***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 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  Mini-Mental State Examination , Wechsler Adult Intelligence Scale-Revised , Wechsler Memory Scale-Revised , Dementia Rating Scale , Free and Cued Selective Reminding Test , and Auditory Verbal Learning Test .  Clinical classifications of dementia and AD were determined according to the Diagnostic and Statistical Manual of Mental Disorders , Revised Third Edition and the National Institute of Neurological and Communicative Disorders and Stroke-Alzheimer 's Disease and Related Disorders Association criteria , respectively . RESULTS The primary distinction between control subjects and subjects with MCI was in the area of memory , while other cognitive functions were comparable . However , when the subjects with MCI were compared with the patients with very mild AD , memory performance was similar , but patients with AD were more impaired in other cognitive domains as well . Longitudinal performance demonstrated that the subjects with MCI declined at a rate greater than that of the controls but less rapidly than the patients with mild AD . CONCLUSIONS Patients who meet the criteria for MCI can be differentiated from healthy control subjects and those with very mild AD . They appear to constitute a clinical entity that can be characterized for treatment interventions One of the defining differences between mild cognitive impairment ( MCI ) and dementia is the degree of independence in everyday activities . Effecting memory-related behavioural change in MCI could help maintain daily function and prolong the time before onset of dependency . However , it is well known that changing previously well-established behaviours is difficult to achieve . We conducted a r and omised controlled trial to evaluate the effectiveness of a multidisciplinary group-based intervention programme in changing everyday memory behaviour in individuals with amnestic MCI . The intervention provided evidence d-based memory training and lifestyle education to optimise memory behaviour .  Fifty-four participants were r and omly assigned to treatment or waitlist-control conditions . Consistent with our primary goal , treatment participants showed an increase in memory- strategy knowledge and use from pre-test to immediate post-test , and these gains were maintained at three-month post-test relative to waitlist controls . There were no group differences in memory beliefs or on laboratory tests of objective memory performance . The increase in memory- strategy knowledge and use was associated with the degree of participation in the programme . Individuals with MCI , therefore , can acquire and maintain knowledge about memory strategies and , importantly , can change their everyday memory behaviour by putting this knowledge into practice . This incorporation of practical memory strategies into daily routines could potentially provide the means for maintaining functional independence by individuals with MCI , an issue to be addressed in future research OBJECTIVES This article describes results of a r and omized controlled trial comparing a time-limited  early-stage memory loss ( ESML )  support group program conducted by a local Alzheimer 's Association chapter to a wait-list ( WL ) control condition . METHODS One hundred and forty-two dyads were r and omized in blocks to ESML ( n = 96 ) or WL ( n = 46 ) . Mean age of participants was 74.9 years , and mean Mini-Mental State Examination was 23.4 . The primary outcome was participant 's quality of life ; secondary outcomes included mood , family communication , and perceived stress . RESULTS On the intent-to-treat ( ITT ) pre-post analysis , significant differences were seen in participant quality of life ( p < .001 ) , depression ( p < .01 ) , and family communication ( p < .05 ) . Within the care partner groups , there was no significant difference between ESML and WL in the ITT analysis . A post hoc exploratory examination of changes that were associated with improved quality of life in ESML participants revealed significant reductions of depressive symptoms and behavior problems ( p < .05 ) , improved family communication ( p < .05 ) , self-efficacy ( p < .01 ) , Medical Outcomes Study short form ( SF-36 ) role-emotional ( p < .05 ) , SF-36 social functioning ( p < .05 ) , and SF-36 mental health components ( p < .01 ) in improvers . DISCUSSION These results support the efficacy of ESML support groups for individuals with dementia Background : Patients with mild cognitive impairment ( MCI ) have to deal with an uncertain prognosis and also face a multitude of memory-related problems and psychosocial consequences . A newly developed group programme proved to be feasible , however , it needed confirmation by a controlled study . Aim : This controlled study evaluates this group therapy for MCI patients aim ed to help them accept and manage the memory problems and the psychosocial consequences . The programme combines elements from psychoeducation , cognitive rehabilitation and cognitive-behavioural therapy . Patients and Methods : Ninety-three MCI patients received treatment , with 30 patients being first assigned to a waiting list , thus serving as their own control group . Pre- and post-treatment acceptance and helplessness were assessed using subscales of the Illness Cognition Question naire , while distress and general well-being were gauged with the Geriatric Depression Scale and subscales of the R AND -36 . Results : Linear mixed model analyses showed that , relative to the controls , acceptance had increased more in the intervention group compared to the waiting-list period ( p = 0.034 ) . Distress and general well-being showed no changes . Treatment responders demonstrating a clinical ly significant effect on acceptance and two of three secondary outcome measures had higher baseline levels of helplessness and fewer self-reported memory complaints in daily life than patients who did not improve . Conclusion : The intervention helped the patients deal better with their uncertain future in that they were overall better able to accept their condition , with especially the female patients showing a decrease in helplessness cognitions , although the effects were relatively small Objectives : The Enriched Opportunities Programme ( EOP ) is a multi-level intervention focussing on improved quality of life for people with dementia . This study compared the experience of people living with dementia and other mental health problems in extra care housing schemes that utilised EOP with schemes that employed an active control intervention . Method : Ten extra care housing schemes were cluster r and omised to receive either the EOP intervention or an active control intervention for an 18-month period . Residents with dementia or other significant mental health problems ( 20–30 per scheme ) were assessed on a number of outcome measures at baseline , six months , one year and 18 months . The primary outcome measure was quality of life . Self-reported depression was an important secondary outcome . Results : The EOP-participating residents rated their quality of life more positively over time ( 4.0 ( SE 0.6 ) units ; 14 % p < 0.001 ) than the active control ( 1.3 ( SE 0.6 ) units ; 4 % p = 