A Randomized Controlled Trial of the Therapeutic Effects of Tai Chi and Mahjong on Older Persons With Cognitive Impairment

Eight nursing homes will be randomized into four treatment groups, each containing two homes: Tai Chi only, mahjong only, Tai Chi cum mahjong, and placebo. During the three-month treatment period, the Tai Chi only and mahjong only groups will practice the respective activity three times a week, and the Tai Chi cum mahjong group will practice each type of activity three times a week on alternate days. Forty participants with an MMSE score >11 and <24, and who have not engaged in Tai Chi and mahjong in the previous three months, will be recruited from each home. Measures of cognitive, physical, emotional and behavioural functioning will be taken at baseline, and at 3, 6, 9, 12 and 15 months. A daily log of relevant events will also be kept for each participant. Possession of the apolipoprotein Ee4 allele (a genetic marker for Alzheimer’s disease) will be tested using the most advanced genotyping procedure, and will be treated as a moderator to see if the efficacy of these treatments applies more to those without the gene. The longitudinal dataset will allow us to assess the extent to which a time-limited intervention changes the long-term participation and functioning of the residents into 12 months post-treatment.