***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: CONTEXT Many observational studies have shown that physical activity reduces the risk of cognitive decline ; however , evidence from r and omized trials is lacking . OBJECTIVE To determine whether physical activity reduces the rate of cognitive decline among older adults at risk . DESIGN AND SETTING R and omized controlled trial of a 24-week physical activity intervention conducted between 2004 and 2007 in metropolitan Perth , Western Australia . Assessors of cognitive function were blinded to group membership . PARTICIPANTS We recruited volunteers who reported memory problems but did not meet criteria for dementia . Three hundred eleven individuals aged 50 years or older were screened for eligibility , 89 were not eligible , and 52 refused to participate . A total of 170 participants were r and omized and 138 participants completed the 18-month assessment . INTERVENTION Participants were r and omly allocated to an education and usual care group or to a 24-week home-based program of physical activity . MAIN OUTCOME MEASURE Change in Alzheimer Disease Assessment Scale-Cognitive Subscale ( ADAS-Cog ) scores ( possible range , 0 - 70 ) over 18 months . RESULTS In an intent-to-treat analysis , participants in the intervention group improved 0.26 points ( 95 % confidence interval , -0.89 to 0.54 ) and those in the usual care group deteriorated 1.04 points ( 95 % confidence interval , 0.32 to 1.82 ) on the ADAS-Cog at the end of the intervention . The absolute difference of the outcome measure between the intervention and control groups was -1.3 points ( 95 % confidence interval,-2.38 to -0.22 ) at the end of the intervention . At 18 months , participants in the intervention group improved 0.73 points ( 95 % confidence interval , -1.27 to 0.03 ) on the ADAS-Cog , and those in the usual care group improved 0.04 points ( 95 % confidence interval , -0.46 to 0.88 ) . Word list delayed recall and Clinical Dementia Rating sum of boxes improved modestly as well , whereas word list total immediate recall , digit symbol coding , verbal fluency , Beck depression score , and Medical Outcomes 36-Item Short-Form physical and mental component summaries did not change significantly . CONCLUSIONS In this study of adults with subjective memory impairment , a 6-month program of physical activity provided a modest improvement in cognition over an 18-month follow-up period . TRIAL REGISTRATION anzctr.org.au Identifier : ACTRN12605000136606 Aims : To examine the effects of pioglitazone or endurance exercise training on cognitive function in older adults with mild cognitive impairment ( MCI ) and insulin resistance . Methods : Seventy-eight adults ( mean age ± SD : 65 ± 7 years ) with central obesity and MCI were r and omized to 6 months of endurance exercise , pioglitazone or control . Results : Sixty-six participants completed the study .  Exercise training did not significantly increase peak oxygen uptake compared to control ( p = 0.12 ) . Compared to control , insulin resistance improved in the pioglitazone group ( p = 0.002 ) but not in the exercise group ( p = 0.25 ) . There was no measureable effect of pioglitazone or exercise on cognitive performance compared to control . Conclusion : In this pilot study , pioglitazone  improved insulin resistance but not cognitive performance in older adults with MCI and insulin resistance 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 Multiple exercise interventions have shown beneficial effects on fatigue and quality of life ( QoL ) in cancer patients , but various psychosocial interventions as well . It is unclear to what extent the observed effects of exercise interventions are based on physical adaptations or rather on psychosocial factors associated with supervised , group-based programs . It needs to be determined which aspects of exercise programs are truly effective . Therefore , we aim ed to investigate whether resistance exercise during chemotherapy provides benefits on fatigue and QoL beyond potential psychosocial effects of group-based interventions . One-hundred-one breast cancer patients starting chemotherapy  were r and omly assigned to resistance exercise ( EX ) or a relaxation control ( RC ) group . Both interventions were supervised , group-based , 2/week over 12 weeks . The primary endpoint fatigue was assessed with a 20-item multidimensional question naire , QoL with the EORTC QLQ-C30/BR23 . Analyses of covariance for individual changes from baseline to Week 13 were calculated . In RC , total and physical fatigue worsened during chemotherapy , whereas EX showed no such impairments ( between-group p = 0.098 and 0.052 overall , and p = 0.038 and 0.034 among patients without severe baseline depression ) . Differences regarding affective or cognitive fatigue were not significant . Benefits of EX were also seen to affect role and social function . Effect sizes were between 0.43 and 0.48 . Explorative analyses indicated significant effect modification by thyroxin use ( p-interaction = 0.044 ) . In conclusion , resistance exercise appeared to mitigate physical fatigue and maintain QoL during chemotherapy beyond psychosocial effects inherent to supervised group-based setting s. Thus , resistance exercise could be an integral part of supportive care for breast cancer patients undergoing chemotherapy OBJECTIVES This study compares the effects of an integrated yoga program with brief supportive therapy in breast cancer out patients undergoing adjuvant radiotherapy at a cancer centre . METHODS Eighty-eight stage II and III breast cancer out patients were r and omly assigned to receive yoga ( n = 44 ) or brief supportive therapy ( n = 44 ) prior to their radiotherapy treatment . Intervention consisted of yoga sessions lasting 60 min daily while the control group was imparted supportive therapy once in 10 days . Assessment s included European Organization for Research in the Treatment of Cancer- Quality of Life ( EORTCQoL C30 ) functional scales and Positive and Negative Affect Schedule ( PANAS ) . Assessment s were done at baseline and after 