As people age, so does the concern about cognitive decline and dementia. With no absolute cure for Alzheimer's and other types of dementia, efforts to prevent it have become a critical public health priority. Perhaps one of the most widespread perceptions among wellness communities and social circles is that doing puzzles—whether Sudoku, crosswords, or jigsaw—will safeguard the brain against cognitive loss. But is there any science to support this brain-bolstering hype? Can a daily puzzle really help prevent dementia?

Based on the National Poll on Healthy Aging by the University of Michigan, most adults between the ages of 50 and 64 are concerned about getting dementia. Nonetheless, only 5% mentioned that they had talked with their doctors about taking preventive measures to lower this risk. Instead, most used brain teasers or vitamins in the hope of protecting their minds.

Although large health organizations such as the World Health Organization and the Global Council on Brain Health have dispelled the efficacy of supplements in preventing dementia, mentally stimulating activities—such as puzzles—continue to enjoy increasing support in scientific literature, albeit with qualifications.

A large UK observational study, which is part of the online PROTECT study of brain aging, used data from more than 19,000 healthy adults aged between 50 and 93. Participants who participated in word or number puzzles regularly had better cognitive function in various domains, including spatial working memory, verbal reasoning, attention, and reaction time.

Notably, various puzzles appeared to challenge different areas of the brain. Puzzles with words were correlated with enhanced grammatical thinking, whereas puzzles involving numbers such as Sudoku were connected with enhancement of executive abilities such as planning and organization.

But the biggest lesson learned wasn't which puzzle was superior—it was how often people did these cognitively challenging activities. People who solved puzzles at least monthly had improved cognitive scores all around compared to those who never did.

Correlation vs. Causation: What's Reducing Dementia Risk?

Even with these encouraging correlations, specialists warn that cause-and-effect conclusions should not be drawn directly. Observational studies such as PROTECT cannot say whether puzzle-solving enhances thought or if individuals with more robust brain powers are inherently inclined to such pursuits.

Yet another limitation is that most studies have not yet separated out lifelong puzzle enthusiasts from those who started solving them later in life. It becomes challenging to determine long-term impacts of puzzle work on dementia onset individually.

The Bronx Aging Study, a 20-year longitudinal study, discovered that older adults who consistently worked on crossword puzzles postponed the onset of dementia by an average of 2.54 years. Although not a guarantee against cognitive decline, this postponement is significant and supports the theory that cognitively stimulating activities can contribute to what's called "cognitive reserve"—the brain's capacity to deal with or compensate for damage.

Role of Brain Puzzles in Preventing Dementia

So, then, can puzzles prevent dementia? Not exactly. But can they slow down cognitive decline? Maybe. And unlike supplements, puzzles pose no health risk, so they are a safe and possibly useful part of a larger brain health plan.

As Dr. Teresa Gomes-Osman cited in the 2020 Lancet Commission Report on Dementia Prevention, lifestyle factors that can be changed—like education, exercise, treating depression, limiting air pollution exposure, and others—combined explain as much as 40% of dementia cases. Mental stimulation, such as puzzle-solving, is a perfect fit on the "cognitive reserve" side of this equation.

Which Puzzles Work Best To Reduce Dementia Risk?

Sudoku

Excellent for building numerical reasoning, Sudoku exercises the mind in logical reasoning, pattern identification, and problem-solving. Its deceptively simple format hides the sophisticated cognitive stimulation it provides.

Riddles

These exercise critical thinking, recall of memory, and lateral thinking. Riddles also hone verbal abilities and understanding in everyday applications.

Word Search

This tried-and-tested puzzle aids in better vocabulary, concentration, and observation. It enhances the brain's liaison with language—a fundamental thinking function during aging.

Jigsaw Puzzles

Fun and healing, jigsaws engage both the visual and memory parts of the brain. The coordination involved assists with motor functions and spatial understanding, and they can also be an excellent social activity.

Ways Puzzles Help Keep your Brain Healthy

Puzzles must be viewed as part of the brain-health puzzle, but only one piece. Puzzles work as part of a multi-pronged strategy to prevent dementia that also includes:

Physical exercise: Exercise maintains neuroplasticity and circulation to the brain.

Social engagement: Solitude is a recognized risk factor; remaining socially engaged maintains emotional and mental well-being.

Balanced nutrition: A Mediterranean-type diet with lots of leafy greens, whole grains, and healthy fat supports brain function.

Medical management: Treating hearing loss, hypertension, and diabetes is crucial for brain health.

While we’re still a long way from declaring puzzles as the magic bullet against dementia, research continues to reinforce the value of mental activity in supporting brain health. Puzzles challenge the brain, offer therapeutic value, and—when combined with a healthy lifestyle—can be an enjoyable and effective part of cognitive aging.

So the next time you grab a crossword or open up a Sudoku grid, you may be doing your brain a long-term favor.

