title: An exploratory study of the effect of mahjong on the cognitive functioning of persons with dementia.
abstract: OBJECTIVE
  To explore the effect of an activity treatment-mahjong-on the cognitive functioning of persons with mild-to-moderate dementia.
  
  
  METHODS
  Participants were 62 older persons (M(age) = 83.94, SD = 7.58) who met DSM-IV diagnosis of any dementia condition, had an initial Mini-Mental State Examination (MMSE) score < or = 24, and were able to play, yet not having played mahjong for the past six months. They were randomly assigned to play either twice (n = 33) or four times (n = 29) a week over a 16-week duration. Digit forward span, digit forward sequence, verbal memory and MMSE were measured at baseline, post-test and 1-month follow-up.
  
  
  RESULTS
  Regardless of frequency of playing, mahjong produced consistent gains across all cognitive performance measures. It had large effect sizes on digit forward memory (1.0-1.4 for both span and sequence), moderate-to-large effect sizes on verbal memory (0.5-0.9), and a moderate effect size on MMSE (around 0.6). The effects lasted after mahjong had been withdrawn for a month, suggesting that constant practice is not necessary to achieve therapeutic effect once an initial threshold is attained.
  
  
  CONCLUSIONS
  Mahjong is a viable treatment option for dementia. Because mahjong therapy basically does not require professional supervision and can be implemented as widely as space allows at a given time, the potential benefits of integrating mahjong into the daily routines of an institution are enormous vis-à-vis minimal, if any, cost to the institution.
authors.affiliation: Department of Applied Social Studies, City University of Hong Kong. tak.cheng@cityu.edu.hk
authors.forename: Sheung-Tak
authors.initials: ST
authors.lastname: Cheng
authors.forename: Alfred C M
authors.initials: AC
authors.lastname: Chan
authors.forename: Edwin C S
authors.initials: EC
authors.lastname: Yu
mesh_terms: D000369:Aged, 80 and over; D003072:Cognition Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy*; D003704:Dementia / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008297:Male; D011939:Mental Recall; D009483:Neuropsychological Tests; D010988:Play and Playthings; D012720:Severity of Illness Index; D014705:Verbal Behavior