, brain plasticity researcher Michael Merzenich, participated in the invention of the cochlear implant and years ago helped design a program called FastForword, which worked by increasing audio speeds to help young students read better and process information more quickly.

Working on FastForword was also unpleasant enough that many kids begged to quit. But the exercises provided a rare, evidence-based route for kids who performed poorly in school—which as a parent, I was grateful for—as Double Decision may do for those facing declines in cognitive health. As long as the brain’s complexity continues to make it difficult to measure improvement, or until there are better strategies for upping mental performance, these games have offered glimmers of hope.

My one attempt at Double Decision was so mind-numbing that I quit after about three minutes. Looking for more appealing ways to boost my brain, I was grateful for NeuroGrow Brain Fitness Center neurologist Majid Fotuhi’s report “that even the simple act of reading and writing can make a person less likely to… experience cognitive decline;” and for 2024 research that linked writing by hand with cognitive activation.

But the best brain-boosting evidence supports another favorite activity: the exercise/socializing combination of walking while talking with friends.