
Puzzle-solving 'doesn't slow down mental decline in older people' - open-source-ux
https://www.nhs.uk/news/older-people/puzzle-solving-doesnt-slow-down-mental-decline-older-people/
======
tannerc
This is a fascinating share, if not for the results—"None of the measures of
intellectual engagement was linked to the speed of decline of people's mental
abilities over time"—but for the study itself.

"Many people also dropped out of the study. Only 96 of the 498 people
recruited took part in the last round of testing. The researchers lost touch
with 13 people, while 57 people died and 332 declined to take part."

Do studies like this often reach the front page of HN?

~~~
ojbyrne
This is a cohort study conducted over 15 years. You can't really criticize it
only based on those numbers, at least not without looking at similar numbers
from other cohort studies with the same length.

I tend to ascribe some value to "It was published in the peer-reviewed British
Medical Journal."

Additional thought: Especially because it is essentially supporting the null
hypothesis.

~~~
joe_the_user
_You can 't really criticize it only based on those numbers, at least not
without looking at similar numbers from other cohort studies with the same
length._

Well, one can't criticize the quality of the study without looking how well
other studies did. But even if all studies involve a massive drop-out rate,
the drop-out rate still seems like something to look at in evaluating the
accuracy of the study.

I mean my concern, looking from the outside, isn't relative accuracy, but
absolute accuracy. Not "is it as good as other studies?" but "it is good
enough that I can rely on it?"

~~~
mjevans
15 -years- is a LONG time for a study. I'm not sure about the dropout rates,
but it is a real statistical issue. I'm just not sure there's anything that
can reasonably be done about it. You'd have to have something like federally
mandated participation / continued participation. That's also very unlikely to
pass ethics boards.

BTW, it would also be an issue if the subjects were compensated to the point
that they differed from the actual population at large.

Fundamentally having more respect for doing things right, the right way, over
the /long/ term, including the STEM fields, would be a 'good thing' for any
society, but particularly western ones (where often the bad/evil antagonist is
based on science or a cold lack of emotions; but the protagonist is based
mostly on emotion and feeling instead of logic).

~~~
joe_the_user
_15 -years- is a LONG time for a study. I 'm not sure about the dropout rates,
but it is a real statistical issue. I'm just not sure there's anything that
can reasonably be done about it._

Everyone keeps replying as if my comments imply a demand that "something be
done about this". That's not my point. Maybe nothing can be done about it. The
situation is still significant or at least appears significant.

~~~
b_tterc_p
Similarly, it may be that running studies like this is really difficult and
that massively reduced sample sizes are something we must accept for practical
reasons... but that doesn’t mean it permits us to ignore statistical
ramifications

------
stevewillows
Anecdotally, my neighbor is in her early 80s and has lived a very sheltered
life.

Recently she did a memory test and nearly aced it (28/30). Since then my
typically... well, clueless... neighbor has taken an interest in learning how
to use stuff like her TV, stereo, talking about better ways to do things
around the yard, etc.

Even with my own mother, the true benefit of puzzles is not that its
exercising her brain or making her smarter, but its the confidence that goes
along with being successful in these things. I think that goes a long way,
even though it may be just a step above sugar pills.

For me, I play Simon Tatham's Portable Puzzle Collection (mobile) every day. I
have a cycle I go through. If I'm having a bad day, a good win at Galaxies
gets me back into the 'you can do this' mindset.

[1]
[https://www.chiark.greenend.org.uk/~sgtatham/puzzles/](https://www.chiark.greenend.org.uk/~sgtatham/puzzles/)

------
TrainedMonkey
But exercise does: [https://www.news-medical.net/news/20160324/Exercise-slows-
do...](https://www.news-medical.net/news/20160324/Exercise-slows-down-
cognitive-decline-in-older-adults.aspx)

~~~
mjfl
I got my genes sequenced recently and it turns out I have a mutant gene that
predisposes me to Alzheimers - APOE e4. it's a cholesterol shuttling gene!
Very important to keep low fat, it effects your entire body.

~~~
stochastic_monk
I hadn’t heard that body fat composition affected Alzheimer’s risk. Out of
curiosity, do you have a reference?

