Take a moment to look at the patients in your waiting room. Many are likely locked on to their smartphones, and some may be among the millions playing Wordle, a puzzle that gives players six chances to guess a five-letter word.

The rise of Wordle got the attention of The New York Times, which added the game to its suite of brainteasers for a sum estimated in the low seven figures. A game with a massive following has monetary value, but do games like this also have clinical utility?

Game on

The world’s population increasingly has a touch of gray, according to the WHO. Globally, there were 1 billion people over the age of 60 in 2019. The WHO estimates that there will be 1.4 billion in this age category by 2030 and 2.1 billion by 2050. Efforts to stave off cognitive decline may prove essential for this aging population.

Cognitive games are one way to do it. A 2020 meta-analysis published in Scientific Reports offers some insights. 

Researchers examined whether computer-based games could improve various cognitive measures among a group of people over the age of 60 without cognitive impairments. The researchers reviewed 16 studies comprising more than 1,500 participants. Among the findings were statistically significant improvements in processing speed, working memory, executive function, and verbal memory. 

There was no relationship between the participant’s age and the amount of training required. This suggests that healthy older adults retain the ability to learn as they age.

For clinicians, the researchers suggested including commercial computerized cognitive games among their recommendations to older patients to help them avoid cognitive decline and maintain cognitive abilities. Such games should be used in combination with healthy lifestyle, aerobic exercise, and other methods of brain training, the researchers wrote.

The games assessed in this study were, for the most part, developed explicitly to improve cognitive performance. This is not the case with Wordle. However, other research indicates that more conventional games—and even some classics—have their clinical benefits.

Get on board

How about a game of chess, bingo, cards, or a crossword puzzle? If your patients aren’t tech-savvy, a 2019 longitudinal cohort study published in The Journals of Gerontology suggests that games of the old school, analog variety are associated with less relative cognitive decline. 

This study Included 1,091 people living in Scotland. All were born in 1936 and were living independently in their communities throughout the study. Cognitive function was assessed at age checkpoints starting from age 11 up to age 79, using 14 cognitive tests. The assessments at age 11 served as controls. Later in life, at ages 70 and 76, researchers asked the participants if they were still playing analog games.

Those who gamed more frequently tended to exhibit the following:

• At age 70, elevated cognitive function, the majority of which could not be attributed to control variables.

• From age 70 to 79, less general cognitive decline and less memory decline.

• From age 70 to 76, less of a drop in cognitive speed among those who increased their gaming

The researchers note that, for clinicians, the difficulty lies in the application of these findings.

“It will be a challenge to determine how best to apply these findings in practice, as our results suggest that a lifetime of playing games is the best way to capture the benefits,” the researchers wrote. Acknowledging that evidence is still limited, they stated that “there do not appear to be any harmful effects of playing games. Thus, analog games are an affordable and fun activity that could protect against cognitive decline.”

Digital games, real-world benefits

While analog games are helpful, research indicates that asking aging patients to pick up a game console controller may be beneficial for them, too.

A 2020 systematic review published in Games for Health Journal combed five databases to identify articles that could shed light on whether video games promoted physical and mental health among people age 65 and older. Of the 806 articles they found on this topic, 23 met their  inclusion criteria.

Among those 23 studies, 20 demonstrated that video games improved physical health, and 14 showed that they promoted mental health. 

For physical health, researchers found that video-game interventions improved walking/gait, fitness, strength, mobility, and balance. 

Mental-health benefits included better processing speed, executive function, reaction time, and confidence in one’s balance. The most popular intervention was Exergame, a platform that blends physical exercise with digital interfaces, emulating a videogame experience.

The researchers concluded that additional research may firm up a surprising hypothesis:

“We also found that videogame-based interventions could outperform traditional training programs regarding walking performance/gait parameter, balance confidence/fear of falling, and executive functions. However, our review could not find any articles that reported direct social health outcomes.”

Sources

1. Altschul DM, Deary IJ. Playing analog games is associated with reduced declines in cognitive function: a 68-year longitudinal cohort study. J Gerontol B Psychol Sci Soc Sci. 2020;75(3):474-482.

2. Ageing. World Health Organization. 2022.

3. Bonnechère B, Langley C, et al. The use of commercial computerised cognitive games in older adults: a meta-analysis. Sci Rep. 2020;10:15276.

4. Tracy M. The New York Times Buys Wordle. The New York Times. January 31, 2022.

5. Xu W, Liang HN, et al. Health benefits of digital videogames for the aging population: a systematic review. Games Health J. 2020;9(6):389-404.