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Can leisure activities slow dementia progression in nursing home residents? A cluster-randomized controlled trial

  • Sheung-Tak Cheng (a1) (a2), Pizza K. Chow (a1), You-Qiang Song (a3), Edwin C. S. Yu (a4) and John H. M. Lam (a1)...



To examine the effects of complex cognitive (mahjong) and physical (Tai Chi) activities on dementia severity in nursing home residents with dementia.


Cluster-randomized open-label controlled design. 110 residents were randomized by nursing home into three conditions: mahjong, Tai Chi, and simple handicrafts (control). Activities were conducted three times a week for 12 weeks. Clinical Dementia Rating (CDR) was taken at 0 (baseline), 3 (post-treatment), 6, and 9 months. The outcome measure was CDR sum-of-box, which is a composite measure of both cognitive and functional deterioration in dementia.


Intent-to-treat analyses were performed using multilevel regression models. Apolipoprotein E ε4 allele and education were included as covariates. Neither treatments had effects on the cognitive and functional components of the CDR, but mahjong had a significant interaction with time on the CDR sum-of-box total, suggesting a slower rate of global deterioration in the mahjong group as compared with the control group.


Mahjong led to a gradual improvement in global functioning and a slightly slower rate of dementia progression over time. The effect was generalized and was not specific to cognition or daily functioning.


Corresponding author

Correspondence should be addressed to: Sheung-Tak Cheng, Department of Psychological Studies, Hong Kong Institute of Education, 10 Lo Ping Road, Tai Po, N.T., Hong Kong. Phone: +852 2948 6563; Fax: +852 2948 7702. Email:


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Can leisure activities slow dementia progression in nursing home residents? A cluster-randomized controlled trial

  • Sheung-Tak Cheng (a1) (a2), Pizza K. Chow (a1), You-Qiang Song (a3), Edwin C. S. Yu (a4) and John H. M. Lam (a1)...


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