~~~
ekianjo
Body fat is a risk for multiple disease. The general idea is that whenever
viruses enter the adipose tissue they are hard to reach by the immune system.
We dont really understand yet what causes Alzheimer but now there is suspicion
of a viral link.

~~~
whatshisface
There is another hypothesis making the rounds that obesity is linked to
chronic metabolic stress and eventual damage (so far uncontroversial), which
is linked to many separate diseases.

------
anongraddebt
FWIW, I told a good friend to get her dementia-diagnosed father on a schedule
of daily Dual N-Back training using open source programs (e.g. Brainworkshop).
She asked his neurologist how effective this would be and he basically said,
"it's the only cognitive training that could do anything."

Not only is Dual N-Back a great mental workout, but it will also put you to
sleep pretty quickly if you set the parameters such that the task is
sufficiently taxing. Here's one that should make you tired within 15-20 mins.
if you're just starting out:

(1) Set N-Back to 3 (for every category of items that you have to remember,
you are trying to remember the repeats in a string that have two items in
between)

(2) Set number of item categories to 3 (e.g. Shapes, Sounds,
Spatial/Placement, and Colors)

(3) Up the baseline 'randomness' factor or level of pattern obscurity.

I cannot overstate how important (2) is. So many people in the N-Back
community care about maxing out (1). IMHO, the real benefits come when you get
(2) maxed out while keeping an N-Back of 3. THEN, work your way to up to
higher levels of N-Back.

You have a one in a billion short-term memory capacity and don't feel sleepy
yet? Okay, throw in some multiple mentalism exercises while literally in the
middle of doing the N-Back training. Ex.: visually 'recite' the alphabet
backwards in your head with the letters being in mirror image format (so from
'behind').

You'll find it impoasible to get even remotely close to 80% accuracy if you
turn the various parameters up high enough, and you'll have an easy way of
falling asleep.

~~~
sethrin
That seems like quite a strong claim. This would need to be supported by
extraordinary empirical evidence. It's rather difficult for us to
independently verify your friend's neurologist's word. Do you perhaps have
some scientific studies to hand which might demonstrate the efficacy of this
treatment?

~~~
anongraddebt
My claim is only that a single neurologist said if any cognitive training
might help, then N-Back training would be it. I have no other evidence other
than my friend's testimony. Say the neurologist did say this, what's the
implication? That you have defeasible justification for trying N-Back
training, on recently diagnosed dementia patients, if you've already made the
decision that cognitive training is worth pursuing (along with other
treatments).

~~~
sethrin
Hearsay and anecdote are not useful for determining the empirical validity of
a theory or therapy. I don't know you, and I have no idea if your reporting is
accurate, or if so, who this neurologist might have been, or whether they are
trustworthy, and even if they are, I don't have any information as to whether
this specific opinion is sound. Without empirical evidence, there is no
objective reason to believe any part of this claim.

~~~
anongraddebt
You are right that hearsay and anecdote are not useful for determining the
empirical validity of a theory or therapy. However, hearsay and anecdote have
been useful a million times over in helping people solve problems or
challenges they've faced at certain times and in certain places (whether fully
or partially).

People you don't know will tell you things like, "Do crossword puzzles. That
will keep you sharp." I'm someone you don't know, and I'm telling you, "If
you've decided to do some cognitive training, you should give N-Back training
a try in the manner I described."

Maybe it will help you sleep on a night where you have trouble sleeping. Maybe
it helps your mental acuity. Maybe nothing. Maybe it will be a waste of 30
minutes for you.

~~~
sethrin
I have no idea why you think that any of this might be persuasive. Do you
really do what random people on the Internet tell you, with no evidence, just
because they say it's a good idea? And were I to accept this proposal, there
are no conditions for success or failure: a willing mind would make for any
number of _post hoc ergo propter hoc_ fallacies.

Empiricism is a much more reliable way to know things than hearsay: this is
the general reason for the push towards evidence-based medicine. There is
every reason to reject unproven therapies, and what you are offering can not
be distinguished from fiction. If you want to make a convincing case for this,
you have no alternative but empirical evidence.

Personally, if programming, playing an instrument, drawing, learning
languages, and studying mathematics, physics, and history aren't enough to
keep my mind sharp, I'm probably not going to worry too much about it.

~~~
anongraddebt
I'm not sure what your argument is.

This is an example of hearsay and anecodote:

"Hey Joe, this brand of probiotic worked well for me. You should give it a
try."

After hearing that, should Joe then look for meta-analyses of the
effectiveness of different probiotic brands, or does he have defeasible
justification for trying it out? Maybe you'll say a search for meta-analyses
is too stringent, but that you could at least look at anonymous reviews on
Amazon. Fine. Then go look at collections of anonymous anecdotal reports in
the N-Back community.

You keep trying to describe a form of rigid empiricism, as-if I don't actually
know or care about epistemology. I did a concentration in philosophy of
science in undergrad, and was an editor/reviewer for an entry on the
philosophy of science in the Stanford Encyclopedia of Philosophy. I'm not
unfamiliar with empiricism.

