Preprint · Jul 20, 2023
Effects of a Digital Mahjong Game on Neuroimaging Signatures, Cognitive Performance, and Health Status in Community-Dwelling Middle-Aged and Older Adults: A Randomized Controlled Trial (Preprint)
By Tung H, Kuo CY, Lee P et al.
BACKGROUND Digital games effectively mitigate the adverse consequences of age-related declines in physical and cognitive abilities, while concurrently facilitating improvements in neuroimaging biosignatures conducive to promoting healthy longevity. OBJECTIVE This study aims to investigate the impact of a 6-month intervention involving the integration of digital Mahjong games (DMG) with incentivized walking on promoting healthy aging. METHODS This randomized controlled trial recruited 60 participants aged 55 years and older from community settings from July 28, 2020, to November 01, 2021. Participants were allocated randomly to the DMG intervention group or controls, with those in the intervention group engaging in two 30-minute DMG sessions per week for 6 months. Main outcomes, and Measures are brain imagery changes via magnetic resonance imaging constituted the primary outcome, while secondary outcomes encompassed cognition, physical activity, mental health (resilience and demoralization), quality of life, physical assessments, body composition, and biochemical markers, with the intervention effects estimated by a per-protocol analysis. RESULTS Compared to controls (n=30), the intervention group (DMG, n=30) demonstrated a significant increase in regional homogeneity (ReHo) in the right insula (FWE-corrected p-value < 0.05), improvements in delayed recall (-0.79; 95% CI, 1.538 to -0.042; P=0.039) and reduced diastolic blood pressure (-3.501, 95% CI, 0.091 to 6.911, P=0.044). The delayed recall performance exhibited a significant correlation with ReHo in the right insula and right anterior cingulate gyrus (FWE-corrected p-value < 0.05), and changes in fractional amplitude of low-frequency fluctuations (fALFF) in the left inferior frontal gyrus and right paracingulate gyrus (FWE-corrected p-value < 0.05). The ReHo in the right insula displayed positive associations with the number of practice sessions (r = 0.48, P=0.009). CONCLUSIONS DMG demonstrated favorable effects on neuroimaging signatures, cognitive performance, and health status among community-living adults aged 55+ years. CLINICALTRIAL This study is registered at ClinicalTrials.gov identifier: NCT05808426