Journal of the International Neuropsychological Society


Association of Crossword Puzzle Participation with Memory Decline in Persons Who Develop Dementia

Jagan A. Pillaia1a2, Charles B. Halla3a4a5, Dennis W. Dicksona5a6, Herman Buschkea3a5, Richard B. Liptona3a4a5 and Joe Verghesea3a5 c1

a1 Department of Neurosciences, University of California San Diego, San Diego, California

a2 Department of Neurology, VA Medical Center San Diego, San Diego, California

a3 Saul B. Korey Department of Neurology, Albert Einstein College of Medicine, Bronx, New York

a4 Department of Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, New York

a5 Einstein Aging Study, Albert Einstein College of Medicine, Bronx, New York

a6 Department of Neuroscience, Mayo Clinic, Jacksonville, Florida


Participation in cognitively stimulating leisure activities such as crossword puzzles may delay onset of the memory decline in the preclinical stages of dementia, possibly via its effect on improving cognitive reserve. We followed 488 initially cognitively intact community residing individuals with clinical and cognitive assessments every 12–18 months in the Bronx Aging Study. We assessed the influence of crossword puzzle participation on the onset of accelerated memory decline as measured by the Buschke Selective Reminding Test in 101 individuals who developed incident dementia using a change point model. Crossword puzzle participation at baseline delayed onset of accelerated memory decline by 2.54 years. Inclusion of education or participation in other cognitively stimulating activities did not significantly add to the fit of the model beyond the effect of puzzles. Our findings show that late life crossword puzzle participation, independent of education, was associated with delayed onset of memory decline in persons who developed dementia. Given the wide availability and accessibility of crossword puzzles, their role in preventing cognitive decline should be validated in future clinical trials. (JINS, 2011, 17, 1006–1013)

(Received November 15 2010)

(Revised July 12 2011)

(Accepted July 13 2011)


  • Dementia;
  • Cognitive decline;
  • Puzzles;
  • Memory;
  • Elderly;
  • Neuropsychology