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How Sudoku Can Provide Neurorehabilitation for Patients with Alzheimer's

Assessed and Endorsed by the MedReport Medical Review Board


 

Introduction

As Andrew Wiles perfectly elucidated, "Just because we can’t find a solution, it doesn’t mean there isn’t one." The same can be said for Alzheimer's disease- Alzheimer's is a type of monster that eats away at a person's cognitive functions, affecting their day-to-day life. Protein aggregation, or the accumulation of abnormal protein fibrils deposited in the brain, usually leads to Alzheimer's disease. AD results in memory loss or decline, oftentimes hurting the patient and their family.


Even though there is no known cure, one way patients have received mentally stimulating treatment is a daily match of Sudoku. Not only does this challenge Alzheimer's patients' brains, but it is also a rewarding and enriching hobby. With practice and dedication, these patients have been able to better their cognitive functions, problem-solving skills, and overall mental agility.



"The global prevalence of dementia has been estimated to be as high as 24 million, and is predicted to double every 20 years until at least 2040." -PubMed


Sudoku Studies

A popular puzzle game for any age is Sudoku. Sudoku is a logic-based, combinatorial number-placement puzzle, meaning that the application and use of logical reasoning and critical-thinking skills are the keys to winning. Unlike many other puzzle games, guessing is not an option when it comes to Sudoku. In addition to being a fun and challenging game, scientific studies are involved in the main idea that solving puzzles keeps the brain healthy; Sudoku is no exception for Alzheimer's patients and is thought to delay cognitive decline.


As we know, Alzheimer's disease is popular as being a serious condition that affects the cognitive abilities of patients- especially decision-making. Due to patients having to execute vital cognitive functions such as decision-making, Sudoku is a necessary therapy for Alzheimer's and can lead to neurorehabilitation for the disease. The prefrontal cortex (PFC) is the most involved region in the brain that participates in important cognitive abilities. The technology used in neurological studies, such as neuroimaging research, shows that the PFC mainly executes cognitive functions like attention, decision-making, a person's memory, and problem-solving. Functional near-infrared spectroscopy (fNIRS) can monitor the brain using near-infrared spectroscopy for neuroimaging. This technology, when applied to a person's forehead, can record the PFC during cognitive tasks. Since solving Sudoku includes those cognitive functions, the PFC is increasingly active during Sudoku compared to other problem-solving tasks.


Benefits

Sudoku is a game filled with extensive cognitive activity- helping with delaying Alzheimer's disease. Sudoku provides important mental stimulation for patients- maintaining and exercising cognitive functions such as problem-solving and decision-making. In addition, it can slow down the progression of cognitive decline, which is a common symptom of Alzheimer's disease.


Moreover, Sudoku can also have a positive impact on mental health. Completing puzzles can boost confidence for patients with Alzheimer's, providing them with a sense of accomplishment.


Sudoku can also be an enriching hobby. It can involve heavy interaction with caregivers and peers, which can promote socialization and provide patients with a sense of community. This is particularly important for individuals who may feel isolated or lonely due to their condition.


Sudoku can be an effective tool for executing cognitive functions and engagement. It can improve the overall health and well-being of individuals with Alzheimer's by reducing the impact of cognitive decline and providing important mental stimulation.


Interview

In the long yet rewarding journey to precisely understand the sciences of Alzheimer's, we turn to the innovative approach and the fascinating realm of Sudoku. Recognized for its grids of numbers and being an exceptional puzzle that required logic, Sudoku is gaining recognition as both a brain-testing hobby but also as a high-potential cognitive exercise for those impacted by Alzheimer's disease.


In a recent interview, a seasoned Advanced Placements and Honors mathematics high school teacher shed light on the subject. Deloris Mercer, a passionate educator, offered a striking perspective on how Sudoku can be a tool for cognitive neurorehabilitation.


