Older adults who play mahjong several times a week are showing measurable gains on standard memory and thinking tests, according to a string of clinical studies spanning nearly two decades.
Quick Take
- Multiple randomized studies link regular mahjong play to improved memory, executive function, and cognitive screening scores in older adults.
- A 2006 trial found gains in dementia patients that held up a month after the games stopped.
- A 2020 trial showed executive function improved in people with mild cognitive impairment after 12 weeks of play.
- Researchers caution the game has not been shown to prevent Alzheimer’s disease or dementia itself.
What The Clinical Trials Actually Found
The clearest evidence comes from a randomized trial of 62 people with mild-to-moderate dementia. Participants played mahjong two or four times weekly for 16 weeks. Researchers reported “consistent gains across all cognitive performance measures,” including large improvements in digit-forward memory and moderate gains on the Mini-Mental State Exam, a standard dementia screening tool. The benefits were still present a month after play ended.
A separate 2020 randomized trial tested 56 older adults with mild cognitive impairment, a condition often seen as a precursor to dementia. After three mahjong sessions a week for 12 weeks, the group showed significant gains on cognitive and functional tests, while a comparison group doing normal daily activities did not improve. A 2014 nursing-home study found something similar. Residents assigned to mahjong or tai chi held steady on cognitive tests over 12 weeks, while a control group doing simple crafts declined.
Newer Research Adds A Digital Twist
A newly reported randomized trial out of Taipei tracked adults 55 and older through a six-month digital mahjong program on tablets, paired with a step-tracking wristband and walking incentives. Compared with a no-intervention group, players showed a statistically meaningful improvement in delayed recall, a memory measure often affected early in dementia. Because the program bundled mahjong with a walking challenge, researchers cannot yet say how much of the benefit came from the tiles versus the steps.
A 2024 scoping review pulled together 53 separate mahjong studies and found a consistent pattern: frequent players tend to score better on cognitive screenings and show lower rates of mild cognitive impairment than nonplayers. A massive 2018 survey of more than 7,000 older adults in China added population-level weight to that pattern, linking card and mahjong play to stronger cognitive function across a far bigger sample than any single lab trial could offer.
Why Doctors Are Talking About It Publicly
Clinicians at Hackensack Meridian Health have pointed to mahjong as a worthwhile activity for aging patients, and local television stations across the country have picked up similar stories, from Chicago to Miami to Boston. That kind of attention makes sense. Mahjong is social, strategic, and requires sustained attention, three things researchers already link to healthier brains. It is also simply more fun for many retirees than a worksheet of memory drills, which matters for actually sticking with it.
The World Health Organization’s updated dementia-prevention guidelines recommend cognitive stimulation and social engagement broadly as part of a healthy-aging strategy, not mahjong specifically. That distinction matters. The game fits neatly into a category of activity doctors already encourage, rather than standing alone as a proven medical treatment.
What The Evidence Does Not Yet Show
None of the studies demonstrate that mahjong prevents Alzheimer’s disease or stops dementia from developing. Most trials are small, ran for only 12 to 20 weeks, and were conducted in China or Taiwan, which raises fair questions about how well results translate to American retirement communities or senior centers. Researchers studying the game have called for larger, longer trials that separate the effects of the tiles themselves from the social contact and structured routine that come bundled with any group activity.
Still, the common-sense takeaway holds up. A game that gets older Americans off the couch, talking with neighbors, and exercising their memory several times a week is a low-risk, low-cost habit worth encouraging, regardless of whether science ever proves it blocks disease outright. Families looking for ways to support aging parents’ independence have far worse options than a mahjong table.
Sources:
mindbodygreen.com, onlinelibrary.wiley.com, aging.jmir.org, academic.oup.com, sciencedirect.com, pmc.ncbi.nlm.nih.gov