In the United States, someone dies from heart disease every 34 seconds, and nearly half of the population has some form of cardiovascular disease (CVD).

What makes these statistics scary is the number of people who experience mental health issues, which is one out of four adults.

A new report from Emory University shows a clear and strong link between mental health conditions and heart disease. The report found that having certain mental health disorders can increase your risk of developing heart disease by a significant amount—anywhere from 50% to 100%. For people who already have a heart condition, these disorders can make things much worse, raising their risk of poor outcomes by 60% to 170%.

Which Mental Health Diseases Affect Heart Health?

The report, led by Dr. Viola Vaccarino and published in The Lancet Regional Health-Europe, highlights the strong link between mental health conditions and an increased risk of developing heart disease. Specifically, it found that certain mental health disorders can increase the risk of developing heart disease by 50% to 100%. For individuals who already have a heart condition, these disorders can worsen outcomes by 60% to 170%.

The report associated the following mental health conditions with these increased risks for developing CVD:

Major depression: 72% increased risk

PTSD: 57% increased risk

Bipolar disorder: 61% increased risk

Panic disorder: 50% increased risk

Phobic anxiety: 70% increased risk

Schizophrenia: nearly 100% increased risk

The study also found a two-way connection. Not only do mental health issues raise the risk for heart disease, but over 40% of people with heart disease also have a mental health condition. For example, a person with heart disease who also has major depression is more than twice as likely to die from their heart condition.

How Is Our Mental And Heart Health Connected?

The report explains how this link works inside the body. It shows that conditions like depression, schizophrenia, and PTSD can cause the body's natural stress response systems to act abnormally. These systems, called the autonomic nervous system and the hypothalamic-pituitary adrenal axis, control important body functions like heart rate and how we handle stress.

When these systems don't work correctly, they can cause long-term problems that harm the heart. This includes things like ongoing inflammation, issues with metabolism, and high blood pressure. All of these issues can raise the risk of developing heart disease over time.

What Are Some Mental Health Barriers That Affect Care?

For people with mental health conditions, getting the right medical care for their physical and mental health can be very difficult. The report points to several key problems.

Social and economic barriers

It can be tough for people with mental health conditions to afford or even get to doctors' appointments.

Communication issues

Sometimes, people may not understand health information or have trouble explaining their symptoms, which can make it harder to get the right diagnosis and treatment.

Stigma

There is still a lot of shame around mental health, which can stop people from seeking help. Doctors may also have their own biases. The report also notes that people with mental health conditions are often left out of clinical trials, so we don't have as much research on them.

Fragmented care

The way our healthcare system is set up often treats the mind and body as separate. This makes it hard to address all of a person's health needs at once.

If menopause had a social media profile, its relationship status with women’s health would be… “complicated”. Sure, the hot flashes and mood swings grab most of the headlines, but lurking quietly in the background is another issue: bone loss. Oestrogen is important when it comes to keeping bones strong. Once its levels dip during menopause, women become much more prone to osteoporosis.”

Why Oestrogen Is Crucial

Bone is a living tissue that constantly rebuilds and repairs itself. Oestrogen is what keeps this construction site running smoothly. “When oestrogen drops, the balance between bone building and bone breakdown collapses,” explains Dr. Pramila Kalra, Consultant, Department of Endocrinology, Ramaiah Memorial Hospital. This leads to bones that weaken faster than they can repair.

And it’s not just an invisible problem on a scan. Weakened bones translate into fractures from the most minor of falls. Hips, spines, and wrists are the usual casualties. “To put it into perspective, women over 50 face a 15% lifetime risk of hip fracture, and recovering from one can seriously affect independence,” says Dr. Kalra.

Understanding Hormone Replacement Therapy (HRT)

“HRT replaces the hormones your body no longer produces enough of after menopause, and this can significantly slow down bone loss,” says Dr. Kalra. Not only does it help bones maintain their density, but in some cases, it can even nudge bone strength upwards.

HRT isn’t a one-size-fits-all pill. It comes in forms that suit different lifestyles: tablets, patches, gels, and even sprays. For women with a uterus, progesterone usually joins the prescription party to protect the uterine lining. And along with stronger bones, many women also notice relief from hot flashes, night sweats, and that infamous menopause brain fog.

Is HRT Right for You?

Before you rush to the pharmacy, there are questions worth asking. “HRT works best for women who have severe menopausal symptoms or are at a high risk of osteoporosis,” says Dr. Kalra. Women who experience early menopause, particularly before age 45, are often strong candidates for HRT because their bones face years of oestrogen shortfall.

Safety concerns around HRT have caused plenty of headlines in the past. But newer research has changed the conversation. “When HRT is started within 10 years of menopause and before age 60, the benefits outweigh the risks for most women,” explains Dr. Kalra.

Still, the risks are not zero. There may be a slight increase in the chance of blood clots or breast cancer depending on personal health, the type of HRT, and how long it’s used. “That’s why an individualised discussion with your doctor is crucial. It’s about weighing your personal benefits against possible risks,” she stresses.