~~~
sethrin
Joe should ignore unproven therapies, particularly when accompanied by
grandiose claims, and especially when the proponent refuses point-blank to
substantiate said claims. Probiotics are another good example of an unproven
therapy, but with substantially more evidence against their efficacy. Joe
should certainly read meta-analyses about such things, and avoid quackery --
and others should avoid spreading quackery.

------
hmahncke
This is a nice study, and confirms earlier work by Tim Salthouse (University
of Virginia [1]), looking at more than a thousand people (cross-sectionally),
and evaluating their cognitive function and crossword puzzling activity. At
every age, people who did more crossword puzzles had better cognitive activity
- but the rate of cognitive decline was identical regardless of crossword
puzzle use. This was interpreted (as in the current study) as showing that
people who are sharper do more crossword puzzles - but doing crossword puzzles
doesn't make a person shaper or change the rate at which a person becomes less
sharp.

[1] PDF:
[https://pdfs.semanticscholar.org/5237/69252dd1d49cbd473844c0...](https://pdfs.semanticscholar.org/5237/69252dd1d49cbd473844c004336920e0087f.pdf)

------
jspash
As an aside, the NHS website is an absolute joy to use. From the legibility of
the type to the navigation, also the style of writing is generally top notch
IMHO.

Regarding the design, I remember when Google products gave me a similar
feeling. Sadly, with "Material Design" usability has sunk to some weird place
where I continually ask "where do i click? what CAN i click? stop sliding
things around!" in frustration.

Apologies for going off topic (and the mini rant).

~~~
thom
Worth pointing out that a lot of the good work NHS Digital do is inspired[1]
by approach that the Government Digital Service did on other public service
sites[2]. Over the last 5-10 years, basically every UK government website I've
had to click on has slowly become sane and usable because of the GDS's work.

1: [https://digital.nhs.uk/blog/transformation-
blog/2018/definin...](https://digital.nhs.uk/blog/transformation-
blog/2018/defining-digital-standards-for-the-nhs)

2: [https://www.gov.uk/service-manual/service-
standard](https://www.gov.uk/service-manual/service-standard)

~~~
qwerty456127
Other governments all over the world should really copy that...

~~~
kace91
Absolutely. I can tell apart my country's official government sites from scams
because the legit one will give warnings about it being potentially
dangerous... Certificates that won't work, services that can only be used
during business hours, and similar dumbfounding behaviour is all over the
place.

------
Angostura
I really enjoy the write-ups that the NHS does for these news analysis pieces.
Informative, well pitched voice - in my opinion. Trustworthy

~~~
open-source-ux
I agree. The A-Z of health conditions is also excellent:

[https://www.nhs.uk/conditions/](https://www.nhs.uk/conditions/)

------
joshuarcher
Whenever the news reports findings of a new study, they should format it this
way..

------
djsumdog
There's been a long standing idea that dementia and Alzheimer can be prevented
by mental exercise. It intuitively seems like a good hypothesis, but as this
an other studies in the comments show, it's not true.

It is difficult to really test for this though, because you can't control for
people's amount of mental exertion, gaming, learning and puzzle solving over
their entire lives, so we substitute things like "knows more than one language
fluently," something we can objectively measure and see if there's a
correlation. This particular study used a group of people that took the same
intelligence test when they were young.

There's been some research that shows some older people's brains have trouble
metabolizing glucose and other sugars, and that diets that push ketosis in
older people (higher fats, coconut oil, less cereal/crabs) can help some
people:

[https://www.youtube.com/watch?v=yooNuOKsa1Q](https://www.youtube.com/watch?v=yooNuOKsa1Q)

------
sn41
Another activity that I have heard as slowing down mental decline is dancing:

[https://blog.frontiersin.org/2017/08/29/dancing-can-
reverse-...](https://blog.frontiersin.org/2017/08/29/dancing-can-reverse-the-
signs-of-aging-in-the-brain/)

Regardless of this dubious study, I will continue to solve crosswords. Cryptic
crossword solvers were prized in Bletchley Park, since it was seen as evidence
of lateral thinking. [1] I used to look down upon quick crosswords since they
were too direct, but lately I have tried to time myself solving quick
crosswords, and I find that they can be challenging as well when tried in a
genuine quick mode - they involve jogging the memory at a very fast rate.

