Can Playing Mahjong Be Good for Your Brain?

What makes mahjong interesting for the brain?

Playing mahjong can engage a number of cognitive systems at the same time:

• attention
• working memory
• visual-spatial processing
• pattern recognition
• planning
• strategy
• decision-making
• cognitive flexibility
• hand-eye coordination
• social interaction

That combination is what makes mahjong an interesting example of a cognitively stimulating leisure activity — a game that asks for memory, judgment, speed and conversation in the same sitting. It is the same reason researchers have looked at dancing and brain health and at pickleball and brain health, both of which pair cognitive demand with movement and company.

What that does not tell us is which brain regions are being "exercised." It has not been proven that these processes work specific brain areas in a way that prevents dementia.

What does the research show?

A peer-reviewed 2024 scoping review evaluated 53 studies on mahjong — 47 observational studies and 6 intervention studies. Taken together:

• greater mahjong-playing experience was associated with better cognitive, psychological and functional outcomes in many observational studies
• intervention studies reported improvements in some measures of general cognition and short-term memory
• some studies reported associations with better attention, executive function and other cognitive outcomes
• not every study found benefits
• much of the literature is observational
• stronger randomized trials are still needed

Longitudinal research in older Chinese adults has also found associations between mahjong participation and playing frequency and cognitive functioning measured over time — again, associations rather than demonstrated cause and effect.

The important limitation

Mahjong has not been proven to prevent Alzheimer's disease or dementia. People who regularly play mahjong may differ from people who do not in many other ways, including:

• social engagement
• education
• physical health
• other leisure activities
• lifestyle
• baseline cognitive ability

Association therefore does not establish causation. The same distinction runs through our page on family history and Alzheimer's risk and our review of dementia risk questions: several things are associated with better cognitive outcomes without having been shown to prevent disease.

Mahjong is a cognitively and socially engaging activity with interesting evidence behind it — but it should not be presented as a proven dementia-prevention treatment.

The social side

Mahjong is particularly interesting because traditional play puts cognitive challenge and regular face-to-face social contact in the same hour. Social connection is studied in its own right in healthy brain aging, which is why we cover loneliness during menopause and the brain and mood and social connection in midlife separately.

That does not mean mahjong has been proven to prevent dementia through socializing. What it does mean is that a weekly game may deliver two things at once — cognitive engagement and company — which is part of why it sits naturally alongside the habits in Brain Health After 40 and exercise and brain health.