***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 
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    ***EXAMPLES*** 
    Input: Background Recent findings suggest that executive function ( EF ) plays a critical role in the regulation of gait in older adults , especially under complex and challenging conditions , and that EF deficits may , therefore , contribute to fall risk . The objective of this study was to evaluate if reduced EF is a risk factor for future falls over the course of 5 years of follow-up . Secondary objectives were to assess whether single and dual task walking abilities , an alternative window into EF , were associated with fall risk . Methodology /Main Results We longitudinally followed 256 community-living older adults ( age : 76.4±4.5 yrs ; 61 % women ) who were dementia free and had good mobility upon entrance into the study . At baseline , a computerized cognitive battery generated an index of EF , attention , a closely related construct , and other cognitive domains . Gait was assessed during single and dual task conditions . Falls data were collected prospect ively using monthly calendars . Negative binomial regression quantified risk ratios ( RR ) . After adjusting for age , gender and the number of falls in the year prior to the study , only the EF index ( RR : .85 ; CI : .74–.98 , p = .021 ) , the attention index ( RR : .84 ; CI : .75–.94 , p = .002 ) and dual tasking gait variability ( RR : 1.11 ; CI : 1.01–1.23 ; p = .027 ) were associated with future fall risk . Other cognitive function measures were not related to falls . Survival analyses indicated that subjects with the lowest EF scores were more likely to fall sooner and more likely to experience multiple falls during the 66 months of follow-up ( p<0.02 ) . Conclusions / Significance These findings demonstrate that among community-living older adults , the risk of future falls was predicted by performance on EF and attention tests conducted 5 years earlier . The present results link falls among older adults to cognition , indicating that screening EF will likely enhance fall risk assessment , and that treatment of EF may reduce fall risk BACKGROUND Executive function ( EF ) deficits may increase fall risk , even among older adults with no overt cognitive impairment . Indeed , the effects of dual tasking ( DT ) on gait , a challenge to executive control , are more exaggerated in persons with a history of falls . Prospect i ve evidence is , however , lacking . METHODS We prospect ively evaluated whether EF predicts falls over a 2-year period among 262 community-living , healthy , and well-functioning older adults , focusing on the 201 who reported no falls during the previous year . At baseline , participants completed a computerized cognitive battery that generated an index of EF and other cognitive domains .  Gait was assessed using performance-based tests and by quantifying walking during single- and dual-task conditions . RESULTS The 262 participants ( mean age : 76.3 ± 4.3 years , 60.3 % women ) had intact cognitive function on testing , a low comorbidity index , and good mobility . The EF index predicted future falls . Among those who reported no previous falls , participants in the worst EF quartile were three times more likely to fall during the 2 years of follow-up , and they were more likely to transition from nonfaller to faller sooner . DT gait variability also predicted future falls and multiple falls , whereas other measures of cognitive function , gait , and mobility did not . CONCLUSIONS Among healthy older adults , individuals with poorer EF are more prone to falls . Higher-level cognitive functions such as those regulated by the frontal lobes are apparently needed for safe everyday navigation that dem and s multitasking . Optimal screening , early detection , and treatment of falls should , apparently , also target this cognitive domain Background Older adults with concerns of falling show decrements of gait stability under single ( ST ) and dual task ( DT ) conditions . To compare the effects of a DT training integrating task managing strategies for independent living older adults with and without concern about falling ( CoF ) to a non-training control group on walking performance under ST and DT conditions . Methods Single center parallel group single blind r and omized controlled trial with group-based interventions ( DT-managing balance training ) compared to a control group ( Ninety-five independent living older adults ; 71.5 ± 5.2 years).A  progressive DT training ( 12 sessions ; 60 min each ; 12 weeks ) including task-managing strategies was compared to a non-training control group . Setting : group based intervention for independent living elderly in a gym .  