***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: This study examined the effects of a multimodal intervention on spontaneous brain activity in healthy older adults . Seventeen older adults received a  six-week intervention that consisted of cognitive training , Tai Chi exercise , and group counseling , while 17 older adults in a control group attended health knowledge lectures .  The intervention group demonstrated enhanced memory and social support compared to the control group . The amplitude of low frequency fluctuations ( ALFF ) in the middle frontal gyrus , superior frontal gyrus , and anterior cerebellum lobe was enhanced for the intervention group , while the control group showed reduced ALFF in these three regions . Moreover , changes in trail-making performance and well-being could be predicted by the intervention-induced changes in ALFF . Additionally , individual differences in the baseline ALFF were correlated with intervention-related changes in behavioral performance . These findings suggest that a multimodal intervention is effective in improving cognitive functions and well-being and can induce functional changes in the aging brain . The study extended previous training studies by suggesting resting-state ALFF as a marker of intervention-induced plasticity in older adults Finnish  Geriatric Intervention Study to Prevent Cognitive Impairment and Disability ( FINGER ) is a multi‐center , r and omized , controlled trial ongoing in Finl and 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 The results of a r and omized controlled trial of repetition-lag training in older adults with amnestic mild cognitive impairment ( aMCI ) are reported . A modified repetition-lag training procedure with extended encoding time and strategy choice was used . The training required discriminating studied words from non-studied lures that were repeated at varying intervals during the test phase . Participants were assessed pre/post using untrained measures of cognition and self-report question naires . Primary outcome measures were recall of unrelated word pairs both immediately following presentation and following a delay . Secondary outcomes were a measure of attention , cognitive flexibility , and visual working memory . Participants were also asked to report on the frequency of cognitive failures and mood before and after training . Participants ( N = 31 ) were r and omized into either the treatment or a no-contact control group  and attended the clinic twice per week over a four week period . Twenty-four participants completed the study ( twelve in each group ) . Results indicated that the training group improved at recalling unrelated word pairs after a delay . There were no significant effects of training on other outcomes , self-reported cognitive failures or mood . The results are discussed along with suggestions for future research We performed a pilot r and omized , controlled trial of intensive , computer-based cognitive training in 47 subjects with mild cognitive impairment . The intervention group performed exercises specifically design ed to improve auditory processing speed and accuracy for 100 min/d , 5 d/wk for 6 weeks ; the control group performed more passive computer activities ( reading , listening , visuospatial game ) for similar amounts of time . Subjects had a mean age of 74 years and 60 % were men ; 77 % successfully completed training . On our primary outcome , Repeatable Battery for Assessment of Neuropsychological Status total scores improved 0.36 st and ard deviations ( SD ) in the intervention group ( P=0.097 ) compared with 0.03 SD in the control group ( P=0.88 ) for a nonsignificant difference between the groups of 0.33 SD ( P=0.26 ) . On 12 secondary outcome measures , most differences between the groups were not statistically significant . However , we observed a pattern in which effect sizes for verbal learning and memory measures tended to favor the intervention group whereas effect sizes for language and visuospatial function measures tended to favor the control group , which raises the possibility that these training programs may have domain-specific effects . We conclude that intensive , computer-based mental activity is feasible in subjects with mild cognitive impairment and that larger trials are warranted Objective : To characterize change through 5-year follow-up , associated with training , booster , adherence , and other characteristics . Methods : Sample included all individuals r and omly assigned to reasoning training ( N = 699 ) . Piecewise latent growth modeling was used to examine trajectory of performance on outcome measures . Results : Training result ed in improved reasoning performance through Year 5 . A significant third annual booster effect was one-half the size of the training effect . Training adherence result ed in greater training effects . Higher education , Mini-Mental State Exam ( MMSE ) , better health , and younger age related to higher baseline performance . Higher MMSE was related to larger training effects , larger linear slopes , and smaller booster effects . Significant functional outcomes included a training effect for complex reaction time ( CRT ) , and first annual booster effects for the CRT and observed tasks of daily living . Discussion : Initial training gain was comparable with magnitude of age-related cognitive decline over 5 years with no training . Neither age nor gender predicted training or booster effects , indicating the generality of training effects across age ( 65 - 90 years ) The Seattle Longitudinal Study ( SLS ; Hertzog , 2010 ; Schaie , 1996a , b , 2000 , 2005a ) began as Schaie ’s doctoral dissertation at the University of Washington ( Seattle , WA ) in 1956 . In an effort to resolve the discrepancies between cross-sectional and longitudinal findings in the study of adult intellectual development , Schaie design ed a follow-up study , put into the field in 1963 , that provided some answers , but also raised enough method ological and substantive questions to dem and a continuing program of studies that is still in progress and has included eight major and several collateral data collection s as well as three cognitive training studies . An important aspect of the study has been the investigation of cohort differences and their implication s for the study of adult cognition . In the more recent phases of the study , a number of context ual , health , and personality variables have been identified that offer explanations for differential change and that provide a basis for possible interventions . Within the context of our monitoring of individual change , the authors therefore design ed cognitive interventions that have been successful in reversing carefully documented declines in ability performance and in improving the cognitive functions of older persons who have remained stable . Many reasonable arguments have been made for the proposition that motivational and other personality variables might have greater potency in predicting adjustment and competence in midlife than does intelligence , but the empirical evidence for this proposition is less than convincing . Questions such as who should be retired for