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Using Puzzles in Dementia Prevention and Treatment
Peer-reviewed Journal articles related to how puzzles assist in dementia prevention and therapy for memory loss
Crossword Puzzles Delay Dementia Onset — Bronx Aging Study (PMC/NIH)
This is one of the most-cited studies in this area. Researchers followed 488 initially cognitively intact individuals with assessments every 12–18 months, and found that crossword puzzle participation at baseline delayed the onset of accelerated memory decline by 2.54 years in people who later developed dementia. The effect held even after accounting for education or participation in other cognitively stimulating activities.
Pillai, J. A., Hall, C. B., Dickson, D. W., Buschke, H., Lipton, R. B., & Verghese, J. (2011). Association of Crossword Puzzle Participation with Memory Decline in Persons Who Develop Dementia. Journal of the International Neuropsychological Society : JINS, 17(6). https://doi.org/10.1017/S1355617711001111
Crossword Puzzles Beat Computer Games — Duke University/Columbia University RCT
In a randomized, controlled trial led by researchers at Duke University School of Medicine and Columbia University, participants around age 71 with mild cognitive impairment (a high-risk state for Alzheimer's) who trained on computerized crossword puzzles showed greater cognitive improvement than those who trained on computerized cognitive games. Researchers called the results "surprising and important" for reducing dementia risk.
Study Shows Crossword Puzzles Beat Computer Games in Slowing Memory Loss. (2022, November 29). Duke University School of Medicine. https://medschool.duke.edu/news/study-shows-crossword-puzzles-beat-computer-games-slowing-memory-loss
Jigsaw Puzzles Tap Multiple Cognitive Abilities — Frontiers in Psychology (PMC6174231)
In a randomized trial of 100 cognitively healthy adults aged 50+, researchers measured eight visuospatial cognitive abilities including perception, working memory, mental rotation, speed, flexibility, reasoning, and episodic memory. Participants were assigned either a 30-day home-based jigsaw puzzle intervention (at least 1 hour/day) plus cognitive health counseling, or counseling alone. Results indicated that jigsaw puzzling strongly engages multiple cognitive abilities, and that long-term (but not short-term) puzzle experience could meaningfully benefit cognition.
Fissler, P., Küster, O. C., Laptinskaya, D., Loy, L. S., von Arnim, C. A. F., & Kolassa, I.-T. (2018). Jigsaw Puzzling Taps Multiple Cognitive Abilities and Is a Potential Protective Factor for Cognitive Aging. Frontiers in Aging Neuroscience, 10(299). https://doi.org/10.3389/fnagi.2018.00299
Games, Puzzles & Reading Help Even Those with Mild Cognitive Impairment — Texas A&M (2025)
In a randomized, controlled trial led by researchers at Duke University School of Medicine and Columbia University, participants around age 71 with mild cognitive impairment (a high-risk state for Alzheimer's) who trained on computerized crossword puzzles showed greater cognitive improvement than those who trained on computerized cognitive games. Researchers called the results "surprising and important" for reducing dementia risk.
Kellett, A. (2024, September 10). Games, puzzles and reading can slow cognitive decline in the elderly—even in those with mild cognitive impairment - Vital Record. Vital Record. https://vitalrecord.tamu.edu/games-puzzles-and-reading-can-slow-cognitive-decline-in-the-elderly-even-in-those-with-mild-cognitive-impairment/
Jigsawdio: Digital Puzzle Technology for Dementia Patients (PMC10736734)
A 2023 study published in a peer-reviewed journal involved a digital jigsaw puzzle program used twice weekly over six weeks with older adults who had mild to moderate cognitive impairment. Using the Montreal Cognitive Assessment (MoCA) to measure changes, researchers found a significant improvement in cognitive function scores between baseline and post-assessment.
Kim Y, Young A, Lee J, Welsh-Bohmer K, Ory M, Kim J. THE EFFECT OF THE JIGSAWDIO PROGRAM ON COGNITION AMONG OLDER ADULTS WITH DEMENTIA. Innov Aging. 2023 Dec 21;7(Suppl 1):1132. doi: 10.1093/geroni/igad104.3636. PMCID: PMC10736734.
PACE Trial — Jigsaw Puzzles as Cognitive Enrichment (PMC5588550)
Researchers noted that engagement in cognitively challenging activities is associated with a reduced risk for future cognitive impairment and dementia, and that visuospatial dysfunctions are common in diseases like Alzheimer's, Lewy body dementia, and posterior cortical atrophy — making jigsaw puzzles particularly relevant since puzzle-solving performance is highly correlated with visuospatial cognitive ability.
Fissler, P., Küster, O. C., Loy, L. S., Laptinskaya, D., Rosenfelder, M. J., von Arnim, C. A. F., & Kolassa, I.-T. (2017). Jigsaw Puzzles As Cognitive Enrichment (PACE) - the effect of solving jigsaw puzzles on global visuospatial cognition in adults 50 years of age and older: study protocol for a randomized controlled trial. Trials, 18(1). https://doi.org/10.1186/s13063-017-2151-9
Combining puzzle activity with exercise, social engagement, and good sleep appears to have the strongest overall effect. Always worth discussing with a physician or neurologist for personalized guidance!
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