ST and DT walking ( visual verbal Stroop task ) were measured on a treadmill . Gait parameters ( step length , step width , and gait line ) and cognitive performance while walking were compared with a 2x2x2 Repeated Measures Analyses of Variance . Results Participants in the intervention group showed an increased step length under ST and DT conditions following the intervention , for both people with and without CoF compared to their respective control groups . Foot rolling movement and cognitive performance while walking however only improved in participants without CoF. Conclusions The results showed that DT managing training can improve walking performance under ST and DT conditions in people with and without CoF. Additional treatment to directly address CoF , such as cognitive behavioural therapy , should be considered to further improve the cautious gait pattern ( as evidence d by reduced foot rolling movements).Trial registration The study was retrospectively registered in the German Clinical Trials Register ( DRKS ; Identification number DRKS00012382 , 11.05.2017 ) Objective : To determine whether brain activity over the prefrontal cortex measured in real time during walking predicts falls in high-functioning older adults . Method : We examined166 older persons ( mean age 75 years , 51 % women ) enrolled in a prospect i ve aging study . High-functioning status defined as the absence of dementia or disability with normal gait diagnosed by study clinicians . The magnitude of task-related changes in oxygenated hemoglobin levels over the prefrontal cortex was measured with functional near-infrared spectroscopy during motor ( walking at normal pace ) and cognitive ( reciting alternate letters of the alphabet ) single tasks and a dual-task condition ( walking while reciting alternate letters of the alphabet ) . Incident falls were prospect ively assessed over a 50-month study period . Results : Over a mean follow-up of 33.9 ± 11.9 months , 116 falls occurred . Higher levels of prefrontal cortical activation during the dual-task walking condition predicted falls ( hazard ratio adjusted for age , sex , education , medical illnesses and general mental status 1.32 , 95 % confidence interval 1.03–1.70 ) . Neither behavioral outcomes ( velocity or letter rate ) on the dual task  nor brain activation patterns on the single tasks ( normal walk or talk alone ) predicted falls in this high-functioning sample . The results remained robust after accounting for multiple confounders and for cognitive status , slow gait , previous falls , and frailty . Conclusions : Prefrontal brain activity levels while performing a cognitively dem and ing walking condition predicted falls in high-functioning seniors . These findings implicate neurobiological processes early in the pathogenesis of falls OBJECTIVE As 90 % of fractures are caused by falls , and as fractures are more common in elderly women than in elderly men , a better underst and ing of potential sex differences in fall rates and underlying mechanisms is needed . The purpose of this study was to determine whether women are more prone than men to falling , and to evaluate whether the risk of falling is associated with variations in gait patterns . DESIGN , SETTING , AND PARTICIPANTS The cohort for this prospect i ve observational study consisted of 1390 community-dwelling men and women aged 70 years , examined in a health survey between July 2012 and November 2014 . MEASUREMENTS  Gait patterns  were measured using a computerized walkway system during normal-speed , fast-speed , and dual-task trials . Triaxial accelerometers were used to collect objective data on  physical activity  , and  self-reported fall data  were collected by telephone 6 and 12 months after examination . Incident low-energy falls were defined as unexpected events in which participants came to rest on the ground . RESULTS During the follow-up period , 148 study participants ( 88 women , 60 men ; P = .01 ) reported falls . After adjusting for multiple confounders , including objective measures of physical activity , socioeconomic factors , cardiovascular disease , and cognitive function , the odds ratio for falling in women was 1.49 ( 95 % confidence interval [ CI ] 1.02 - 2.19 ) . Variations in gait pattern were significantly ( 20%-40 % ) increased in fallers compared with nonfallers during the dual-task trial for step width , step length , stride length , step time , stance time , stride velocity , and single support time ( all P < .05 ) . Furthermore , women showed 15 % to 35 % increased variability in all of these gait parameters during the dual-task trial compared with men ( all P < .01 ) . CONCLUSION In the present cohort , 70-year-old women were at greater risk of falls compared with their male counterparts . This increased risk was associated with increased variation in gait pattern during dual-task activities , and may contribute to women 's greater fracture risk compared with men Objective : To evaluate the long-term effects of a progressive and specific balance group-based program in healthy elderly individuals with increased risk of falling . Design : Follow-up of a