***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: Publication bias , sometimes known as the " file-drawer problem " or " funnel-plot asymmetry , " is common in empirical research . The authors review the implication s of publication bias for quantitative research synthesis ( meta- analysis ) and describe existing techniques for detecting and correcting it . A new approach is proposed that is suitable for application to meta-analytic data sets that are too small for the application of existing methods . The model estimates parameters relevant to fixed-effects , mixed-effects or r and om-effects meta- analysis contingent on a hypothetical pattern of bias that is fixed independently of the data . The authors illustrate this approach for sensitivity analysis using 3 data sets adapted from a commonly cited reference work on research synthesis ( H. M. Cooper & L. V. Hedges , 1994 ) Background Epidemiologic evidence suggests that cognitive and physical activities are associated with better cognition in late life . The present study was conducted to examine the possible benefits of four structured lifestyle activity interventions and compare their effectiveness in optimizing cognition for older adults with mild cognitive impairment ( MCI ) . Method and Findings This was a 12-month cluster r and omized controlled trial . 555 community-dwelling Chinese older adults with MCI ( 295 with multiple-domain deficits ( mdMCI ) , 260 with single-domain deficit ( sdMCI ) ) were recruited . Participants were r and omized into physical exercise ( P ) , cognitive activity ( C ) , integrated cognitive and physical exercise ( CP ) , and social activity ( S , active control ) groups . Interventions comprised of one-hour structured activities three times per week . Primary outcome was Clinical Dementia Rating sum of boxes ( CDR-SOB ) scores . Secondary outcomes included Chinese versions of Alzheimer ’s Disease Assessment Scale - Cognitive subscale ( ADAS-Cog ) , delayed recall , Mini-Mental State Examination , Category Verbal Fluency Test ( CVFT ) and Disability Assessment for Dementia – Instrumental Activities of Daily Living ( DAD-IADL ) . Percentage adherence to programs and factors affecting adherence were also examined . At 12th month , 423 ( 76.2 % ) completed final assessment . There was no change in CDR-SOB and DAD-IADL scores across time and intervention groups . Multilevel normal model and linear link function showed improvement in ADAS-Cog , delayed recall and CVFT with time ( p<0.05 ) . Post-hoc subgroup analyses showed that the CP group , compared with other intervention groups , had more significant improvements of ADAS-Cog , delayed recall and CVFT performance with sdMCI participants ( p<0.05 ) . Overall adherence rate was 73.3 % . Improvements in ADAS-Cog and delayed recall scores were associated with adherence after controlling for age , education , and intervention groups ( univariate analyses ) . Conclusions Structured lifestyle activity interventions were not associated with changes in everyday functioning , albeit with some improvements in cognitive scores across time . Higher adherence was associated with greater improvement in cognitive scores . Factors to enhance adherence should be specially considered in the design of psychosocial interventions for older adults with cognitive decline . Trial Registration Clinical Trials.gov BACKGROUND Participation in leisure activities has been associated with a lower risk of dementia .  It is unclear whether increased participation in leisure activities lowers the risk of dementia or participation in leisure activities declines during the pre clinical phase of dementia . METHODS We examined the relation between leisure activities and the risk of dementia in a prospect i ve cohort of 469 subjects older than 75 years of age who resided in the community and did not have dementia at base line . We examined the frequency of participation in leisure activities at enrollment and derived  cognitive-activity and physical-activity scales in which the units of measure were activity-days per week . Cox proportional-hazards analysis was used to evaluate the risk of dementia according to the base-line level of participation in leisure activities , with adjustment for age , sex , educational level , presence or absence of chronic medical illnesses , and base-line cognitive status . RESULTS Over a median follow-up period of 5.1 years ,  dementia  developed in 124 subjects ( Alzheimer 's disease in 61 subjects , vascular dementia in 30 , mixed dementia in 25 , and other types of dementia in 8) . Among leisure activities , reading , playing board games , playing musical instruments , and dancing were associated with a reduced risk of dementia . A one-point increment in the cognitive-activity score was significantly associated with a reduced risk of dementia ( hazard ratio , 0.93 [ 95 percent confidence interval , 0.90 to 0.97 ] ) , but a one-point increment in the physical-activity score was not ( hazard ratio , 1.00 ) . The association with the cognitive-activity score persisted after the exclusion of the subjects with possible pre clinical dementia at base line . Results were similar for Alzheimer 's disease and vascular dementia . In linear mixed models , increased participation in cognitive activities at base line was associated with reduced rates of decline in memory . CONCLUSIONS Participation in leisure activities is associated with a reduced risk of dementia , even after adjustment for base-line cognitive status and after the exclusion of subjects with possible pre clinical dementia . Controlled trials are needed to assess the protective effect of cognitive leisure activities on the risk of dementia OBJECTIVES Investigate the psychometric characteristics of the  coping self-efficacy ( CSE ) scale , a 26-item measure of one 's confidence in performing coping behaviors when faced with life challenges . DESIGN Data came from two r and omized clinical trials ( N1=149 , N2=199 ) evaluating a theory-based Coping Effectiveness Training ( CET ) intervention in reducing psychological distress and increasing positive mood in persons coping with chronic illness . METHODS The 348 participants were HIV-seropositive men with depressed mood who have sex with men . Participants were r and omly assigned to intervention and comparison conditions and assessed pre- and post-intervention . Outcome variables included the CSE scale , ways of coping , and measures of social support and psychological distress and well-being . RESULTS Exploratory ( EFA ) and confirmatory factor analyses ( CFA ) revealed a 13-item reduced form of the CSE scale with three factors : Use problem-focused coping ( 6 items , alpha=.91 ) , stop unpleasant emotions and thoughts ( 4 items , alpha=.91 ) , and get support from friends and family ( 3 items , alpha=.80 ) . Internal consistency and test-retest reliability are strong for all three factors . Concurrent validity analyses showed these factors assess self-efficacy for different types of coping . Predictive validity analyses showed that residualized change scores in using problem- and emotion-focused coping skills were predictive of reduced psychological distress and increased psychological well-being over time . CONCLUSIONS The CSE scale provides a measure of a person 's perceived ability to cope effectively with life challenges , as well as a way to assess changes in CSE over time in intervention research The results of a r and omized controlled trial of repetition-lag training in older adults with amnestic mild cognitive impairment ( aMCI ) are reported . A modified repetition-lag training procedure with extended encoding time and strategy choice was used . The training required discriminating studied words from non-studied lures that were repeated at varying intervals during the test phase . Participants were assessed pre/post using untrained measures of cognition and self-report question naires . Primary outcome measures were recall of unrelated word pairs both immediately following presentation and following a delay . Secondary outcomes were a measure of attention , cognitive flexibility , and visual working memory . Participants were also asked to report on the frequency of cognitive failures and mood before and after training . Participants ( N = 31 ) were r and omized into either the treatment or a no-contact control group  and attended the clinic twice per week over a four week period . Twenty-four participants completed the study ( twelve in each group ) . Results indicated that the training group improved at recalling unrelated word pairs after a delay . There were no significant effects of training on other outcomes , self-reported cognitive failures or mood . The results are discussed along with suggestions for future research BACKGROUND This paper describes the development and validation of the Memory Inventory for Chinese ( MIC ) , for measuring the awareness of memory deficits in the Chinese population with Alzheimer 's disease ( AD ) . METHODS A combination of qualitative and quantitative approaches was adopted . The MIC was developed with focus group discussion and pilot testing . It has a patient and a caregiver version . A consecutive series of 79 new out- patients with the National Institute of Neurological and Communicative Disorders and Stroke and the Alzheimer 's Disease and Related Disorder Association ( NINCDS-ADRDA ) criteria of probable and possible AD and 20 non-demented elderly subjects were recruited . RESULTS A high internal consistency was found , with Cronbach alpha of 0.89 for the patient version and 0.90 for the caregiver version of MIC . The inter-rater reliability was satisfactory . For