This process is repeated for approximately 70 rounds to complete the hand as quickly as possible. Each player has 13 tiles and has to take one tile from the remaining blocks in a counterclockwise direction and discard one simultaneously. Mahjong, a table game played by three to four players, uses 136 tiles, four each of 34 types. This makes it difficult to conduct prospective studies therefore, fewer prospective studies have been conducted. Moreover, it is difficult to grasp the rules of table games, such as chess, and they require a certain amount of effort and a minimum level of intelligence as a prerequisite. This is not because video games have a stronger impact on intelligence and cognitive function than table games, but rather because video games are easy and quick, and anyone can play them, making intervention studies easier. In comparison, video games have been the subject of many positive studies, indicating that the effects of video games increased intelligence and cognitive function (Stern et al., 2011 Baniqued et al., 2013 Oei and Patterson, 2013). Hence, a causal relationship has not been clearly identified. However, the relationship between chess and IQ is unclear, and most studies exploring this relationship were cross-sectional. This finding was consistent with the report by Campitelli and Gobet ( 2011). ( 2007) reported that the amount of practice was the factor that affected chess skills the most, but not IQ. In addition, a weak correlation was found between chess performance and IQ (Bilalić et al., 2007). Furthermore, the average IQ of chess players was approximately 120, higher than the population average. For chess, the most studied table game regarding its relationship with brain function, some studies have shown that game skill is correlated with processing speed and executive function (Burgoyne et al., 2016). There is no consensus on whether interpersonal table games are correlated with IQ. In addition to environmental and genetic factors, IQ is also affected by training (Sauce and Matzel, 2018). In contrast, for IQ, the younger the age, the more the individual is influenced by the environment (Fulker et al., 1988). The heritability of BMI is higher during childhood, and the influence of environmental factors becomes stronger as the child grows. The heritability of intelligence is approximately 0.8 (Sauce and Matzel, 2018), stronger than the heritability of cancer (0.1), mental disorders (0.4) (Athanasiadis et al., 2022), and body mass index (BMI) (0.6) (Elks et al., 2012). The degree to which genes are involved in an individual's characteristics is indicated by the concept of heritability, expressed as 1.0 when the entire effect can be explained by genes. Heredity is considered to strongly influence intelligence quotient (IQ). This study suggests that children who participate in Mahjong classes during their childhood have increased PSI scores of WISC-IV. The PSI of the children included in the analysis showed a statistically significant increase compared to the historical control group. Based on the subscale index, the verbal comprehension index (VCI) and processing speed index (PSI) scores both showed a statistically significant increase from 100.6 to 106.75 and from 108.05 to 119.05 ( p < 0.01), respectively. The mean overall full-scale IQ of the 20 children during the initial and post-1-year examinations was 106.05 and 113.75, respectively, and showed a statistically significant increase ( p < 0.01). The change in the IQ of this group was compared to that of a historical control group with a similar age range and test–retest interval. In addition, we conducted a 1-year post-examination. Their mean age at the time of the initial evaluation was 9 years and 6 months. Twenty children were included in the analysis. The participants were children between the age of 6 and 15 years, and their IQ was assessed immediately after enrolling in children's Mahjong classes and 1 year after the enrollment using the Wechsler Intelligence Scale for Children Fourth Edition (WISC-IV). This study investigated the effect of Mahjong, which is a table game played by three or four players and involves intellectual activity, on the intelligence quotient (IQ) of children.
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