***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: Purpose Age-related cognitivee decline is a growing public health concern worldwide . More than a quarter of adults with cognitive impairment experience sleep disturbance . The objective of this pilot study was to evaluate the preliminary effects of tai chi qigong ( TCQ ) on improving the night-time sleep quality of older adults with cognitive impairment . Participants Older adults with cognitive impairment who complain of sleep disturbance . Methods A r and omized controlled trial with two groups . Fifty-two subjects were recruited from two district elderly community centers and r and omly assigned to either the  TCQ  group ( n=27 ) or the control group ( n=25 ) . The intervention group received TCQ training consisting of two 60-minute sessions each week for 2 months . The control group was advised to maintain their usual activities .  Sleep quality was measured by the Chinese Pittsburgh Sleep Quality Index . Quality of life was measured by Short-form 12 , cognitive functions measured by mini-mental state examination , and subjective memory deficits measured by the memory inventory for Chinese . Results Data were collected at baseline , 2 months , and 6 months . Significant results were noted at 6 months in the Chinese Pittsburgh Sleep Quality Index global score ( P=0.004 ) , sleep duration ( P=0.003 ) , habitual sleep efficiency ( P=0.002 ) , and the Short-form 12 mental health component ( P<0.001 ) . The TCQ participants reported better sleep quality and a better ( quality of life ) mental health component than the control group . Conclusion TCQ can be considered a useful nonpharmacological approach for improving sleep quality in older adults with cognitive impairment . Clinical trial registration CUHK_CCT00448 ( https://www2.ccrb.cuhk.edu.hk/registry/public/287 ) 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 OBJECTIVE To detect the effects of Tai Chi Chuan practice on the cognition of elderly subjects with Mild Cognitive Impairment . METHODS This is a pilot study with 26 elderly patients ( mean age of 74 years ) with Mild Cognitive Impairment . The evaluation instruments were Subjective Memory Complaint Scale ( SMC ) , Rivermead Behavioral Memory Test ( RBMT ) and Digit Span Forward and Backward ( DSF and DSB ) from the Wechsler Adult Intelligence Scale ( WAIS ) . One group of 13 patients received two weekly 60-minute classes of Tai Chi Chuan ( Yang style ) for 6 consecutive months , and the rest formed the Control Group . The Tai Chi Chuan Group was also evaluated as to learning of the Tai Chi Chuan practical exercises by means of a Specific Learning Test applied after three months of intervention . RESULTS After six months of intervention , the TCC Group showed significant improvement on the RBMT and the SMC ( p = 0.007 and p = 0.023 , respectively ) . The Control Group showed no significant differences in the cognitive tests during the study . There was a significant correlation between the Tai Chi Chuan  Learning Test and RBMT ( p = 0.008 ) , showing that patients with a better performance in exercising TCC also showed a better performance in memory . CONCLUSIONS In this study , a six-month program of Tai Chi Chuan afforded a significant improvement of the performance of memory complaints in the elderly with Mild Cognitive Impairment . Additional r and omized studies with larger sample s and more prolonged follow-up are needed to confirm these benefits OBJECTIVE : To test the feasibility of creating a valid and reliable checklist with the following features : appropriate for assessing both r and omised and non-r and omised studies ; provision of both an overall score for study quality and a profile of scores not only for the quality of reporting , internal validity ( bias and confounding ) and power , but also for external validity . DESIGN : A pilot version was first developed , based on epidemiological principles , review s , and existing checklists for r and omised studies . Face and content validity were assessed by three experienced review ers and reliability was determined using two raters assessing 10 r and omised and 10 non-r and omised studies . Using different raters , the checklist was revised and tested for internal consistency ( Kuder-Richardson 20 ) , test-retest and inter-rater reliability ( Spearman correlation coefficient and sign rank test ; kappa statistics ) , criterion validity , and respondent burden . MAIN RESULTS : The performance of the checklist improved considerably after revision of a pilot version . The Quality Index had high internal consistency ( KR-20 : 0.89 ) as did the subscales apart from external validity ( KR-20 : 0.54 ) . Test-retest ( r 0.88 ) and inter-rater ( r 0.75 ) reliability of the Quality Index were good . Reliability of the subscales varied from good ( bias ) to poor ( external validity ) . The Quality Index correlated highly with an existing , established instrument for assessing r and omised studies ( r 0.90 ) . There was little difference between its performance with non-r and omised and with r and omised studies . Raters took about 20 minutes to assess each paper ( range 10 to 45 minutes ) . CONCLUSIONS : This study has shown that it is feasible to develop a checklist that can be used to assess the method ological quality not only of r and omised controlled trials but also non-r and omised studies . It has also shown that it is possible to produce a checklist that provides a profile of the paper , alerting review ers to its particular method ological strengths and weaknesses . Further work is required to improve the checklist and the training of raters in the assessment of external validity CONTEXT Because Tai Chi ( TC ) is beneficial to elders without cognitive impairment ( CI ) , it also may benefit elders with CI . But elders with CI have generally been excluded from TC studies because many measurement tools require verbal reports that some elders with CI are unable to provide . OBJECTIVES To test the efficacy of a TC program in improving pain and other health outcomes in community-dwelling elders with knee osteoarthritis ( OA ) and CI . METHODS This pilot cluster-r and omized trial was conducted between January 2008 and June 2010 ( Clinical Trials.gov Identifier : NCT01528566 ) . The TC group attended Sun style TC classes , three sessions a week for 20 weeks ; the control group attended classes providing health and cultural information for the same length of time . Measures included the Western Ontario and McMaster Universities Osteoarthritis Index ( WOMAC ) pain , physical function and stiffness subscales ; the Get Up and Go test ; the Sit-to-St and test ; and the Mini-Mental State Examination ( MMSE ) , administered at baseline , every four weeks during the intervention and at the end of the study ( post-test ) . RESULTS Eight sites participated in either the TC group ( four sites , 28 participants ) or control group ( four sites , 27 participants ) .  