Home › Research › Prevention and risk
Mental and physical activities delay cognitive decline in older persons with dementia
Cheng ST, Chow PK, Song YQ, Yu EC, Chan AC, Lee TM, Lam JH.. The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry, 2013-02-06
Topic: Risk, prevention and care in population studies
Objectives To examine the effects of cognitive stimulation (mahjong) and physical exercise (tai chi [TC]) on cognitive performance in persons with dementia. Design Cluster-randomized open-label controlled design. Setting Nursing homes. Participants One hundred ten residents, most of whom were cholinesterase-inhibitor naive. Inclusion criteria were Mini-Mental State Examination (MMSE) = 10-24 and suffering from at least very mild dementia (Clinical Dementia Rating ≥ 0.5). Exclusion criteria were being bedbound, audio/visual impairment, regular activity participation before study, or contraindications for physical or group activities. Interventions Homes were randomized into three conditions (mahjong, TC, and simple handicrafts [control]). Activities were conducted three times weekly for 12 weeks. Measurements Primary outcome was MMSE. Secondary outcomes were immediate/delayed recall, categorical fluency, and digit span. Various biological risk factors, including apolipoprotein E ε4 allele, were included as covariates. Measures were collected at 0 (baseline), 3 (posttreatment), 6, and 9 months. Results Intent-to-treat analyses were performed using mixed-effects regression. Mahjong's effect varied by time for MMSE, delayed recall, and forward digit span. TC had similar effects but not for delayed recall. The typical pattern was that control participants deteriorated while mahjong and TC participants maintained their abilities over time, leading to enlarged treatment effects as time progressed. By 9 months, mahjong and TC differed from control by 4.5 points (95% confidence interval: 2.0-6.9; d = 0.48) and 3.7 points (95% confidence interval: 1.4-6.0; d = 0.40), respectively, on MMSE. No treatment effects were observed for immediate recall and backward digit span. Conclusions Mahjong and TC can preserve functioning or delay decline in certain cognitive domains, even in those with significant cognitive impairment.
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
APA 7th
Cheng, S. T., Chow, P. K., Song, Y. Q., Yu, E. C., Chan, A. C., Lee, T. M., et al. (2014). Mental and physical activities delay cognitive decline in older persons with dementia. The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry. https://doi.org/10.1016/j.jagp.2013.01.060
Vancouver
Cheng ST, Chow PK, Song YQ, Yu EC, Chan AC, Lee TM, et al. Mental and physical activities delay cognitive decline in older persons with dementia. The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry. 2014. doi:10.1016/j.jagp.2013.01.060. PMID: 23582750.
BibTeX
@article{cheng2014-23582750,
author = {Cheng, S. T. and Chow, P. K. and Song, Y. Q. and Yu, E. C. and Chan, A. C. and Lee, T. M. and Lam, J. H.},
title = {{Mental and physical activities delay cognitive decline in older persons with dementia}},
journal = {The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry},
year = {2014},
doi = {10.1016/j.jagp.2013.01.060},
pmid = {23582750},
url = {https://doi.org/10.1016/j.jagp.2013.01.060}
}
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. The record names 7 authors; APA and Vancouver show the first six, BibTeX and the downloads carry all of them. Check the citation against the original before you use it.
Key findings
- Results Intent-to-treat analyses were performed using mixed-effects regression.
- Conclusions Mahjong and TC can preserve functioning or delay decline in certain cognitive domains, even in those with significant cognitive impairment.
Why it matters
In this 12-week trial in nursing homes, mahjong and tai chi preserved functioning or delayed decline in certain cognitive domains in people who already had dementia. The typical pattern was that control participants deteriorated while the activity groups did not, but this was an open-label study, so it does not show that these activities prevent or cure Alzheimer's disease.
New to this subject? Start with our plain-English guide: Prevention →
Study details
- Study designopen-label trial
- Evidence strengthHigh
How this study scored 62/100
Published in a peer-reviewed journal, and it is a randomised controlled trial. Scored zero for sample size and effect reported because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry) |
| Journal's citation record | 2 / 4 | American Journal of Geriatric Psychiatry: journal h-index 178 (OpenAlex, 2026-10-29) |
| Study design | 11 / 12 | A randomised controlled trial (from PubMed type “Randomized Controlled Trial”) |
| Strength of evidence | 5 / 5 | Rated “high” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 1 / 5 | 2014 — within 20 year(s) of the newest study here |
| Sample size | 0 / 4 | Participant count not stated — scores zero (not stated in the record — scored 0) |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 3 / 3 | Studied in people (pubmed indexes it as a clinical or observational study) |
| Randomised / blinded | 1 / 2 | Randomised (as stated in the record) |
| Times cited | 5 / 7 | Cited 258 times (OpenAlex, 2026-10-10) |
| Citations per year | 3 / 5 | 18.4 citations a year over 14 year(s) since 2014 |
| Impact for its field and year | 4 / 6 | Cited 14.5× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 2 / 6 | Cited by 7 other studies in this library |
| Still being cited | 2 / 4 | Cited 38 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 1 / 4 | Last-listed author John Lam: h-index 10 (OpenAlex, whole career) |
| Institution's track record | 1 / 3 | University of Hong Kong: institution h-index 1,069 (OpenAlex) |
| Multi-centre collaboration | 2 / 3 | OpenAlex lists 4 institution(s) in 2 countries |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 23582750) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Total | 62 / 100 | — |
What each of these 20 components measures, and what this score is not →
Read the original
May need a subscription OpenAlex found no free copy of the full text (checked 6 Feb 1020), so the publisher may charge for it. The PubMed abstract is free.
Studies this one cites
Referenced by this study and also in the alzhub library, so you can read them here.
Later studies that cite this one
7 studies in the alzhub library list this one in their references.
Related studies in Prevention and risk
Also tagged “cognitive-function”
1,118 studies in the library carry the topic tag “cognitive-function”; these are this study's neighbours in a fixed, alphabetical-by-hash tour of them, not the closest in content. All 1,118 tagged studies.