Digital Mahjong-Based Cognitive Engagement Intervention for Older Adults: Randomized Controlled Trial

Area of Science:

• Neuroscience
• Gerontology
• Digital Health

Background:

• Limited evidence links gamified digital training to neuroimaging outcomes in aging populations.
• Home-based cognitive engagement interventions show potential for older adults.

Purpose of the Study:

• To test if a digital mahjong intervention enhances cognition in community-dwelling older adults.
• To explore associated brain changes using multimodal MRI.

Main Methods:

• A 6-month randomized controlled trial involving older adults (55+ years).
• Intervention group played digital mahjong on an iPad with incentivized walking.
• Primary outcomes included gray matter volume, ReHo, fALFF, global connectivity, and cognition (Montreal Cognitive Assessment).

Main Results:

• The intervention group showed improved delayed recall compared to controls (P=.04).
• Neuroimaging revealed increased ReHo in the right insula and decreased gray matter volume in the left frontal pole.
• Delayed recall improvements correlated with right insular ReHo and other brain regions.

Conclusions:

• A 6-month home-based digital mahjong intervention improved delayed recall and right insular ReHo.
• Culturally familiar cognitive challenges integrated with lifestyle engagement may support salience network function and memory.
• Future trials should use active controls and factorial designs to isolate mechanisms.