When it comes to protecting brain health as we age, most people think of crossword puzzles, reading, or taking on a new hobby in retirement. But mental health experts say an unlikely 19th-century game that's popular in retirement communities and senior centers may offer a powerful combination of mental stimulation and social connection: mahjong. Research suggests this centuries-old tile game may help support cognitive function while reducing loneliness — two factors closely linked to healthy aging.
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A Brief History of Mahjong
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Mahjong traces its roots to China, where historians believe it evolved from earlier card and paper-based games before eventually taking the tile-based form players recognize today. By the late 19th century, mahjong had arrived in the West and experienced a boom in the United States in the 1920s.
The game is played with tiles featuring different symbols and suits, requiring players to form winning combinations while tracking opponents' moves and adapting their strategies. Today, mahjong remains especially popular among older adults, thanks in part to its social nature and mentally engaging gameplay — making it one of the more underrated brain games for seniors.
Does Mahjong Help Prevent Cognitive Decline?
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According to Dr. Lori Bohn, a Board-Certified Psychiatric-Mental Health Nurse Practitioner and Medical Director at Voyager Recovery Center, the game's challenging demands are what set it apart. "When watching older adults play mahjong, it is clear to me how continuous engagement in the game demands their constant attention, memory, ability to recognize patterns, ability to make decisions strategically, and reading social cues for interaction with fellow players," Bohn tells Parade.
"There is research showing that participating in games such as mahjong on a consistent basis has an association with greater cognitive function, lower rates of cognitive decline and improved emotional states," she says. "However, most of this evidence is correlational instead of causal."
The Social Connection May Be Just as Important for Healthy Aging
Though Bohn notes that researchers have not yet clinically proven that mahjong directly prevents cognitive decline, a 2024 study found that adults age 60 and older who played mahjong reported a stronger sense of social connection and improved self-esteem.
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"Research shows that social engagement is one of the strongest factors in protecting the aging brain," says Rachel Lambert, LPC, BCN, founder of Braincode Centers. "Mahjong requires interaction with others, which is a key reason it is so effective."
Katie Grigg, a dementia specialist and former NHS dementia practitioner, agrees. "Activities that challenge the mind and encourage social connection can be particularly beneficial, as social isolation is itself a known risk factor."
Related: Looking for another retirement hobby?
A Winning Hand for Healthy Aging
While mahjong isn't a guaranteed defense against dementia or declining mental faculties, experts say it offers something many brain-health activities lack: a combination of mental challenge, strategy, memory training, and meaningful social interaction. And that may be a winning hand for healthy aging.
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