6 weeks of radiotherapy treatment . RESULTS An intention to treat GLM repeated measures ANOVA showed significant difference across groups over time for positive affect , negative affect and emotional function and social function . There was significant improvement in positive affect ( ES = 0.59 , p = 0.007 , 95%CI 1.25 to 7.8 ) , emotional function ( ES = 0.71 , p = 0.001 , 95%CI 6.45 to 25.33 ) and cognitive function ( ES = 0.48 , p = 0.03 , 95%CI 1.2 to 18.5 ) , and decrease in negative affect ( ES = 0.84 , p<0.001 , 95%CI -13.4 to -4.4 ) in the yoga group as compared to controls . There was a significant positive correlation between positive affect with role function , social function and global quality of life . There was a significant negative correlation between negative affect with physical function , role function , emotional function and social function . CONCLUSION The results suggest a possible role for yoga to improve quality of life and affect in breast cancer out patients Purpose The purpose of this study was to explore the effects of an innovative momentum-based dumbbell-training intervention on cognitive function in older adults with mild cognitive impairment ( MCI ) . Subjects and methods A total of 45 community-dwelling older adults with MCI were r and omly assigned to either a dumbbell-training group ( DTG ; n=22 ) or a control group ( CG ; n=23 ) . Participants in the DTG participated in exercise sessions three times weekly for 12 weeks . The primary outcome measures were cognitive function , including the Alzheimer ’s Disease Assessment Scale ( ADAS ) – Cognitive subscale , Trail Making Test part B , Digit Span Test ( DST ) – forward , and DST – backward , with secondary outcome measures being Timed Up and Go , functional reach , and the Activities-Specific Balance Confidence Scale . Results In an intent-to-treat analysis , participants in the DTG had significantly improved ADAS – Cognitive subscale scores compared to those in the CG ( 5.02 points , P=0.012 ) . There was a significant within-group change ( improvement ) in Trail Making Test part B ( 33.32 seconds , P<0.001 ) and DST – backward ( 0.41 points , P=0.025 ) scores . No change was observed for the DST – forward measure . Participants in the DTG also improved their functional mobility compared to those in the CG ( Timed Up and Go , 0.81 seconds ; P=0.043 ) . Conclusion There is preliminary evidence showing the potential benefit of momentum-based dumbbell training for improving cognitive function in older adults with MCI Background To examine the effect of multicomponent exercise program on memory function in older adults with mild cognitive impairment ( MCI ) , and identify biomarkers associated with improvement of cognitive functions . Methodology /Principal Findings Subjects were 100 older adults ( mean age , 75 years ) with MCI . The subjects were classified to an amnestic MCI group ( n = 50 ) with neuroimaging measures , and other MCI group ( n = 50 ) before the r and omization . Subjects in each group were r and omized to either a multicomponent exercise or an education control group using a ratio of 1∶1 . The exercise group exercised for 90 min/d , 2 d/wk , 40 times for 6 months . The exercise program was conducted under multitask conditions to stimulate attention and memory . The control group attended two education classes . A repeated- measures ANOVA revealed that no group × time interactions on the cognitive tests and brain atrophy in MCI patients . A sub- analysis of amnestic MCI patients for group × time interactions revealed that the exercise group exhibited significantly better Mini-Mental State Examination ( p = .04 ) and logical memory scores ( p = .04 ) , and reducing whole brain cortical atrophy ( p<.05 ) compared to the control group . Low total cholesterol levels before the intervention were associated with an improvement of logical memory scores ( p<.05 ) , and a higher level of brain-derived neurotrophic factor was significantly related to improved ADAS-cog scores ( p<.05 ) . Conclusions / Significance The results suggested that an exercise intervention is beneficial for improving logical memory and maintaining general cognitive function and reducing whole brain cortical atrophy in older adults with amnestic MCI . Low total cholesterol and higher brain-derived neurotrophic factor may predict improvement of cognitive functions in older adults with MCI . Further studies are required to determine the positive effects of exercise on cognitive function in older adults with MCI . Trial Registration UMIN-CTR UMIN000003662 ctr.cgi?function = brows&action = brows&type = summary & recptno = R000004436 & language = OBJECTIVES Long-term interventions aim ed at analyzing the impact of physical exercise on important health markers in institutionalized individuals with dementia are relatively scarce . This longitudinal study intends to identify the effects of a physical exercise program on cognitive decline , memory , depression , functional dependence and neurops 
    Output:
    
The main analysis revealed a positive overall r and om effect of exercise intervention on cognitive function in patients with chronic diseases .
The secondary analysis revealed that aerobic exercise interventions and aerobic included exercise interventions had a positive effect on cognition in patients with chronic diseases .
The intervention offering low frequency had a positive effect on cognitive function in patients with chronic diseases .
Finally , we found that interventions offered at both low exercise intensity and moderate exercise intensity had a positive effect on cognitive function in patients with chronic diseases .
The secondary analysis also revealed that exercise interventions  were beneficial in Alzheimer 's disease patients when grouped by disease type .
This meta- analysis and systematic review suggests that exercise interventions  positively influence cognitive function in patients with chronic diseases .
Beneficial effect was independent of the type of disease , type of exercise , frequency , and the intensity of the exercise intervention