***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: BACKGROUND Dietary carbohydrates can improve memory . Whether these effects are related to elevations in blood glucose or to energy ingestion is unknown . OBJECTIVES Our objectives were to determine 1 ) the influence of isoenergetic protein- , carbohydrate- , and fat-containing drinks on cognitive performance and 2 ) whether the time period after ingestion affects cognition . DESIGN After fasting overnight , 11 men and 11 women aged 61 - 79 y consumed either a 300-mL drink containing 774 kJ as pure protein ( whey ) , carbohydrate ( glucose ) , or fat ( safflower oil ) or a nonenergy placebo on 4 separate mornings .  Cognitive tests were administered 15 and 60 min after ingestion of the drinks . Plasma glucose and serum insulin concentrations were measured . RESULTS Only the carbohydrate drink increased blood glucose ( P < 0.0001 ) . Compared with the placebo , all 3 macronutrients improved delayed paragraph recall ( PR ) ( P < 0.001 ) and improved or tended to improve immediate PR ( P < 0.04 ) 15 min after ingestion . Beneficial effects on other cognitive tests were confined to one or more of the macronutrients : carbohydrate improved Trail Making Test ( Trails ) performance at 60 min ( P = 0.02 ) and tended to improve Trails at 15 min ( P = 0.04 ) and PR at 60 min in men , carbohydrate and fat improved or tended to improve performance on Trails at 15 and 60 min in subjects with poor baseline scores ( r > -0.41 , P < 0.03 ) , fat tended to improve attention at 60 min ( P < 0.05 ) , and protein reduced the rate of forgetting on the PR at 15 min ( P = 0.002 ) . CONCLUSIONS Energy intake from protein , carbohydrate , or fat can enhance memory independently of elevations in blood glucose . Each macronutrient may also exert unique effects on cognition The influence of seven highly prevalent somatic chronic diseases on changes in cognitive functioning is investigated in older persons in a prospect i ve design covering a 6-year follow-up period . The data were collected as part of the Longitudinal Aging Study Amsterdam ( LASA ) . The associations between chronic diseases and cognitive functioning during 6 years of follow-up were analyzed among 1358 respondents ( age 62 - 85 ) using generalized estimated equations ( GEE ) . Cognitive tests were used to assess : general cognitive functioning , fluid intelligence , information processing speed and memory performance . In the fully adjusted models diabetes mellitus , stroke and peripheral artherosclerosis were associated with cognitive decline during a 6-year follow-up period in older persons . In the unadjusted models cardiac disease was negatively associated with memory function . However , after the correction for possible confounders this association became positive . Cancer was also associated with better memory function . A faster decline in especially memory function was found for diabetes mellitus , stroke , cancer , and peripheral artherosclerosis . The study shows that in older persons specific chronic diseases ( diabetes mellitus , stroke , cancer , and peripheral artherosclerosis ) are associated with decline in one or more domains of cognitive functioning during a 6-year follow-up period . These findings further stress that careful clinical evaluation of cognitive functioning in older persons with these diseases is required in order to provide adequate care A sample of 704 cognitively intact individuals ( M age = 63.7 years ) performed a battery of cognitive tests on as many as three occasions , at approximately 3-year intervals . The authors used r and om effects models to analyze cross-sectional relationships between cognitive performance and state anxiety and longitudinal relationships between cognitive change and neuroticism , after controlling for gender , age , and education . Cross-sectionally , higher state anxiety was associated with poorer performance on Wechsler Adult Intelligence Scale Synonyms , WIT III Analogies , Koh 's Block Design , two measures of visual learning ( Names and Faces and Thurstone 's Picture Memory ) , and , for men , CVB-Scales Digit Span Test and Card Rotations . In longitudinal models , the main effects for neuroticism were significant for Block Design , Symbol Digit , and Names and Faces , but there were no significant interactions among neuroticism , gender , and time . These results provide some support for Eysenck 's processing efficiency theory but none for neuroticism as a risk factor for cognitive decline in normal aging Background : Cross-sectional studies suggest gender differences in cognitive function and risk of AD in older persons . However , longitudinal studies comparing change in cognitive function and risk of AD in men and women have had mixed results . The authors investigated gender differences in rate of decline for different cognitive systems and for risk of developing AD . Methods : Participants were from the Religious Orders Study , a longitudinal , clinical –pathologic study of aging and AD in older Catholic nuns , priests , and brothers . Longitudinal data were available from 577 older women and 271 older men , who completed an average of 5.8 annual evaluations with more than 95 % follow-up participation in survivors . The evaluations included 21 neuropsychological tests  , from which summary measures of global cognitive function and 5 functional domains were formed , and clinical classification of AD . Results : R and om effects models were used to analyze change in cognitive function , and proportional hazards models were used to assess risk of incident AD . On average , men and women declined in all abilities during the 8-year period but did not differ in annual rates of change in analyses that controlled for age , education , and initial level of cognitive function . Risk of incident AD did not differ between men and women . Furthermore , results were unchanged after controlling for possession of the apolipoprotein-ε4 allele . Duration of estrogen use was related to rate of global cognitive decline and visuospatial abilities in women but did not influence comparisons between men and women in cognitive decline . Conclusions : The results suggest that patterns of cognitive decline and incidence of AD are similar in older men and women Objective : To study the difference in risk for dementing diseases between men and women . Background : Previous studies suggest women have a higher risk for dementia than men . However , these studies include small sample sizes , particularly in the older age groups , when the incidence of dementia is highest . Methods : Pooled analysis of four population -based prospect i ve cohort studies  was performed . The sample included persons 65 years and older , 528 incident cases of dementia , and 28,768 person-years of follow-up . Incident cases were identified in a two-stage