Alzheimer’s disease is a progressive neurodegenerative disorder and the most common cause of dementia, characterized by a gradual decline in memory, thinking, and behavioral skills severe enough to interfere with daily life. Since no cure is currently available, public interest is high in non-drug interventions that might delay the onset or slow the progression of this condition. The potential role of video games has captured significant attention among the various lifestyle activities being investigated. While research has shown benefits for specific cognitive functions, the evidence for outright prevention requires a closer look at the underlying brain mechanisms and the types of games studied.
How Cognitive Activity Impacts Brain Health
The hypothesis that mental stimulation, such as playing video games, can influence dementia risk is rooted in two key concepts. The first is neuroplasticity, which describes the brain’s ability to reorganize itself by forming new neural connections and strengthening existing ones throughout life. This adaptability allows the brain to continually learn and adjust its structure and function in response to new experiences.
Another element is cognitive reserve, which acts as a buffer against damage or disease. Individuals with high cognitive reserve can better cope with the brain pathology associated with Alzheimer’s disease before showing clinical symptoms of decline. This reserve is built up over a lifetime through mentally stimulating activities, education, and social interaction. Cognitive activity strengthens the efficiency of neural circuits and improves prefrontal network function.
While the underlying physical changes of Alzheimer’s disease may still occur, greater cognitive reserve allows a person to function normally for a longer period. The goal of cognitive training is not to stop the disease but to build up this reserve, allowing the brain to work more efficiently and compensate for damage.
Categories of Games Studied for Brain Function
Not all video games offer the same type of cognitive exercise; research categorizes them based on the specific mental demands they place on the player.
Action and Strategy Games
Action and strategy games, such as real-time strategy (RTS) titles, require intense perceptual skills and rapid decision-making under pressure. These games have been linked to improvements in top-down attention, spatial cognition, and psychomotor speed. The fast pace demands that players track multiple objects and rapidly switch between tasks, enhancing attentional control and processing speed.
Puzzle and Role-Playing Games
Puzzle and platform games focus more on internal mental manipulation and problem-solving. These genres are often associated with gains in visuospatial working memory and visual search performance. Role-playing games (RPGs) have also been studied, showing positive associations with verbal working memory and short-term visuospatial memory.
Specialized Cognitive Training
A third category includes specialized cognitive training programs, which are often proprietary apps designed to target narrow cognitive domains. These interventions aim to improve specific functions like processing speed, attention, or executive function through repetitive, tailored exercises. While these games are built on cognitive principles, the benefits gained are often highly specific to the task trained, rather than translating to a broad enhancement of all mental faculties.
Research Findings on Delaying Decline
Current scientific evidence suggests that video games can be an effective tool for improving and delaying the decline of specific cognitive skills. However, they do not yet have definitive evidence to prevent Alzheimer’s disease pathology itself. Studies involving computerized cognitive training, including commercial “brain games,” have shown modest benefits in older adults and those with mild cognitive impairment (MCI) in areas like attention, processing speed, and executive functions. One type of digital training, known as “exergaming,” combines physical exercise with interactive play and has been associated with positive changes in brain matter and improvements in global cognition for some individuals with MCI.
A primary distinction in the research is the difference between improving cognitive performance and preventing the neurodegenerative disease. While games may sharpen the mind and increase cognitive reserve—making the brain more resilient to the effects of the disease—there is no conclusive evidence that they stop the formation of amyloid plaques or tau tangles, the biological hallmarks of Alzheimer’s. The observed benefits often relate to delaying the manifestation of symptoms by improving the brain’s efficiency.
Longitudinal studies, such as the ACTIVE trial (Advanced Cognitive Training for Independent and Vital Elderly), show that training can lead to sustained improvements in the specific cognitive function that was practiced, such as processing speed. However, the current research is limited by methodological shortcomings and the lack of long-term studies tracking participants over decades to confirm true prevention. More rigorous and long-term trials are necessary to fully understand the potential of video games for delaying the onset of dementia.
The Role of Lifestyle Factors Beyond Gaming
While video games contribute to cognitive health, they are only one component of a holistic strategy for reducing the risk of cognitive decline. Evidence-based factors have consistently demonstrated a protective effect on brain health.
Physical Activity
Regular physical activity, particularly aerobic exercise, is recommended, as it increases blood flow to the brain and helps preserve brain volume. The World Health Organization suggests adults aged 65 and over aim for at least 150 minutes of moderate-intensity aerobic physical activity each week.
Diet and Cardiovascular Health
Dietary choices also play a significant part. The Mediterranean and MIND diets are the most studied for their association with reduced cognitive decline risk. These diets emphasize consumption of fish, nuts, whole grains, olive oil, and fresh produce while limiting red meat and sweets. Managing cardiovascular health, which includes controlling blood pressure, diabetes, and obesity, is also recognized as a way to protect the brain.
Social and Behavioral Factors
Social engagement, not smoking, and minimizing alcohol consumption complete the set of proven lifestyle changes. These factors offer the most comprehensive approach to maintaining a healthy brain throughout life.