Could a few rounds of mahjong with friends help middle-aged and elderly people prevent depression? A study jointly conducted by Professor Zhuo Chen, Chair Professor in Health Economics at the University of Nottingham Ningbo China (UNNC), together with scholars from Huazhong University of Science and Technology, has recently attracted widespread attention. Entitled Melancholy or mahjong? Diversity, frequency, type, and rural-urban divide of social participation and depression in middle- and old-aged Chinese: A fixed-effects analysis, the research was published in the leading international journal Social Science & Medicine.
Drawing on data from the China Health and Retirement Longitudinal Study, the researchers analysed nearly 11,000 Chinese residents aged 45 and above, offering a culturally adapted perspective on mental health interventions among middle-aged and elderly populations.
Professor Chen noted that, during the process of urbanisation, many middle-aged and elderly people face loneliness and psychological stress, with more than 25% of Chinese individuals aged 45 and above at risk of depression. Although social interaction is known to benefit mental health, evidence on the effects of specific social activities remains limited.
Against this backdrop, the study found that moving from no social participation to regular involvement in one or more activities can significantly ease depressive symptoms. Even taking part in an activity once a week can improve wellbeing by strengthening social support and reducing loneliness.
The effects of different social activities also vary between urban and rural elderly populations. Urban residents can benefit from activities such as playing mahjong, card games, or joining sports clubs and dance teams. However, these do not appear to bring the same benefits for rural elderly people. In some rural areas, mahjong is often linked to gambling, and the anxiety and financial losses associated with winning or losing may increase psychological stress. Instead, rural elderly people tend to derive "emotional support" from relationship-based interactions, such as visiting relatives and friends or chatting with neighbours.
Professor Chen suggested tailored intervention measures: in urban areas, support should be given to developing community activity facilities such as mahjong rooms and clubs; in rural areas, more emphasis should be placed on promoting neighbourhood interactions, such as organising tea gatherings, to help rebuild rural social networks.
"With limited mental health resources available," he stated, "strategically promoting social participation offers a cost-effective and accessible way to address the psychological challenges of ageing. These social frameworks not only improve wellbeing but also create vital support networks for vulnerable older people."