NEWS
Mississippi medical experts see health benefits of playing mahjong
Studies show playing mahjong daily can lower the risk of dementia
Mary EvansMississippi Clarion Ledger
July 27, 2026, 4:44 a.m. CT
- Playing mahjong engages multiple areas of the brain, including memory, strategy, and probability calculation.
- Mahjong challenges executive functions like decision-making and requires players to adapt to new rules annually.
Though often characterized as an “old-lady” activity, the game of mahjong is anything but passive
Each hand, or round, requires you to remember multiple things at the same time: which tiles have been discarded, what your opponents might be building and when to shift strategy
Kevin Sullivan, Associate Professor of Medicine in the Division of Geriatrics at the University of Mississippi Medical Center, said games such as mahjong are generally a good health practice
“I consider this healthy behavior in older adults and ways they can age optimally, but it does not actually prevent you from getting dementia,” Sullivan said
A 10-year study by Frontiers Journal found that daily mahjong or card playing was associated with a 37% risk of developing dementia, while the lifetime risk of developing the condition after age 55 is estimated to be 42%, according to a Nature Medicine study
Social connectivity helps the brain
Mahjong engages multiple areas of the brain. Players must track tiles, remember discards, calculate probabilities and plan moves ahead
“A large social aspect is trying to interpret and read the intentions of others,” Sullivan said
Social isolation is one of the largest risk factors for cognitive decline in older adults, Sullivan said, and games like mahjong are a great way for people to stay connected
“If anything, I would say the social connectedness is one of the most important aspects of the game,” Sullivan said
A 2024 review found that social engagement and participation in social activities are among the most consistent social factors associated with better cognitive health and reduced cognitive decline among older adults
Executive function of the brain
Mahjong engages multiple executive functions, or decision-making processes, including memory and flexibility because players must recognize patterns and constantly adjust, according to a Diamond psychology review
Sullivan also said the game’s involvement of executive function, or decision-making processes, has the greatest benefits
“In mahjong, you are interpreting the information in front of you and using it to make decisions about what you’re going to do, optimizing reward change and minimizing risk,” Sullivan said
Unlike other brain games, the winning hands change every year when the National Mahjong League releases a new card in April
“It is good for older adults to be learning and integrating changes and new things and not falling into these patterns,” Sullivan said. “There is an advantage to having to adapt to new information.”
Mobility helps maintain motor skills
Mahjong also poses a mind-body connection with its use of motor skills and strategy that other brain games do not offer
“The involvement of manipulating the tiles around is good verses something like Sudoku or crosswords, which doesn’t have the same level of spatial motor involvement,” Sullivan said
Sullivan said exercises that engage the mind as well as the body are incredibly beneficially in minimizing cognitive decline
“In older age, exercising those mind-body connections is important,” Sullivan said. “I’m not suggesting that the physical function in mahjong is comparable to something like Tai Chi, but I think it has an advantage compared to other sorts of games,” Sullivan said
Vicki McGuinness agrees, having played the game for years
“The tactile quality of engaging in something with multiple senses,” McGuinness said. “You’ve got your hands, you’re mixing the tiles, you’re engaging multiple sensory experiences at once.”
While nowhere near geriatric in age, Jessica Derrick has been playing the game more than one year and said she has reaped the game’s mental health benefits
“Since I’ve played mahjong, I’ve been getting better sleep,” Derrick said. “Then I realized, I’m not on my phone nearly as much as I used to be. There’ no doom scrolling in mahjong.”
Mary Evans is a reporter for the Clarion-Ledger. Email her at mcevans@gannett.com
This is the second in an occasional series on the growing popularity of mahjong n Mississippi
