| Author: | Tse, Cho Kwan |
| Title: | Relationships between leisure activity participation, mahjong playing and cognitive, psychological and daily functions in older individuals |
| Advisors: | Shum, David (RS) |
| Degree: | Ph.D. |
| Year: | 2025 |
| Department: | Department of Rehabilitation Sciences |
| Pages: | xix, 358 pages : color illustrations |
| Language: | English |
| Abstract: | Ageing is a dynamic and modifiable process (Dixon, 2011). As population ageing would lead to significant social and financial burdens, it is important to investigate strategies that may promote functions in older adults. Previous studies have shown that leisure activity participation is one strategy to increase cognitive reserve and promote better functions of ageing. The literature, however, had focused on general cognition and seldom probed into higher-order cognitive (e.g., executive functions [EF]), psychological, and daily functions. Moreover, there is little research examining the benefits of culturally specific activities such as mahjong playing, which is a common and enjoyable leisure activity among Chinese older adults. Therefore, the current PhD project addressed the research gaps and investigated whether leisure activity participation and mahjong playing could help to facilitate better functions of ageing. To achieve this aim, three studies were conducted. Study 1 was a cross-sectional survey study (n = 525) that explored the relationships between leisure activity participation, mahjong playing, and the cognitive, psychological, and daily functions in older adults. Results showed that engaging in leisure activities could significantly predict general cognition, EF, loneliness, levels of depression, anxiety, stress, and functional independence. In addition, participation in a culturally specific leisure activity, mahjong playing, could significantly predict all of the above functions, suggesting that mahjong playing is a potential activity to promote better functions in Hong Kong older adults. Study 2 was a scoping review that examined the existing literature and synthesised the benefits of mahjong playing on cognitive, psychological, and daily functions in older adults. Fifty-three studies from the Western and Asian literature were included in the review, and the benefits of mahjong playing could be categorised into five domains: (i) subjective meaning attached to mahjong playing, (ii) short-term benefits, (iii) long-term benefits, (iv) relationship between mahjong playing and disease prevalence, and (v) effectiveness of mahjong interventions. The findings suggested that mahjong playing is beneficial for older adults, improving cognitive, psychological, and daily functions. Nevertheless, the underlying functional and neural mechanisms of how it facilitates better functions remained unclear. Study 3 used functional near-infrared spectroscopy (fNIRS) to clarify the relationships between mahjong playing and the updating and switching components of EF in younger (n = 36) and older adults (n = 36). Results showed that mahjong playing is closely related to EF, and significant prefrontal activations were observed during the computerised mahjong games designed to assess the two components of EF. More importantly, it was found that although older adults showed comparable behavioural performance to younger adults during the computerised mahjong games; they showed a significantly higher prefrontal activation than younger adults. It suggested that older adults may utilise neural compensation to offset the differences in behavioural performance, further explaining the underlying neural mechanism of the benefits of mahjong playing. Overall, findings in this thesis have contributed to the ageing literature by providing empirical evidence to support the benefits of leisure activity participation and one culturally specific activity (i.e., mahjong playing) in older adults. The research has also expanded the examination from general cognition to EF, psychological, and daily functions. Finally, this thesis has provided neural evidence to support the involvement of EF during mahjong playing and the reason for its benefits in older adults. |
| Rights: | All rights reserved |
| Access: | open access |
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