When inquired if Mercer could explain her perspective on the potential benefits of Sudoku as a cognitive exercise for individuals with Alzheimer's disease, Mercer- with a hint of enthusiasm- responded, "When we have something hereditary, like Alzheimer's or dementia, it's already in our genetics."


"Yes, medicine works," Mercer noted, "But I do think because numbers are a universal language, that numbers start with us when we're little. We're counting our blocks and it goes all the way through our lifespan. If we can practice numbers and adding in mental math, then it may I believe, starve off something in your genetics."


Mercer pointed out the fact that numbers have a universal appeal and can be intriguing to people of any age. Mercer highlights the universal magnet of numbers and suggests that engaging in Sudoku exercises may help prevent cognitive decline in those genetically predisposed to Alzheimer's. This could have significant implications for maintaining brain health.


The next question explores if there are any specific mathematical concepts or principles Sudoku helps reinforce or improve within Alzheimer's patients.


"It does if you're young," Mercer concluded. "If you're young, you still have Alzheimer's; it's [the practice of Sudoku] helping you develop critical thinking skills because you've got to look in the column and the row and make sure you're not reusing the number. If you're older, it's giving your mind a workout. You're working your muscles, like your mind is a muscle, and it's helping you remember how to add."


Mercer explains that Sudoku has a double advantage for both those who haven't developed Alzheimer's yet- still having it in their genetics and posing a potential risk for Alzheimer's- and those who have fully developed the disease. It helps patients develop critical thinking skills for those undeveloped, while it provides a healthy mental workout for the elderly. This sharpens patients' mental faculties and improves memory retention.


The final question of the interview centers on how we can customize Sudoku puzzles to accommodate varying cognitive abilities among Alzheimer's patients.


"Right now, it's [Sudoku puzzles] black and white most of the time, but let's say I'm going colorblind," Mercer contemplated, "maybe I can differentiate by having different colors. If I'm losing my eyesight, I would change the font- I would make it bigger. I would also have it on a computer to read out the numbers."


This reflective response highlights the potential for customization, including considerations such as color differentiation and font size adjustments to accommodate individuals with a diverse range of cognitive abilities.


Conclusion

As previously demonstrated, Alzheimer's disease poses many challenges and obstacles to patients, caregivers, and families of the patients. Being a cognitive exercise and neurorehabilitation tool, or in other words- a treadmill for the brain, Sodoku plays an extremely crucial role in participating in the improvement of an Alzheimer's patient's cognitive function and emotional well-being. While Sudoku is not a cure, nor will it replace pharmaceutical medicine, this popular puzzle game offers a fun and engaging way to mentally stimulate cognitive skills and give patients an enriching and structured hobby. This maintains their mental well-being and aids in patients enjoying a better quality of life amidst the challenges of the disease. When incorporated into a care plan, Sudoku can be a valuable addition to the limitless amount of therapies and interventions for Alzheimer's patients.


 

References


Ashlesh, P., Deepak, K. K., & Preet, K. K. (2020). Role of prefrontal cortex during Sudoku task: fNIRS study. Translational Neuroscience, 11(1), 419–427. https://doi.org/10.1515/tnsci-2020-0147

Burrows, L. (2019, August 15). Using math to help treat Alzheimer’s, Parkinson’s and other, diseases. Seas.harvard.edu. https://seas.harvard.edu/news/2019/08/using-math-help-treat-alzheimers-parkinsons-and-other-diseases

CDC. (2011). Cognitive impairment: A Call for Action, Now! (p. 1). https://www.cdc.gov/aging/pdf/cognitive_impairment/cogimp_poilicy_final.pdf

Dhakal, A., & Bobrin, B. D. (2023, February 14). Cognitive Deficits. PubMed; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK559052/

Martin, R. C., Annis, S. M., Darling, L. Z., Wadley, V., Harrell, L., & Marson, D. C. (2003). Loss of Calculation Abilities in Patients With Mild and Moderate Alzheimer Disease. Archives of Neurology, 60(11), 1585. https://doi.org/10.1001/archneur.60.11.1585




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