[1] [https://www.telegraph.co.uk/history/world-war-
two/11151478/C...](https://www.telegraph.co.uk/history/world-war-
two/11151478/Could-you-have-been-a-codebreaker-at-Bletchley-Park.html)

------
ww520
They ought to have a study on whether playing fast paced video game shows down
mental decline.

~~~
sandos
Not related to memory, but I have had trouble with balance issues for years,
and I'm only 38 years old. Now I got a Xbox One X recently, which means, of
course, increased gaming. I'm not 100% yet but it does seem to have almost
wiped my balance issues. I was always feeling nauseous and tired when, for
example, moving my head too quickly sideways, or simply driving a car.

Its not outside the realm of possibility, my hypothesis is that I am very
visually dependent when it comes to my sense of balance. Lots of fast-moving
visual stimuli without any input to my balance organ probably tunes my brain
to not use my eyes as much. There is also something called "Roll adaptation"
which is rolling the head under visual stimuli that does not match. Maybe I
should roll my head when gaming for even better effect...

------
raphar
I really liked the shared article.

In contast to what other news sources publish, this article links the original
paper, reviews the metodology, gives some introductory explanations on the
subject and provides all sorts of 'further reading' resources.

Really enjoyed it, thanks for sharing!

------
p1necone
Seems to me that even if it didn't slow down the "rate" of mental decline,
starting from a higher point because of "brain training" for want of a better
term would still be good, no?

~~~
hmahncke
Yes, but you don't really get to pick your starting point - in the study,
cognitive function at age 11 predicted crossword puzzle use and eventual
cognitive decline. So if you're fortunate enough to be sharp at age 11 (thanks
to your genes, your parents, and your environment), then you're in great
shape. But that's not a solution that can be applied to all of us.

------
djpowell
The whole of the NHS 'Behind the Headlines' blog is fantastic btw; taking
newspaper stories, looking at the studies behind them and sifting out the
truth from the sensationalism.

------
siliconunit
Lots of highbrow denial:D /sarcasm

------
markrages
... but Lumosity!

------
george-marshall
This is a test

------
buboard
i wish they 'd suggest "programming" instead of puzzle solving. i mean, it's a
form of puzzle solving, but it s also useful in real life.

~~~
whoisjuan
"Doesn't slow down mental decline"... They're not suggesting anything. They
are summarizing the conclusion of the study which determined that intellectual
engagement may not offset age related cognitive decline.

~~~
dang
> _Did you even read the article?_

Please edit such swipes or nasty tropes out of your comments here. This is in
the site guidelines:
[https://news.ycombinator.com/newsguidelines.html](https://news.ycombinator.com/newsguidelines.html).
We're trying for a bit better than internet median in HN discussions.

~~~
whoisjuan
Done. I wouldn't go as far as calling it a "swipe or nasty trope". The
guideline just says to avoid this type of insinuations.

~~~
dang
Thanks for the edit. It helps.

------
TangoTrotFox
Chess seems to show the opposite. In particular speak with literally just
about any older grandmaster and you'll invariably find their mental faculties
are still in great shape. Of course there's always a correlation != causation
problem that plagues all sort of social studies. This observation does not
necessarily mean that becoming a grandmaster would slow mental decline. It
could simply be something within the individuals that drives them to become
grandmasters that itself is what staves off the decline.

Ultimately I'm not entirely sure what the point of science along these lines
even is. The big risk is you notice a correlation to something and assume
causation. You then start working to try to pursue that end in cases where the
correlation is good - or avoid that end in cases where the correlation is bad.
And you spend immense energy and resources doing this, only to find that in
the end there was no actual causation at all and you just spent immense
amounts of time, energy, and resources doing nothing.

Even worse is that sometimes you might pursue the correlation and falsely end
up at the desired end thus assuming causality when none exists. Maybe the best
example of this is human/animal sacrifice of ancient civilizations. Those
sacrifices were not baseless from their perspective. What undoubtedly happened
is that at one point a civilization has e.g. a bad harvest. They feel they
must have wronged the gods, so they end up sacrificing something. And,
completely by coincidence, the next harvest is bountiful. Lo and behold, you
now have centuries of human and animal sacrifice in a model where you can
ignore any negative outcomes by suggesting it simply means that you didn't
sacrifice enough. Keep ramping up the sacrifices and indeed eventually you'll
get a good harvest, but it has absolutely nothing to do with the sacrifices
you've made.

~~~
gnode
> It could simply be something within the individuals that drives them to
> become grandmasters that itself is what staves off the decline.

Or it could just be survival bias. If your mental faculties are in decline,
then you would be disinclined to continue competing in chess. I can imagine
people would stop competing at that level long before they completely lost
their marbles.

~~~
TangoTrotFox
People generally reach grandmaster when they're very young and I'm not
restricting my statement to only those that continue to play in international
tournaments. One may retire from high level competitive chess, but people
rarely give up the game altogether.