validity assessment , the caregiver score of the MIC  correlated significantly with cognitive score of the subject as assessed by the Mini-Mental State Examination ( rp = -0.37 ; p < 0.01 ) . The Memory Deficit Awareness Score , calculated by subtracting the patient score from the caregiver score , correlated significantly with clinician ratings of awareness of memory impairment ( rs = -0.67 ; p < 0.01 ) . CONCLUSIONS The MIC appears to be a culturally appropriate and valid instrument for the measurement of awareness of memory deficits in Chinese patients with AD . Potential applications of the MIC should be further explored in other subtypes of dementia and in prospect i ve studies Background : Evidence as to the benefits of nonpharmacological interventions for the boundary state between normal aging and dementia [ mild cognitive impairment or a Clinical Dementia Rating ( CDR ) of 0.5 ] remains weak due to a lack of positive controls . Aims : To directly compare the effects of cognitive interventions ( CI ) , physical activities ( PA ) and a group reminiscence approach ( GRA ) , we conducted a pilot study on the basis of a cluster r and omized controlled trial design . Method : A total of 127 participants aged > 74 years with a CDR of 0.5 were cluster r and omized into three groups for CI , PA and GRA . The intervention lasted 12 weeks and consisted of weekly group sessions and home assignments . Mini-Mental State Examination ( MMSE ) , Trail Making Test part A ( TMT-A ) , word fluency ( WF ) , 6-meter walk time and Quality of Life ( QOL ) Face Scale scores were evaluated as primary outcomes . Results : Methodology -related benefits of CI and PA were found for MMSE scores and walk time , respectively . TMT-A , WF and QOL Face Scale scores improved irrespective of the method ologies used . Conclusions : Our findings suggest that CI and PA may be beneficial to cognitive and physical abilities , respectively . Executive functions and QOL may improve irrespective of the intervention method ologies used OBJECTIVE This study evaluates the efficacy at 12 months of a computer-based cognitive training ( CBCT ) program , adjunctive to traditional cognitive training ( TCT ) , on the basis of pen- and -paper exercises . METHODS Sixty patients with multi-domain mild cognitive impairment and mild Alzheimer 's disease who were already receiving cognitive training , recruited from a day hospital , were assigned into two groups following a simple r and omization procedure ( computerized r and om numbers ) : ( i ) a group that received CBCT during 3 months and TCT ( CBCT + TCT ) , n = 37 , and ( ii ) a group that received only TCT , n = 23 . Patients were assessed at baseline and after 3 and 12 months of treatment by a neuropsychologist blinded to group assignment , with a neuropsychological battery ( primary outcomes ) and measures of decision making , memory complaints , and emotional disturbances . RESULTS With the use of repeated- measures analyses of covariance , the CBCT + TCT group showed less anxiety symptoms ( F = 5.13 , p = 0.03 , d = 1.12 ) and less disadvantageous choices ( F = 4.70 , p = 0.04 , d = 0.89 ) in decision making than the TCT group at 12 months . No significant improvement or worsening was observed in the other measures examined . However , positive effect sizes favoring the CBCT + TCT group were observed in all variables . CONCLUSIONS The addition of a CBCT program was effective in anxiety and decision making but had no significant effects on outcomes in basic cognitive functions in patients who were already receiving cognitive training , possibly due to a ceiling effect . Future studies should compare the efficacy of CBCT with TCT in naïve patients BACKGROUND Subjects with a mild cognitive impairment ( MCI ) have a memory impairment beyond that expected for age and education yet are not demented . These subjects are becoming the focus of many prediction studies and early intervention trials . OBJECTIVE To characterize clinical ly subjects with MCI  cross-sectionally and longitudinally . DESIGN A prospect i ve , longitudinal inception cohort . SETTING General community clinic . PARTICIPANTS A sample of 76 consecutively evaluated subjects with MCI were compared with 234 healthy control subjects and 106 patients with mild Alzheimer disease ( AD ) , all from a community setting as part of the Mayo Clinic Alzheimer 's Disease Center/Alzheimer 's Disease Patient Registry , Rochester , Minn. MAIN OUTCOME MEASURES The 3 groups of individuals were compared on demographic factors and measures of cognitive function including the 
    Output:
    
Computerized studies appeared to benefit mood ( depression , anxiety , and apathy ) compared to controls , while therapist-based interventions and multimodal interventions had more impact on ADLs and metacognitive outcomes than control conditions .