Playing board games may protect against cognitive decline and even boost cognitive function in seniors, new research suggests.

Results of a large, longitudinal study showed that higher frequency of playing board games, which are also known as analog games, seemed to guard against cognitive decline.

Even among individuals in their 70s, those who played more board games experienced less decline in memory and other cognitive measures compared to their counterparts who either did not play board games or who played fewer board games.

"Playing games might have a modest effect on the healthy decline of cognitive abilities, but this study was not an intervention, so we do not have surefire causal evidence," lead author Drew M. Altschul, PhD, a research fellow in cognitive epidemiology, University of Edinburgh, United Kingdom, told Medscape Medical News.

"Playing games can be seen as one facet in a healthy lifestyle that consists of other behavioral modifications a person can make, such as getting more exercise, not smoking, not drinking to excess, and eating healthier foods [all of which] might be beneficial for healthy cognitive aging," he said.

The study was published online November 18 in the Journals of Gerontology: Psychological Sciences.

Exceptional Dataset

"Computerized brain training is a controversial subject at the moment, as are the effects of analog games on cognitive functions — although analog games are much less studied," Altschul said.

Previous studies of analog games have been limited because they have not examined cognitive changes over time or they have not controlled for confounding effects.

The researchers used data from the Lothian Birth Cohort of 1936 (LBC1936) — a community-dwelling sample of 1091 initially healthy individuals born in 1936.

At age 11 years, participants received a group-administered intelligence test (the Moray House Test–12), which included word classification, proverbs, spatial items, and arithmetic.

Participants received cognitive and health testing in four waves:

Age 70 (n = 1091)

Age 73 (n = 866)

Age 76 (n = 697)

Age 79 (n = 550)

The LBC1936 "is exceptional because we have early-life measures of many variables, as well as many cognitive tests from the eighth decade, and a variable in which the participants told us how often they played games," said Altschul.

Participants were required to be free of dementia and cognitive impairment; 11 participants were excluded from the analysis at age 70, and another 37 were excluded because they had developed dementia or cognitive impairment between ages 70 and 79.

At age 70, participants were asked how often they engaged in playing games (eg, cards, chess, bingo, or crosswords). At wave 3 (age 76), the researchers also assessed whether individuals reported any increase in the frequency of game playing between ages 70 and 76 and, if relevant, the degree of change.

Potential confounders included sociodemographic variables (sex, years of education, and social class); other activities in which participants might have engaged; and medical risk factors for cognitive decline (history of hypertension, stroke, diabetes, or cardiovascular disease).

"Key Results"

At age 70, 33% of participants reported playing games daily or nearly every day, and 20% played games less than once a year or never. The remaining participants fell in between.

The largest number of participants reported playing daily; the second-largest number of participants reported playing less than once a year or never — a distribution the researchers described as U-shaped.

Some participants changed their game-playing habits between the ages of 70 and 76, with 160 playing more games than they had prior to age 70.

A regression analysis showed that playing games was positively associated with cognitive function at age 70 (std β = 0.094; t = 4.07; P < .001). Higher cognitive function at age 11, female sex, higher social class, and higher educational level were also associated with higher cognitive function at age 70.

In addition, those who played more games during that period experienced positive change in cognitive function, with "visible" changes between individuals who were more vs less frequent game players (std β = 0.095; t = 4.07; P < .001) — a finding the researchers called a "key result."

Lower cognitive function at age 11, female sex, higher social class, and higher educational level were associated with positive cognitive change that was calculated to be equivalent to a gain of approximately 1.42 IQ-like points per standard deviation (SD) increase in playing games.

Using a model of expected life course relationship among the variables, the researchers found that cognitive function at age 11 "has a positive downstream association with education, social class, and age 70 cognitive function, as well as playing games."

Even after controlling for the direct and indirect associations of age 11 function, education, and social class, playing more games was still associated with higher cognitive function at age 70 (std β = 0.083; z = 3.24; P = .001).

"In this model, there was a 1.25 IQ-like point gain from age 11 to age 70 per standard deviation increase in playing games," the authors comment.

Although there was a mean cognitive decline across the eighth decade in all participants, the decline was "more severe" in less-frequent game players.

However, another key result obtained using latent growth curve models showed that playing more games was associated with less decline in general cognitive function from age 70 to age 79 (β = .068; z = 2.523; P = .012).

In particular, reduced decline was significant for the memory and processing speed subdomains (β = .204; z = 3.114; P = .002; and β = .110; z = 2.689; P = .007, respectively) but did not reach significance for the other domains.

In IQ-terms, 1 SD of increased game playing was associated with a 1.02-point less reduction in general cognitive ability and a 3.06-point less reduction in memory ability during the years between ages 70 and 79.

"For members of the general public, playing games might help with cognitive aging, and it certainly wouldn't hurt," Altschul said.

Fun, Inexpensive, Beneficial

Commenting on the study for Medscape Medical News, Ria Vaportzis, PhD, lecturer in psychology, School of Social Sciences, University of Bradford, West Yorkshire, United Kingdom, noted that the study sample is unique.

"There aren't many data available that allow us to look at people's cognitive function over such a long period of time — it basically looks at people's lifetime, [which is] not something we can easily replicate."

It is, however, "difficult to make any practical suggestions based on the findings, given that some of the data were collected retrospectively," Vaportzis, who was not involved in the study, added.

Nevertheless, "analog games are widely available, they can be a cheap and fun activity that can keep people engaged both mentally and socially, so the bottom line is that they do no harm, and there's some evidence that they can be potentially good."

Altschul agreed.

"Games are an inexpensive way to have fun, spend time with people you care about, and maybe do something positive for your brain health," he said.

The study was supported by the University of Edinburgh Center for Cognitive Ageing and Cognitive Epidemiology, which is funded by the Biotechnology and Biological Sciences Research Council and the Medical Research Council. Altschul is funded by an MRC Mental Health Data Pathfinder award. The LBC1936 data were collected using a Research Into Ageing Program grant; this research continues as part of the Age UK-funded Disconnected Mind project. Altschul, his study coauthor, and Vaportzis report no relevant financial relationships.

J Gerontol B Psychol Sci Soc Sci. Published online November 18, 2019. Full text

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