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Are all puzzles created equally?

DEAR DR. ROACH: Are all puzzles created equal in terms of their value in keeping the mind sharp? I enjoy Sudoku and word-finding puzzles, with an occasional crossword puzzle. I also play games requiring puzzle solving on my computer or handheld device. My partner primarily enjoys crossword puzzles. I thought I would ask. — T.M.H.

ANSWER: Puzzles are fun and keep the mind active. Although there is no evidence supporting the idea that doing puzzles of any kind can prevent Alzheimer’s dementia, there is evidence that interventions — an action to improve a certain problem — taken targeting specific cognitive abilities can lead to long-lasting improvements. A well-done trial showed that interventions designed to improve performance in three areas (memory, reasoning and speed of processing) improved function in that specific area for five years.

In the study, the interventions were intensive. However, I think it’s reasonable that different types of puzzles are likely to have their own individual benefits. So, Sudoku or other number puzzles are likely to have separate benefits from crosswords. I would recommend doing multiple types of cognitive games and puzzles to keep your mind sharp.

Regular physical activity has strong evidence to support it as a means of preventing or delaying Alzheimer’s, and a healthy diet probably has benefit as well. Adding all together is best.

DEAR DR. ROACH: I was diagnosed with a hernia on my lower right side. I sometimes have slight burning and it bulges out. My doctor told me to press on it, and when I do, it goes right back in. I was also told not to lift anything heavy, which now I don’t. I am 87. Will I need surgery? Should I consider a truss? My doctor didn’t say. — L.M.

ANSWER: Hernias in the groin are very common. They are a defect in the abdominal wall, and if they are big enough, abdominal contents can come through the defect. If the contents can be pushed easily back in, it is called a reducible hernia. If the contents cannot be pushed back in, the hernia is said to be “incarcerated.”

Any incarcerated hernia or those with symptoms such as pain or inability to do activities of daily life without discomfort are usually recommended for surgery. However, surgery in an 87-year-old is a prospect that should be thoroughly discussed by both patient and doctor. Your overall health condition and the severity of your symptoms need to be carefully considered before a referral to a surgeon, who must also exercise discretion before making a recommendation about whether to proceed.

If you elect not to get surgery — and the symptoms sound mild, as you have briefly described them — a truss is sometimes prescribed. This device puts pressure on the hernia defect to keep the abdominal contents from coming out. I seldom prescribe them, and there is no clear evidence they work, though they do seem to help some individuals. If you get one, you need to be taught how to use it properly. A truss placed improperly can damage the abdominal contents.

(Roach is a columnist for the North American Press Syndicate. Write to him at 628 Virginia Drive, Orlando, FL 32803.)

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