procedure in which the total cohort was screened for cognitive impairment , and screen positives underwent detailed diagnostic assessment . Dementia and main subtypes of AD and vascular dementia were diagnosed according to internationally accepted guidelines . Sex- and age-specific incidence rates , and relative and cumulative risks for total dementia , AD , and vascular dementia were calculated using log linear analysis and Poisson regression . Results : There were significant gender differences in the incidence of AD after age 85 years . At 90 years of age , the rate was 81.7 ( 95 % CI , 63.8 to 104.7 ) in women and 24.0 ( 95 % CI , 10.3 to 55.6 ) in men . There were no gender differences in rates or risk for vascular dementia . The cumulative risk for 65-year-old women to develop AD at the age of 95 years was 0.22 compared with 0.09 for men . The cumulative risk for developing vascular dementia at the age of 95 years was similar for men and women ( 0.04 ) . Conclusion : Compared with men , women have an increased risk for AD . There are no gender differences in risk for vascular dementia In this prospect i ve study we examined whether total cholesterol and the oxysterols 24S- and 27-hydroxycholesterol were related to cognitive performance  and  rate of cognitive decline in elderly , and whether these associations were modified by ApoE epsilon 4 . Data were collected during 6 years of follow-up as part of the Longitudinal Aging Study Amsterdam ( N=1181 , age > or=65 years ) , and analyzed using generalized estimating equations . Cognitive performance was measured with the  mini-mental state examination ( general cognition ) , the auditory verbal learning test ( memory ) and the coding task ( information processing speed ) . Lower cholesterol at baseline was negatively associated with both general cognition ( p=.012 ) and information processing speed ( p=.045 ) . ApoE modified the association between cholesterol and cognitive decline , and the association between the ratio of 27-hydroxycholesterol to cholesterol and cognitive functioning . In ApoE epsilon 4 carriers , lower cholesterol was related to a higher rate of decline on information processing speed ( p=.006 ) , and a higher ratio of 27-hydroxycholesterol to cholesterol was related to a lower level of general performance ( p=.002 ) and memory functioning ( p=.045 ) . The results implicate that lower total cholesterol may be considered as a frailty marker , predictive of lower cognitive functioning in elderly Purpose : To analyse the effects of two interventions on the cognition and balance of institutionalized elderly people with mixed dementia . Methods : Fifty-four participants were allocated into three groups . Group 1 was assisted by an interdisciplinary programme comprising physiotherapy , occupational therapy and physical education . A physiotherapist alone carried out the intervention in group 2 . Group 3 was considered as control . Assessors were blinded to guarantee the absence of bias . Cognitive functions were analysed with the  Mini-Mental State Examination and the Brief Cognitive Screening Battery . Balance was assessed with the Berg Balance Scale and the Timed Get-Up- and -Go Test . Multiple analysis of variance ( MANOVA ) was used to test possible main effects of the interventions . Results : The results showed benefits on the balance of subjects in both groups 1 ( F=3.9 , P<0.05 ) and 2 ( F=3.1 , P<0.05 ) , compared with group 3 . MANOVA did not indicate benefits on the cognitive functions between groups 1 and 3 ( F=1.1 , P>0.05 ) and groups 2 and 3 ( F=1.6 , P>0.05 ) . However , univariate analysis indicated some benefits of the interdisciplinary intervention on two specific domains measured by the Brief Cognitive Screening Battery ( F=26.5 , P<0.05 ; F=4.4 , P<0.05 ) . Conclusion : Six months of multidisciplinary or physiotherapeutic intervention were able to improve a person 's balance . Although global cognition did not improve through treatment , when the intervention was carried out on a multidisciplinary basis we observed an attenuation in the decline of global cognition on two specific cognitive domains . Exercises applied in different context s may have positive outcomes for people with dementia Interpretations of longitudinal studies of cognitive aging are misleading unless effects of practice and selective drop-out are considered . A r and om effects model taking practice and drop-out into account analyzed data from four successive presentations of each of two intelligence tests , two vocabulary tests , and two verbal memory tests during a 17-year longitudinal study of 5,899 community residents whose ages ranged from 49 to 92 years . On intelligence tests , substantial practice effects counteracted true declines observed over 3 to 5 years of aging and remained significant even with intervals of 7 years between successive assessment s. Adjustment for practice and drop-out revealed accelerating declines in fluid intelligence and cumulative learning , linear declines in verbal free recall , and no substantial change in vocabulary . Socioeconomic status and basal levels of general fluid ability did not affect rates of decline . After further adjustment for demographics , variability between individuals was seen to increase as the sample aged The benefits of physical exercise on cognitive functioning have been reported in the literature , but the potential benefits to slow the eventual decline in executive functioning ( EF ) caused by neurodegeneration from Parkinson 's Disease ( PD ) have rarely been studied . Thus the objective of this study was to analyze the effects of a multimodal physical exercise program on EF in older people with Parkinson 's disease . The EF of the older people was evaluated by neuropsychological testing , and for confounding variables such as attention , depressive symptoms and anxiety , before and after intervention . The 20 participants were assigned into  Control ( CG ) and Trained ( TG ) Groups . The TG participated in generalized physical training for 6 months . The ANOVA showed a significant interaction ( p<.05 ) that indicated a beneficial contribution of training on EF . No significant interactions were found in the results for confounding variables between groups and pre- and post-intervention , which supports the beneficial findings of physical exercise training on EF 
    Output:
    
Elderly women showed better performance in tests of episodic memory , whereas elderly men had a better visuospatial ability .
Despite differences observed in some domains , most of the studies showed that this rate is similar between the sexes until the age of 80 years .
It is unclear whether sex influences the rate of cognitive decline after the age of 80 years .
The present review observed that sex does not determine the rate of cognitive decline between 60 and 80 years-of-age .