***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 in a secondary analysis of a r and omised controlled trial , we investigated whether 6 months of music-based multitask training had beneficial effects on cognitive functioning and mood in older adults . METHODS 134 community-dwellers aged ≥65 years at increased risk for falling were r and omly assigned to either an intervention group ( n = 66 ) who attended once weekly 1-h supervised group classes of multitask exercises , executed to the rhythm of piano music , or a control group with delayed intervention ( n = 68 ) who maintained usual lifestyle habits , for 6 months . A short neuropsychological test battery was administered by an intervention-blinded neuropsychologist at baseline and Month 6 , including the mini-mental state examination ( MMSE ) , the clock-drawing test , the frontal assessment battery ( FAB ) and the hospital anxiety ( HADS-A ) and depression scale . RESULTS intention-to-treat analysis showed an improvement in the sensitivity to interference subtest of the FAB ( adjusted between-group mean difference ( AMD ) , 0.12 ; 95 % CI , 0.00 to 0.25 ; P = 0.047 ) and a reduction in anxiety level ( HADS-A ; AMD , -0.88 ; 95 % CI , -1.73 to -0.05 ; P = 0.039 ) in intervention participants , as compared with the controls . Within-group analysis revealed an increase in MMSE score ( P = 0.004 ) and a reduction in the number of participants with impaired global cognitive performance ( i.e. , MMSE score ≤23 ; P = 0.003 ) with intervention . CONCLUSION six months of once weekly music-based multitask training was associated with improved cognitive function and decreased anxiety in community-dwelling older adults , compared with non-exercising controls . Studies design ed to further delineate whether training-induced changes in cognitive function could contribute to dual-task gait improvements and falls reduction , remain to be conducted OBJECTIVE We evaluated the effects of exercise on neurobehavioral function in healthy older people more than 75 years of age . DESIGN A r and omized controlled trial with 6-month follow-up was conducted . SETTING The study was performed in the rural town of Kahoku , Japan , the population of which is considered representative of the older population of Japan . PARTICIPANTS We studied 42 healthy volunteers ( 18 men and 24 women ; mean age , 79 years ( range 75 to 87 years ) ) who were r and omly assigned to one of two groups , exercise or control . INTERVENTION Subjects assigned to the exercise group were instructed to exercise for 60 minutes twice a week for 6 months . Subjects in the control group were not instructed to engage in an specific exercise regimen . MEASUREMENTS The following measurements were recorded for both groups at baseline and at 6-month follow-up : ( 1 ) Neurobehavioral function as determined by the following tests : Mini-Mental State Exam ( MMSE ) , Hasegawa Dementia Scale Revised ( HDSR ) , Visuospatial Cognitive Performance Test ( VCP-test ) , Button score , Up & Go test , and Functional Reach ; and ( 2 ) Body mass index and blood pressure . RESULTS The effects of exercise were shown in the Up & Go test , and Functional Reach ( ANOVA with repeated measures ) . CONCLUSION This study demonstrates the acceptability and effectiveness of exercise on neurobehavioral function , even in older people more than 75 years of age Physical exercise has been shown to increase brain volume and improve cognition in r and omized trials of non-demented elderly . Although greater social engagement was found to reduce dementia risk in observational studies , r and omized trials of social interventions have not been reported . A representative sample of 120 elderly from Shanghai , China was r and omized to four groups ( Tai Chi , Walking , Social Interaction , No Intervention ) for 40 weeks . Two MRIs were obtained , one before the intervention period , the other after . A neuropsychological battery was administered at baseline , 20 weeks , and 40 weeks . Comparison of changes in brain volumes in intervention groups with the No Intervention group were assessed by t-tests . Time-intervention group interactions for neuropsychological measures were evaluated with repeated- measures mixed models . Compared to the No Intervention group , significant increases in brain volume were seen in the Tai Chi and Social Intervention groups ( p < 0.05 ) . Improvements also were observed in several neuropsychological measures in the Tai Chi group , including the Mattis Dementia Rating Scale score ( p = 0.004 ) , the Trailmaking Test A ( p = 0.002 ) and B ( p = 0.0002 ) , the Auditory Verbal Learning Test ( p = 0.009 ) , and verbal fluency for animals ( p = 0.01 ) . The Social Interaction group showed improvement on some , but fewer neuropsychological indices . No differences were observed between the Walking and No Intervention groups . The findings differ from previous clinical trials in showing increases in brain volume and improvements in cognition with a largely non-aerobic exercise ( Tai Chi ) . In addition , intellectual stimulation through social interaction was associated with increases in brain volume as well as with some cognitive improvements 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 OBJECTIVES To primarily ascertain the effect of the Otago Exercise Program ( OEP ) on physiological falls risk , functional mobility , and executive functioning after 6 months in older adults with a recent history of falls and to ascertain the effect of the OEP on falls during a 1-year follow-up period . DESIGN R and omized controlled trial . SETTING Dedicated falls clinics . PARTICIPANTS Seventy-four adults aged 70 and older who presented to a healthcare professional after a fall . INTERVENTION The OEP , a home-based program that consists of resistance training and balance training exercises . MEASUREMENTS Physiological falls risk was assessed using the Physiological Profile Assessment . Functional mobility was assessed using the Timed Up and Go Test . Three central executive functions were assessed : set shifting , using the Trail Making Test Part B ; updating , using the verbal digits backward test ; and response inhibition , using the Stroop Color-Word Test . Falls were prospect ively monitored using