cause ( read incompetence ) in the absence of m and atory retirement at relatively early ages ; whether there is sufficient remaining competence for independent living ; or whether persons can continue to conserve and dispose of their property all involve the assessment of intellectual functioning ( see Schaie , 1988a ) . We need to examine at what age developmental peaks do occur and assess generational differences as well as within-generation age changes . Most important , we must determine the reasons why some individuals show intellectual decline in early adulthood , while others maintain or increase their level of intellectual functioning well into advanced old age . Initial studies in 1949 ( PMA 11–14 ; L. L. Thurstone & T. G. Thurstone , 1949 ) and 1953 ( Schaie , Rosenthal , & Perlman , 1953 ) , explored whether the factorial independence of the five abilities measured in the most advanced form of the PMA test would be retained in adulthood . In a 1963 follow-up study , in addition to tracking down and retesting as many of the individuals studied in 1956 as possible , we decided to draw a new r and om sample from the original population frame to provide the necessary controls for examining retest effects and began addressing the possibility that socio-cultural variation affects intellectual performance . The latter concern was stimulated by the thoughtful admonitions previously voiced by Raymond Kuhlen ( 1963 ) . Our new sample therefore was extended over the original age range ( 22–70 years ) plus an additional 7-year interval to match the age range now attained by the original sample . The second cross-sectional study essentially replicated the findings of the base study . The short-term longitudinal study , however , disclosed substantially different information about peak levels and rate of decline . Publication of findings was therefore delayed until a theoretical model could be built that accounted for the discrepancy between the longitudinal and cross-sectional data ( Schaie , 1965 , 1977 , 2007 ) . These analyses suggested that comparisons of age group means needed to be conducted for the repeatedly measured sample s as well as for successive independent sample s drawn from the same cohort . Results were reported that called attention to substantial cohort differences and that question ed the universality and significance of intellectual decrement with advancing age in community-dwelling persons ( Nesselroade , Baltes , & Schaie , 1972 ; Schaie & Strother , 1968 ) . The results from the third data collection seemed rather definitive in replicating the short-term longitudinal findings , but discrepancies between findings in the repeated-measurement and independent-sampling studies suggested the need for a replication of the 14-year longitudinal sequences , and it further seemed useful to follow the original sample for as long as 21 years , so a fourth data collection was conducted in 1977 , again retesting the previous sample s and adding a new r and om sample , this time from an exp and ed population frame ( Schaie & Hertzog , 1983 ) , adding collateral questions of the effects of monetary incentives on participant characteristics ( Gribbin & Schaie , 1976 ) ; an examination of the aging of tests ; and the beginning of causal analyses of health and environmental factors on change or maintenance of adult intellectual performance ( Gribbin , Schaie , & Parham , 1980 ; Hertzog , Schaie , & Gribbin , 1978 ) Despite the growing interest in cognitive training programs as a potential non-pharmacological approach to slowing cognitive decline in mild cognitive impairment ( MCI ) , there has been little research on the differential effectiveness of training among subtypes of MCI ( i.e. , amnestic , single non-amnestic , and multi-domain ) . The current study examined the longitudinal effects of  cognitive speed of processing training ( SOPT )  among older adults with psychometricallydefined MCI from the Advanced Cognitive Training for Independent and Vital Elderly ( ACTIVE ) trial . Mixed model ANOVAs examined the effectiveness of SOPT in participants with MCI relative to controls and also compared training effectiveness in MCI subgroups to appropriate controls . A mixed effects model compared SOPT training effects longitudinally across five years relative to controls . A second mixed effects model compared the durability of training gains between the MCI subtypes across 5 years . All subtypes of MCI showed immediate improvement post-training relative to controls , with the single non-amnestic subtype showing the most benefit . Additionally , all subtypes showed similar trajectories across five years . There were no significant changes in performance across time , indicating initial training gains were maintained . These results provide support for the effectiveness and potential durability of SOPT among persons with MCI regardless of subtype . Future research should investigate if SOPT transfers to improvements in the everyday functioning of those with MCI A r and omized pilot experiment examined the neural substrates of response to cognitive training in participants with mild cognitive impairment ( MCI ) . Participants performed exercises previously demonstrated to improve verbal memory and an active control group performed other computer activities . An auditory-verbal fMRI task was conducted before and after the two-month training program .  Verbal memory scores improved significantly and left hippocampal activation increased significantly in the experimental group ( gains in 5 of 6 participants ) relative to the control group ( reductions in all 6 participants ) . Results suggest that the hippocampus in MCI may retain sufficient neuroplasticity to benefit from cognitive training BACK 
    Output:
    
We found significant overall effects for intervention content with memory focused interventions appearing to be more effective than multidomain approaches .
There was no evidence of an influence on outcomes for the other covariates examined .
Overall , these findings suggest individuals with MCI who received multicomponent training or interventions targeting multiple domains ( including lifestyle changes ) were apt to display an improvement on outcome measures of cognition post-intervention .
As such , multicomponent and multidomain forms of intervention may prompt recruitment of alternate neural processes as well as support primary networks to meet task dem and s simultaneously .
In addition , interventions with memory and multidomain forms of content appear to be particularly helpful , with memory-based approaches possibly being more effective than multidomain methods .
Other factors , such as program duration , appear to have less of an influence on intervention outcomes .
Given this , although the creation of new primary network paths appears strained in MCI , interventions with memory-based or multidomain forms of content may facilitate partial activation of compensatory scaffolding and neuroplastic reorganization .
The positive benefit of memory-based strategies may also reflect transfer effects indicative of compensatory network activation and the multiple-pathways involved in memory processes .