r and omized controlled trial at nine and 15 months on a population that has previously been described at three months . Setting : The study was conducted in Stockholm , Sweden . Subjects : 59 community-dwelling elderly ( age 67–93 years ) , recruited by advertisement , were r and omly allocated to training or to serve as controls . Intervention : Group balance training three times per week during 12 weeks with a 15 month follow-up time . Main measures : Participants were assessed at baseline , three , nine , and 15 months thereafter for gait function ( preferred and fast walking ) , rapid step execution ( single and dual task ) , fear of falling , and likelihood of depression . Results : Fast gait speed ( p = 0.004 ) , dual task step execution ( p = 0.006 ) and fear of falling ( p = 0.001 ) were still improved in the training group at nine months follow-up . Only self-perceived fear of falling remained significantly improved ( p = 0.012 ) at 15 months follow-up . Although fast gait speed had decreased to baseline level in the training group ( 1.49 m/s ) it remained significantly higher than in the control group ( 1.37 m/s ) at the end of the study , a difference between the groups that was not seen at baseline . Conclusion : This training program provided important positive short and long-term benefits to gait , balance function , and fear of falling OBJECTIVES To determine whether dual task-related changes in walking speed were associated with recurrent falls in frail older adults . DESIGN Twelve-month prospect i ve cohort study . SETTING Thirteen senior housing facilities . PARTICIPANTS Two hundred thirteen subjects ( mean age 84.4+/-5.5 ) . MEASUREMENTS  Usual and dual-tasking walking speeds ( m/s ) were calculated on a 10-m straight walkway at baseline . Information on incident falls during the follow-up year was collected monthly , and participants were divided into three groups based on the occurrence of falls ( 0 , 1 , and > or=2 ) . Recurrent falls were defined as two or more falls during the 12-month follow-up period . RESULTS Twenty subjects ( 9.4 % ) were classified as recurrent fallers . The occurrence of recurrent falls was associated with age ( crude odds ratio (OR)=1.11 , P=.02 ) , number of drugs ( crude OR=1.28 , P=.002 ) , and walking speed under both walking conditions ( crude OR=0.96 , P=.002 for usual walking and crude OR=0.60 , P=.005 for walking while counting backward ) . Multiple Poisson regression showed that only walking speed while  dual tasking and number of drugs were associated with incident falls ( incident rate ratio (IRR)=0.84 , P=.045 and IRR=1.10 , P=.004 ) . CONCLUSION Slower walking speed while counting backward was associated with recurrent falls , suggesting that changes in gait performance while dual tasking might be an inexpensive way of identifying frail older adults prone to falling Objective : To evaluate the effects of a new , individually adjusted , progressive and specific balance group training programme on fear of falling , step execution , and gait in healthy elderly people with fear of falling and tend to fall . Design : R and omized controlled trial . Setting : The study was conducted in Stockholm County , Sweden . Subjects : Fifty-nine community dwelling elderly people were recruited by advertisement , and allocated at r and om to an intervention group ( n = 38 ) or a control group ( n = 21 ) . Intervention : Individually adjusted , progressive and specific balance group training was given three times a week for three months . The training incorporated elements included in , and required for , independent activities of daily living , and for reactions to loss of balance during dual or multiple tasks . Main measures : Fear of falling was assessed with Falls Efficacy Scale International ( FES-I ) . The reaction time of step execution was measured with the step-execution test , and gait was measured with GAITRite ® . Results : After three months the intervention group showed significant positive changes in the FES-I ( P = 0.008 ) , in the step-execution phase of dual-task performance ( P = 0.012 ) , and in gait at preferred speed during single-task performance ; in cadence ( P = 0.030 ) and , at fast speed , in velocity ( P = 0.004 ) and cadence ( P = 0.001 ) . Significant decreases were also found for the likelihood of depression after participating in the training programme . Conclusion : This new balance training programme is feasible and leads to decreased fear of falling , decreased time for step execution during dual-task performance and increased velocity during fast walking OBJECT 
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Conclusion CMI was not significantly different between fallers and non-fallers or people with and without CoF ; however , our taxonomy revealed a large variety of cognitive conditions and a higher number of studies using mental tracking tasks , which make it impossible to draw firm conclusions .