daily calendars . RESULTS At 6 months , there was no significant between-group difference in physiological falls risk or functional mobility ( P > or= .33 ) . There was a significant between-group difference in response inhibition ( P=.05 ) . A falls histogram revealed two outliers . With these cases removed , using negative binomial regression , the unadjusted incidence rate ratio of falls in the OEP group compared with the control group was 0.56 . The adjusted incidence rate ratio was 0.47 . CONCLUSION The OEP may reduce falls by improving cognitive performance The aim of this study was to investigate the effects of a 6-month exercise program on cognitive function and blood viscosity in sedentary elderly men . Forty-six healthy inactive men , aged 60–75 years were r and omly distributed into a control group ( n=23 ) and an experimental group ( n=23 ) . Participants underwent blood analysis and physical and memory evaluation , before and after the 6-month program of physical exercise . The control group was instructed not to alter its everyday activities ; the experimental group took part in the fitness program . The program was conducted using a cycle ergometer , 3 times per week on alternate days , with intensity and volume individualized at ventilatory threshold 1 . Sessions were continuous and maximum duration was 60 min each . There was significant improvement in memory ( 21 % ; P<0.05 ) , decreased blood viscosity ( −19 % ; P<0.05 ) , and higher aerobic capacity ( 48 % ; P<0.05 ) among participants in the experimental group compared with the control group . These data suggest that taking part in an aerobic physical fitness program at an intensity corresponding to ventilatory threshold-1 may be considered a nonmedication alternative to improve physical and cognitive function OBJECTIVE Physical exercise has been linked to higher cognitive functioning and enhanced brain plasticity in aging humans . The most consistent positive effects have been reported for executive functions associated with frontal brain regions . In rodents , however , running has been shown to induce functional and structural changes in the hippocampus , a brain region known to be important for memory . It is still a matter of debate which cognitive functions are susceptible to exercise and whether an increase in cardiovascular fitness is beneficial for cognitive functioning . Moreover , little is known about the impact of exercise on cognition in middle-aged humans . METHOD Sixty-eight sedentary men and women between 40 and 56 years of age were r and omly assigned to one of two training programs : aerobic endurance training ( cycling ) or nonendurance training ( stretching/coordination ) . Both groups exercised twice a week for six months . Additionally , a sedentary control group was tested . At baseline and after six months , episodic memory , perceptual speed , executive functions , and spatial reasoning were assessed with st and ardized psychometric tests , and all participants underwent a cardiovascular fitness test . RESULTS Significant improvements in memory were observed in both the cycling and the stretching/coordination group as compared with the sedentary control group . The improvement in episodic memory correlated positively with the increase in cardiovascular fitness . The stretching/coordination training particularly improved selective attention as compared with the cycling training . CONCLUSIONS The results suggest that cardiovascular fitness has beneficial effects even in high-functioning middle-aged participants , but that these benefits are very specific to memory functions rather than a wider range of cognitive functions BACKGROUND No large trials have been done to investigate the efficacy of an intervention combining a specific compound and several lifestyle interventions compared with placebo for the prevention of cognitive decline . We tested the effect of omega 3 polyunsaturated fatty acid supplementation and a multidomain intervention ( physical activity , cognitive training , and nutritional advice ) , alone or in combination , compared with placebo , on cognitive decline . METHODS The Multidomain Alzheimer Preventive Trial was a 3-year , multicentre , r and omised , placebo-controlled superiority trial with four parallel groups at 13 memory centres in France and Monaco . Participants were non-demented , aged 70 years or older , and community-dwelling , and had either relayed a spontaneous memory complaint to their physician , limitations in one instrumental activity of daily living , or slow gait speed . They were r and omly assigned ( 1:1:1:1 ) to either the multidomain intervention ( 43 group sessions integrating cognitive training , physical activity , and nutrition , and three preventive consultations ) plus omega 3 polyunsaturated fatty acids ( ie , two capsules a day providing a total daily dose of 800 mg docosahexaenoic acid and 225 mg eicosapentaenoic acid ) , the multidomain intervention plus placebo , omega 3 polyunsaturated fatty acids alone , or placebo alone . A computer-generated r and omisation procedure was used to stratify patients by centre . All participants and study staff were blinded to polyunsaturated fatty acid or placebo assignment , but were unblinded to the mult 
    Output:
    
For any cognitive outcome , evidence was insufficient to draw conclusions about most interventions ( aerobic training , resistance training , tai chi , physical activity with diet , and physical activity with a cognitive component ) .
Low-strength evidence showed that multicomponent physical activity interventions of 1 to 2 years did not improve multidomain neurologic performance ; executive function , attention , and processing speed ; or memory compared with an attention control .
Low-strength evidence showed that an intervention combining physical activity , diet , and cognitive training  benefited multidomain neuropsychological test performance and executive function , attention , and processing speed compared with an attention control ; however , evidence was insufficient to draw conclusions about the efficacy of this intervention on memory .
Moderate-strength evidence showed that more participants in the intervention than the control groups had musculoskeletal pain .