A Bigger Bone Health Plan

Dr. Kalra recommends thinking beyond medication. A diet rich in calcium and vitamin D, regular exercise—particularly weight-bearing workouts—and avoiding smoking and excessive alcohol are all essential. “HRT is most effective as part of a holistic bone health plan,” she says.

The Need for Personalised Care

There’s no “universal prescription” for menopause management. “The decision to start HRT must be highly individualised,” advises Dr. Kalra. Your doctor will consider your family history, existing health conditions, and results from a bone density scan. Together, you can discuss the type, dose, and duration of therapy that best fits your needs.

The conversation should cover not just symptoms but also your future risks. “It’s not about erasing menopause—it’s about empowering women to make informed choices so they can stay active and independent for years to come,” says Dr. Kalra.

Menopause may be inevitable, but brittle bones don’t have to be. With the right support, including HRT where appropriate, women can safeguard their bone health and dramatically reduce their risk of fractures. “Think of it as investing in your future mobility and independence,” Dr. Kalra concludes.

Autism is often painted as a childhood condition, usually spotted in the school playground when social quirks or communication differences raise eyebrows. But what happens when those children grow up without anyone connecting the dots? According to new research from King’s College London, the answer is unsettling: most autistic adults over 40 are still flying under the diagnostic radar.

The review, published in the Annual Review of Developmental Psychology, estimates that a staggering 89 per cent of people over 40 with autism remain undiagnosed. To put that into perspective, while around 23 per cent of autistic children under 19 are missed, nearly 96 per cent of those over 60 have never been recognised as autistic. That’s not just a gap; that’s a canyon.

The Age Factor

When the researchers broke it down by age and gender, the numbers looked even more lopsided. Among men aged 40 to 59, more than 91 per cent had never been diagnosed. For women in the same age group, the figure was almost 80 per cent. By the time people reached their sixties, both men and women crossed into the 96 to 97 per cent range of being undiagnosed.

Compare that with the 20 to 39 age group, where roughly half remained undiagnosed, and the generational divide becomes clear. Today’s younger adults are far more likely to be spotted, assessed and supported. Older adults, meanwhile, have often been left to muddle through without a name for their lifelong differences.

Why It Matters

Gavin Stewart, lead author of the study, explains that a lack of diagnosis means many autistic adults were never offered the right support, leaving them more vulnerable to age-related problems. These range from social isolation to poor physical and mental health.

The review found that autistic people in middle age and beyond have higher rates of almost every health condition compared to non-autistic peers, like heart disease, neurological issues, autoimmune disorders, gastrointestinal problems, anxiety and depression. Add age-related conditions like osteoporosis, arthritis and Parkinson’s disease, and the picture gets even more complicated.

Even more concerning, autistic older adults were six times more likely to report suicidal thoughts or self-harm and four times more likely to develop early-onset dementia.

The Hidden Struggles

The study highlighted another layer of challenge: healthcare itself. Many older autistic adults face obstacles in accessing medical support due to communication differences, sensory sensitivities or simply not knowing how to navigate the system. Combine that with a shortage of healthcare professionals trained in recognising autism in adults, and it’s no wonder so many cases slip through the cracks.

Professor Francesca Happé, co-author of the review, stresses that this is a global public health issue. “Understanding the needs of autistic people as they age is a pressing global public health concern. As autistic people age, the nature of the challenges they face changes. We must adopt a lifespan approach that funds long-term research, integrates tailored healthcare, and expands social supports so that ageing autistic people can live happy and healthy lives,” she says. In other words, autism doesn’t disappear after childhood, so neither should support.

Lost in the Shuffle

The findings also suggest that research into autism may have been skewed for years. If most older adults remain undiagnosed, then studies have largely overlooked them. That means our current understanding of how autistic people age is incomplete at best. No wonder policies and services have not caught up.

Employment struggles, strained relationships and social isolation were all noted as common experiences for older autistic adults. Without the framework of a diagnosis, many never knew why they felt out of step with the world, and their difficulties were often chalked up to personality flaws or “just how they are”.

Why a Diagnosis Still Matters

If you’re wondering whether getting a diagnosis later in life makes a difference, the answer is yes. Recognition can bring clarity, opening doors to support systems, healthcare adaptations and even financial benefits. It can also reshape how family, friends and colleagues understand a person’s behaviour and needs.

The NHS encourages adults who suspect they might be autistic to speak to their GP and ask about a referral for an assessment. Specialists can help by gathering life history, speaking with people who know you well and observing how you interact with others.

A Call for Change

The review ends with a clear message: it’s time to stop treating autism as a childhood-only issue. For too long, older autistic adults have been invisible, their experiences untold and their needs unmet. With diagnosis rates still alarmingly low, researchers are urging more studies, better services and a cultural shift that embraces autism across the lifespan.