Neurology · Medical Literature
Can executive functions be improved by playing board games across the lifespan? A systematic review and meta-analysis.
Abstract
Board games are usually played with other people across the lifespan. They seem to improve executive functions, which are psychological processes key to our daily lives. Therefore, this systematic review aimed to show whether board games could improve executive functions at different ages. At first, 5288 studies were found in four databases (Scopus, WOS, PsycINFO, and Medline). Twenty-four studies met the inclusion criteria for the systematic review, and 16 studies were included in the meta-analytical analysis. In the systematic review, we especially found effects in verbal short-term memory in children. In addition, the meta-analysis showed significant results for visuospatial short-term memory in kindergarten and processing speed in older people. We also assessed heterogeneity and conducted a meta-regression analysis considering the risk of bias. High heterogeneity was observed in some meta-analyses. Overall, the results suggest that the current empirical evidence is not yet sufficient to support a strong recommendation for the use of board games to improve executive functions. However, the findings are promising and highlight the potential of board games as a cognitive intervention. Therefore, future well-designed randomized controlled trials are needed to clarify the effectiveness of such interventions.
Clinical relevance
Executive functions — encompassing working memory, processing speed, inhibitory control, and cognitive flexibility — are critical neuropsychological capacities whose decline is implicated in pediatric neurodevelopmental disorders, age-related cognitive impairment, and dementia. This systematic review and meta-analysis addresses a clinically meaningful gap by evaluating whether a low-cost, widely accessible, and socially engaging intervention (board games) can serve as a non-pharmacological cognitive intervention across the full lifespan. Given the limited pharmacological options for enhancing executive function and the growing interest in scalable cognitive training modalities, neurologists and neuropsychologists need current evidence to counsel patients and caregivers appropriately.
Key findings
1. Literature search across four databases (Scopus, WOS, PsycINFO, Medline) identified 5,288 candidate studies; 24 met inclusion criteria for the systematic review and 16 were eligible for meta-analytical pooling, indicating a still-limited but growing evidence base. 2. Systematic review findings demonstrated notable effects of board game interventions on verbal short-term memory specifically in pediatric populations, suggesting age-specific cognitive benefits. 3. Meta-analysis revealed statistically significant effects of board games on visuospatial short-term memory in kindergarten-aged children, representing a potentially sensitive developmental window for this cognitive domain. 4. Meta-analysis also demonstrated significant improvement in processing speed in older adults, a domain of particular clinical relevance given its role in functional independence and dementia risk. 5. High heterogeneity was observed across multiple meta-analyses, limiting the strength of pooled estimates and precluding firm quantitative conclusions; specific effect sizes, confidence intervals, and p-values were not reported in the abstract. 6. Meta-regression analyses incorporating risk of bias were conducted, and overall the authors concluded that current empirical evidence is insufficient to support a strong clinical recommendation for board games as a cognitive intervention.
Practice implications
At present, neurologists should not routinely prescribe board game interventions as a validated, evidence-based treatment for executive dysfunction in any age group, given high inter-study heterogeneity and the authors' explicit conclusion that evidence remains insufficient for a strong recommendation. However, clinicians may reasonably discuss board games as a low-risk, socially enriching adjunctive activity — particularly targeting visuospatial working memory in young children and processing speed in older adults — while framing expectations as exploratory rather than therapeutic. Future clinical adoption should be contingent on well-designed, adequately powered randomized controlled trials that standardize game type, intervention duration, and outcome measures across pediatric, adult, and geriatric populations.