0.003 ) . There was also a significant group – time interaction for depressive symptoms ( p = 0.003 ) . The EOP-participating residents reported a reduction of 25 % at both six and 12 months and a 37 % reduction at 18 months ( all p 's < 0.001 ) . EOP residents were less likely than residents in the active control sites to move to a care home or to be admitted to a hospital inpatient bed . They were more likely to be seen by a range of community health professionals . Conclusion : The EOP had a positive impact on the quality of life of people with dementia in well-staffed extra care housing schemes Background After diagnosis of a dementing illness , patients and their spouses have many concerns related to the disease and their future . This often leads to poor psychological well-being and reduced health-related quality of life ( HRQoL ) of the family . Support for self-management skills has been proven to be an effective method to improve prognosis of asthma , heart failure and osteoarthritis . However , self-management interventions have not been studied in dementia . Therefore , our aim was to examine , in an objective -oriented group intervention , the efficacy of self-management support program ( SMP ) on the HRQoL of dementia patients and their spousal caregivers as well as on the sense of competence and psychological well-being of caregivers . Methods During the years 2011 to 12 , 160 dementia patients and their spouses will be recruited from memory clinics and r and omized into two arms : 80 patients for group-based SMP sessions  including topics selected by the participants , 80 patients will serve as controls in usual community care . Sessions may include topics on dementia , community services , active lifestyle and prevention for cognitive decline , spousal relationship , future planning and emotional well-being . The patients and spouses will have their separate group sessions ( ten participants per group ) once a week for eight weeks . Main outcome measures will be patients ’ HRQoL ( 15D ) and spousal caregivers ’ HRQoL ( R AND -36 ) , and sense of competence ( SCQ ) . Secondary measures will be caregivers ’ psychological well-being ( GHQ-12 ) and coping re sources , patients ’ depression , cognition and signs of frailty . Data concerning admissions to institutional care and the use and costs of health and social services will be collected during a two-year follow-up . Discussion This is a ‘ proof-of-concept ’ study to explore the efficacy of group support for self-management skills among dementia families . It will also provide data on cost-effectiveness of the intervention . Trial registration Background Social support is important in daily activities of the elderly . This study tests the hypothesis that there is an association between social support and cognitive function among the elderly in a community setting . Methods Face-to-face interviews were conducted in a cross-sectional stratified r and om sample of 4,993 elderly ( ≥65 years ) city residents . Using multiple regression analysis , we investigated the influence of social support on cognitive function . Results 12 % were over 80 years old . 53.28 % were men . 67.14 % were married . Higher Short Portable Mental Status Question naire ( SPMSQ ) scores ( higher score means better cognitive function ) were associated with strong social support , as measured by marital status and perceived positive support from friends . Lower cognitive function was associated with older and with female respondents . Only instrumental activities of daily living ( IADL ) were statistically and negatively related to SPMSQ . Lower functional status was associated with lower cognitive function . Elders with grade school educations had lower SPMSQ scores than did elders with high school educations . Conclusions In Taiwan , higher cognitive function in community-living elderly was associated with increased social support . Life-style management should provide social activities for the elderly to promote a better quality of life BACKGROUND Relatives and caregivers of patients with dementia are often insecure about the impact of their efforts . This study examines whether and to what extent social support in the form of regular visits is increasing the well-being of demented aged . PROCEDURE A field experiment with slightly to seriously demented institutionalized aged persons ( MMS 5 - 25 ) was carried out to assess the effect of increased social support upon their well-being . Voluntary helpers , who were willing to visit their patients on a regular basis , were recruited by appeals at the senior university and by advertisements . The volunteers were trained to deal with the demented and were looked after regularly . The test subjects were r and omly assigned to one of two test groups . The first group was visited regularly for ten weeks , whereas the second group served as a control group . The participants of the experimental group received a visiting card with a photo of the volunteer and the next appointment date to remember their visitors and to increase the effect of predictability . RESULTS The effect of visits on the well-being of the institutionalized aged persons was significantly positive ( F(1,39 ) = 11.16 , p < 0.002 ) . The psychological , physiological and social well-being of the participants was improved . Additionally , visits moderated the pain result ing from physical illness and seemed to decrease the effects of mental decline on their performance . Furthermore , it was most impressive to find that the demented aged really took notice of the visits and seemed to remember them in one way or an other . The study pointed out that demented aged persons are still very sensitive in an emotional respect and that they are still able to give astonishing good and differentiated information about their feelings even in an advanced state of dementia . Even the volunteers gained from their visits , which was shown by their higher well-being after their visits Accurate clinical staging of dementia in older subjects has not previously been achieved despite the use of such methods as psychometric testing , behavioural rating , and various combinations of simpler psychometric and behavioural evaluations . The  Clinical Dementia Rating ( CRD )  , a global rating device , was developed for a prospect i ve study of mild senile dementia -- Alzheimer type ( SDAT ) . Reliability , validity , and correlational data are discussed . The CRD was found to distinguish unambiguously among older subjects with a wide range of cognitive function , from healthy to severely impaired OBJECTIVES To determine whether community care of demented patients can be prolonged by means of a 2-year support program based on nurse case management . DESIGN R and omized controlled intervention study with 2-year follow-up . SETTING Demented patients entitled to payments from the Social Insurance Institution for community care , in five municipalities in eastern Finl and . PARTICIPANTS One hundred demented patients , age 65 and older , living at home with the primary support of 
    Output:
    
CONCLUSIONS Limited data from two studies suggest that support groups may be of psychological benefit to people with dementia by reducing depression and improving quality of life and self-esteem .