The WOMAC pain ( P = 0.006 ) and stiffness scores ( P = 0.010 ) differed significantly between the two groups at post-test , whereas differences between the two groups in the WOMAC physical function score ( P = 0.071 ) and the MMSE ( P = 0.096 ) showed borderline significance at the post-test . WOMAC pain ( P = 0.001 ) , physical function ( P = 0.021 ) , and stiffness ( P ≤ 0.001 ) scores improved significantly more over time in the TC group than in controls . No adverse events were found in either group . CONCLUSION Practicing TC can be efficacious in reducing pain and stiffness in elders with knee OA and CI This one-arm pilot study investigated the effect of tai chi on cognition in elders with cognitive impairment . Although no significant difference existed between pre- and post-test performance on all cognition measures , a dose-response relationship was demonstrated between attendance and some cognition measures This study evaluated whether Tai Ji Quan : Moving for Better Balance ( TJQMBB ) could improve global cognitive function in older adults with cognitive impairment . Using a nonr and omized control group pretest-posttest design , participants aged ≥65 years who scored between 20 and 25 on the Mini-Mental State Examination ( MMSE ) were allocated into either a 14-week TJQMBB program ( n=22 ) or a control group ( n=24 ) . The primary outcome was MMSE as a measure of global cognitive function with secondary outcomes of 50-ft speed walk , Timed Up&Go , and Activities-Specific Balance Confidence ( ABC ) scale . At 14 weeks , Tai Ji Quan participants showed significant improvement on MMSE ( mean=2.26 , p<0.001 ) compared to controls ( mean=0.63 , p=0.08 ) . Similarly , Tai Ji Quan participants performed significantly better compared to the controls in both physical performance and balance efficacy measures ( p<0.05 ) . Improvement in cognition as measured by MMSE was related to improved physical performance and balance efficacy . These results provide preliminary evidence of the utility of the TJQMBB program to promote cognitive function in older adults in addition to physical benefits OBJECTIVES To examine whether combined center- and home-based Tai Chi training can improve cognitive ability and reduce physiological fall risk in older adults with amnestic mild cognitive impairment ( a-MCI ) . DESIGN R and omized controlled trial . SETTING Chiang Mai , Thail and . PARTICIPANTS Adults aged 60 and older who met Petersen 's criteria for multiple-domain a-MCI ( N = 66 ) . INTERVENTION Three weeks center-based and 12 weeks home-based Tai Chi ( 50 minutes per session , 3 times per week ) . MEASUREMENTS Cognitive tests , including Logical Memory ( LM ) delayed recall , Block Design , Digit Span forward and backward , and Trail-Making Test Part B-A ( TMT B-A ) , and fall risk index using the Physiological Profile Assessment ( PPA ) . RESULTS At the end of the trial , performance on LM , Block Design , and TMT B-A were significantly better for the Tai Chi group than the control group after adjusting for baseline test performance . The Tai Chi group also had significantly better composite PPA score and PPA parameter scores : knee extension strength , reaction time , postural sway , and lower limb proprioception . CONCLUSION Combined center- and home-based Tai Chi training three times per week for 15 weeks significantly improved cognitive function and moderately reduced physiological fall risk in older adults with multiple-domain a-MCI . Tai Chi may be particularly beneficial to older adults with this condition OBJECTIVES To examine the effects of cognitive stimulation ( mahjong ) and physical exercise ( tai chi [ TC ] ) on cognitive performance in persons with dementia . DESIGN Cluster-r and omized open-label controlled design . SETTING Nursing homes . PARTICIPANTS One hundred ten residents , most of whom were cholinesterase-inhibitor naive . Inclusion criteria were Mini-Mental State Examination ( MMSE ) = 10 - 24 and suffering from at least very mild dementia ( Clinical Dementia Rating ≥ 0.5 ) . Exclusion criteria were being bedbound , audio/visual impairment , regular activity participation before study , or contraindications for physical or group activities . INTERVENTIONS Homes were r and omized into three conditions ( mahjong , TC , and simple h and icrafts [ control ] ) . Activities were conducted three times weekly for 12 weeks . MEASUREMENTS Primary outcome was MMSE . Secondary outcomes were immediate/delayed recall , categorical fluency , and digit span . Various biological risk factors , including apolipoprotein E ε4 allele , were included as covariates . Measures were collected at 0 ( baseline ) , 3 ( posttreatment ) , 6 , and 9 months . RESULTS Intent-to-treat analyses were performed using mixed-effects regression . Mahjong 's effect varied by time for MMSE , delayed recall , and forward digit span . TC had similar effects but not for delayed recall . The typical pattern was that control participants deteriorated while mahjong and TC participants maintained their abilities over time , leading to enlarged treatment effects as time progressed . By 9 months , mahjong and TC differed from control by 4.5 points ( 95 % confidence interval : 2.0 - 6. 
    Output:
    
The studies suggest Tai Chi has impacts on global cognitive functions , visuospatial skills , semantic memory , verbal learning/memory , and self-perception of memory .
The effects of Tai Chi on overall cognition for people with mild cognitive impairment are comparable to those in control groups which engaged in exercise .
Conclusion : The studies review ed affirm the potential of Tai Chi to improve short-term cognitive function in the elderly at the onset of dementia