Benefits of Online Mahjong by Older Adults

Study Overview
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Brief Summary
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This study aims to examine the clinical efficacy of online Mahjong in improving physical health, cognitive performance, happiness, laboratory biomarkers, and structural brain imaging (magnetic resonance imaging, MRI) by a randomized controlled trial design, and hopefully to expand the scope of healthy aging intervention activities with strong scientific evidence.

Detailed Description
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Psychomotor function among older adult's decline was associated with reducing people interaction during pandemic has been reported. The research focused on examining the benefit and efficacy of digital based Mahjong games with 6-month intervention is very limited or none. A random control design was conducted with comparing intervention group and with control group, followed the CONSORT guidelines. Six months program was intervened to ensure the impact of the intervention. Primary outcome is brain imagery changes between groups, which showed changes in temporal fusiform cortex but not in resting-state fMRI. The total score of MoCA, delayed recall was increase from baseline to after intervention in experimental group. Overall cognitive function and visuospatial/executive, in experimental group improved more than control group. Improving self-rating daily health status as associated with achievement rate of Mahjong game. Increasing level of resilience was associated with demoralization level, subtraction of cognitive function, and 5th month walking steps. In addition, affecting incased self -rate overall heath was related to demoralization. In short, online mahjong intervention has positive impact on older adults in cognitive function , resilience, demoralization and overall quality of life.

Official Title
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Randomized Trial of Online Mahjong Intervention to Promote Cognitive Function and Health Status in Community-dwelling Middle Aged and Older Adults.

Conditions
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Aged

Intervention / Treatment
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* Device: Bonus Winner Mahjong


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Age ≥ 55 years old. More than 6 years of formal education. Can communicate in Mandarin and Taiwanese. Can accept MRI examination without claustrophobia. Can understand the research process, meet the requirements of the research, and can sign the consent form and participate in the subject. Exclusion Criteria: Have engaged in any Mahjong games in the past three months. Engaged in Mahjong games more than three times per year in the past three years.

Ages Eligible for Study
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Minimum Age: 55 Years
Maximum Age: 74 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Supportive Care
Allocation: Randomized
Intervention Model: Parallel Assignment
Interventional Model Description: This study is a single-blind, parallel-group randomized controlled trial. Eligible participants were allocated randomly 1:1, without stratification, to either the intervention or the control group, according to a computer-generated random number sequence.
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| No Intervention: observation with no intervention group<br>The control group only performed routine data collection; the research assistant asked the subjects about their usual activities by telephone every month to understand their physical activity in this half of the year. | |
| Experimental: Mahjong group<br>The experimental group intervened a Bonus Winner Mahjong developed by Bonus Winner Online Entertainment Co., Ltd. The participants in experimental group played three times a week, each time requiring at least lasting 30 minutes, for half of a year. | Device: Bonus Winner Mahjong<br>* Bonus Winner Mahjong developed by Bonus Winner Online Entertainment Co., Ltd. The participants in experimental group played three times a week, each time requiring at least lasting 30 minutes, for half of a year.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in MRI study from baseline to 6 months in the intervention group. | Change in MRI study from baseline to 6 months in the intervention group. | baseline and 6 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Montreal Cognitive Assessment (MoCA) | Cognitive function measure by MoCA , which comprise a 30-question test.Score range: 0-30, and a score of 26 and higher is considered normal. | baseline and 6 months | 
| EuroQol instrument (EQ-5D) | Quality of life measure by EQ-5D, which include five questions on mobility, self care, pain, usual activities, and psychological status. Score range: There are three level of the answers for each question, the maximum score of 1 refers to the best condition without problem, and higher scores refers more severe of the issue. Moreover, the visual analogue scale (VAS) which from 0-100, higher score indicating better health status. | baseline and 6 months | 
| International Physical Activity Questionnaire (IPAQ) | Physical activity measured by IPAQ, indicates that spent being physically active within the prior 7 days. Score range: There are no established thresholds for presenting MET-minutes, the IPAQ Research Committee proposes that reported as comparisons of median values and interquartile ranges for different populations. | baseline and 6 months | 
| Brief Resilience Scale (BRS) | Resilience measured by BRS to assess ability to bounce back or recover from stress and adversity. Score range: 6-30, and higher scores refers to higher level of resilience. | baseline and 6 months | 
| Demoralization Scale-Mandarin Version (DS-MV) | Demoralization measure by DS-MV, comprised 24 items and each rated on a five-point Likert scale.Score range: 0-96, and cut-off point score ≥30 was considered to identified demoralization. | baseline and 6 months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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online Mahjong, physical activity, cognitive function, quality of life in older adults