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Brain Health

More Older People Than Ever Are Playing Video Games – Here’s Why You Should Too

Posted on 14 June 2023

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If I ask you to imagine the average video game player, 87 year-old Shirley Curry probably isn’t the first sort of person who comes to mind. Shirley is a great grandmother of three who rose to fame playing The Elder Scrolls V: Skyrim on her YouTube channel, which currently has over 1.2 million subscribers. People like her are in the minority, but perhaps a larger minority than many may realise. According to surveys, 15% of gamers in the US are aged 55 and over, and 48% are female.

Though less so than in the past, video games sometimes get bad press for encouraging violence (an accusation that has been thoroughly debunked) or encouraging physical inactivity (a more reasonable criticism, though by no means unique to this pastime). However, there’s emerging evidence that playing video games every now and then could be good for your brain, including preventing cognitive decline in older adults.

Cognitive Reserve, Video Games And You

The restoration skill would probably make medicine a whole lot easier.

Our current understanding of the brain suggests that it can be trained like a muscle (or alternatively, like skill levels in the Elder Scrolls V: Skyrim). Regions of the brain that are used regularly get better at what they do, while those that are neglected get weaker. Unfortunately, some cognitive decline seems to be an inevitable part of ageing, but it’s clear that not everyone suffers from this to the same extent. Some people remain sharp until the last years of life, while others get early-onset dementia. Many researchers think this variation could be related to something called cognitive reserve.

Cognitive reserve is the idea that people who build stronger brain function through repeated use can afford to lose more of that function in old age and disease, without suffering many ill effects. This could explain why some elderly people have normal cognitive function for their age, yet when autopsies are performed after their death, they are found to have significant signs of neurodegenerative disease. Even though brain ageing is inevitable, its effects may be greatly offset by building a cognitive reserve.

A visual representation of how cognitive reserve delays the effects of neurodegenerative disease (the Dark Souls boss of geriatric medicine), in this case Alzheimer’s. Someone who begins with higher cognitive reserve will take longer to reach the criteria for Alzheimer’s diagnosis, though they may deteriorate more rapidly once they are diagnosed. This is consistent with what we see – diagnosed dementia typically progresses faster in more educated people, for example.
Cognitive reserve in ageing and Alzheimer’s disease

While a stimulating environment and good education during early life are important for building cognitive reserve, the brains of adults seem to be more malleable than was once thought. Research suggests that even people in their 80s can grow new neurons and benefit from interventions and practices that build cognitive reserve. Playing video games could be especially beneficial for this purpose. 

Why video games in particular? If the goal is to engage and test many different brain functions at once, not many many pastimes do so as effectively while being available on-demand and from the comfort of your home. Most games engage visuospatial cognition (identifying and understanding what is on-screen), decision making and motor coordination, often during a tight time window. Many games, especially real-time strategy games, engage working memory due to requiring extensive multi-tasking and time management. Many games also involve the interpretation and memorisation of three-dimensional spaces. 

Age of Empires II
The Scientific Gamer

What’s The Evidence?

Let’s start with the good news: most meta-analyses (studies that review and combine data from multiple different studies) suggest that video games can improve at least some aspects of cognitive function in both younger and older age groups.

Let’s look at a few specific trials as examples. In one study, researchers divided 56 adults aged 60 to 80 into three groups and had them play video games for 30 minutes a day for 4 weeks. One group played Super Mario 3D and another played Angry Birds. As a control, the third group played computerised Solitaire – the intention of this was to limit any cognitive benefits associated with learning an unfamiliar interface. They found that both video games significantly improved hippocampal function scores relative to solitaire, with Super Mario 3D World being the most effective. These benefits were still present 4 weeks after participants stopped playing. The hippocampus is an important brain region for learning and memory, and may be particularly important for spatial memory, which could explain why the 3D game was more effective.

A summary of the study design (A) and results using two tests for hippocampal function (B and C).
Enriching hippocampal memory function in older adults through video games

Some trials also suggest that video games can improve other cognitive functions like working memory (the ability to hold on to information for short-term use) and problem-solving abilities. There’s evidence that these cognitive benefits are reflected in changes in brain structure. One study found that 55-75 year-old adults who played a 3D platforming game over 6 months benefited from an increase in grey matter within the hippocampus and cerebellum (responsible for motor coordination). Those who took computerised piano lessons, meanwhile, only gained cerebellar grey matter, while those who did not receive an intervention lost grey matter in both regions.

Video games even seem to benefit people who already have dementia. A meta-analysis of 12 randomised controlled trials found that cognitively demanding games significantly improved cognitive function and reduced depression in people with dementia.

The Devil Is In The Details

Despite there being quite a few studies looking at the benefits of video games in both young and older adults, there’s still a lack of consensus on this topic. While some meta-analyses and literature reviews lean strongly in favour of video games boosting brain function, others suggest that they only benefit specific aspects of cognition or even that they offer no benefits at all. What’s going on?

Researchers studying the benefits of video games suffer from similar challenges to those studying the benefits of exercise: defining and categorising the thing that they’re trying to study. If you play a computerised version of solitaire or chess, most people would not call that a video game. What specific elements need to be added before the benefits of a video game are achieved? Some studies might just be picking the wrong games.

Video games range from simple and intuitive to ridiculously complex
EVE Online, image by u/hoboguy26, Reddit

Likewise, there’s a wide array of different video game genres with drastically different cognitive requirements. Some games are 3D and some are 2D, some are turn-based and others real-time, some games are puzzle games and others are social online games. Studies pick different games and use different methods. Much like as in the case of exercise research, this makes the comparison and interpretation of their results very difficult, though some have tried. It’s hard to take any conclusions at face value given the problems described above.

Video Game GenreCognitive Benefits
ActionImproved attention, cognitive control, reaction time, and accuracy 1
Real-Time StrategyFaster information processing, better allocation of cognitive resources, improved temporal visual attention 2
PuzzleEnhanced problem-solving skills, improved function of the prefrontal cortex 3
Brain TeaserImproved cognitive indices, increased mental flexibility 4
Active Video Games (VR)Improved cognitive performance, increased physical activity 5
StrategyImproved cognitive processing function, executive function, and memory ability 6
A summary of benefits associated with different video game genres (to be taken with a grain of salt). Composed with the aid of Perplexity AI

To make matters worse, different studies use all kinds of different methods for assessing cognitive function, and many have methodological problems like small sample sizes, inadequate control groups, short study duration or simply picking a game that isn’t challenging enough. Unfortunately, these problems are not uncommon in science, but smaller, newer areas of research can suffer more. While the evidence still favours a benefit to gaming, the extent of this benefit could have been exaggerated in some areas or underestimated in others. 

As is ever the case, more evidence is needed, but video games look to be a promising way of keeping your brain in shape. The catalogue of games is large enough that most people should be able to find something they like. Access to video games is not limited by location or physical ability. An increasing number of games now have accessibility options that allow even people with severe disabilities to enjoy them. Best of all, most people find video games enjoyable to play!

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    Cognitive reserve in ageing and Alzheimer's disease

    Enriching hippocampal memory function in older adults through video games

    Effects of computer gaming on cognition, brain structure, and function: a critical reflection on existing literature

    Playing Super Mario 64 increases hippocampal grey matter in older adults

    A systematic review and meta-analysis of randomized controlled trials on the effect of serious games on people with dementia

    Using Video Games to Improve Capabilities in Decision Making and Cognitive Skill: A Literature Review

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