***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 Age-related cognitive decline is common and may lead to substantial difficulties and disabilities in everyday life . We hypothesized that 10 hours of visual speed of processing training would prevent age-related declines and potentially improve cognitive processing speed . Methods Within two age b and s ( 50–64 and ≥65 ) 681 patients were r and omized to ( a ) three computerized visual speed of processing training arms ( 10 hours on-site , 14 hours on-site , or 10 hours at-home ) or ( b ) an on-site attention control group using computerized crossword puzzles for 10 hours . The primary outcome was the Useful Field of View ( UFOV ) test , and the secondary outcomes were the Trail Making ( Trails ) A and B Tests , Symbol Digit Modalities Test ( SDMT ) , Stroop Color and Word Tests , Controlled Oral Word Association Test ( COWAT ) , and the Digit Vigilance Test ( DVT ) , which were assessed at baseline and at one year . 620 participants ( 91 % ) completed the study and were included in the analyses . Linear mixed models were used with Blom rank transformations within age b and s. Results All intervention groups had ( p<0.05 ) small to medium st and ardized effect size improvements on UFOV ( Cohen 's d = −0.322 to −0.579 , depending on intervention arm ) , Trails A ( d = −0.204 to −0.265 ) , Trails B ( d = −0.225 to −0.320 ) , SDMT ( d = 0.263 to 0.351 ) , and Stroop Word ( d = 0.240 to 0.271 ) . Converted to years of protection against age-related cognitive declines , these effects reflect 3.0 to 4.1 years on UFOV , 2.2 to 3.5 years on Trails A , 1.5 to 2.0 years on Trails B , 5.4 to 6.6 years on SDMT , and 2.3 to 2.7 years on Stroop Word . Conclusion Visual speed of processing training delivered on-site or at-home to middle-aged or older adults using st and ard home computers result ed in stabilization or improvement in several cognitive function tests . Widespread implementation of this intervention is feasible . Trial Registration Clinical Trials.gov CONTEXT Cognitive function in older adults is related to independent living and need for care . However , few studies have addressed whether improving cognitive functions might have short- or long-term effects on activities related to living independently . OBJECTIVE To evaluate whether 3 cognitive training interventions improve mental abilities and daily functioning in older , independent-living adults . DESIGN R and omized , controlled , single-blind trial with recruitment conducted from March 1998 to October 1999 and 2-year follow-up through December 2001 . SETTING AND PARTICIPANTS Volunteer sample of 2832 persons aged 65 to 94 years recruited from senior housing , community centers , and hospital/clinics in 6 metropolitan areas in the United States . INTERVENTIONS Participants were r and omly assigned to 1 of 4 groups : 10-session group training for memory ( verbal episodic memory ; n = 711 ) , or reasoning ( ability to solve problems that follow a serial pattern ; n = 705 ) , or speed of processing ( visual search and identification ; n = 712 ) ; or a no-contact control group ( n = 704 ) . For the 3 treatment groups , 4-session booster training was offered to a 60 % r and om sample 11 months later . MAIN OUTCOME MEASURES Cognitive function and cognitively dem and ing everyday functioning . RESULTS Thirty participants were incorrectly r and omized and were excluded from the analysis . Each intervention improved the targeted cognitive ability compared with baseline , durable to 2 years ( P<.001 for all ) . Eighty-seven percent of speed- , 74 % of reasoning- , and 26 % of memory-trained participants demonstrated reliable cognitive improvement immediately after the intervention period . Booster training enhanced training gains in speed ( P<.001 ) and reasoning ( P<.001 ) interventions ( speed booster , 92 % ; no booster , 68 % ; reasoning booster , 72 % ; no booster , 49 % ) , which were maintained at 2-year follow-up ( P<.001 for both ) . No training effects on everyday functioning were detected at 2 years . CONCLUSIONS Results support the effectiveness and durability of the cognitive training interventions in improving targeted cognitive abilities . Training effects were of a magnitude equivalent to the amount of decline expected in elderly persons without dementia over 7- to 14-year intervals . Because of minimal functional decline across all groups , longer follow-up is likely required to observe training effects on everyday function OBJECTIVES To determine the effects of cognitive training on cognitive abilities and everyday function over 10 years . DESIGN Ten-year follow-up of a r and omized , controlled single-blind trial ( Advanced Cognitive Training for Independent and Vital Elderly ( ACTIVE ) ) with three intervention groups and a no-contact control group . SETTING Six U.S. cities . PARTICIPANTS A volunteer sample of 2,832 persons ( mean baseline age 73.6 ; 26 % African American ) living independently . INTERVENTION Ten training sessions for memory , reasoning , or speed of processing ; four sessions of booster training 11 and 35 months after initial training . MEASUREMENTS Objective ly measured cognitive abilities and self-reported and performance-based measures of everyday function . RESULTS Participants in each intervention group reported less difficulty with instrumental activities of daily living ( IADLs ) ( memory : effect size = 0.48 , 99 % confidence interval ( CI ) = 0.12 - 0.84 ; reasoning : effect size = 0.38 , 99 % CI = 0.02 - 0.74 ; speed of processing : effect size = 0.36 , 99 % CI = 0.01 - 0.72 ) . At a mean age of 82 , approximately 60 % of trained participants , versus 50 % of controls ( P < .05 ) , were at or above their baseline level of self-reported IADL function at 10 years . The reasoning and speed-of-processing interventions maintained their effects on their targeted cognitive abilities at 10 years ( reasoning : effect size = 0.23 , 99 % CI = 0.09 - 0.38 ; speed of processing : effect size = 0.66 , 99 % CI = 0.43 - 0.88 ) . Memory training effects were no longer maintained for memory performance . Booster training produced additional and durable improvement for the reasoning intervention for reasoning performance ( effect size = 0.21 , 99 % CI = 0.01 - 0.41 ) and the speed-of-processing intervention for speed-of-processing performance ( effect size = 0.62 , 99 % CI = 0.31 - 0.93 ) . CONCLUSION Each Advanced Cognitive Training for Independent and Vital Elderly cognitive intervention result ed in less decline in self-reported IADL compared with the control group . Reasoning and speed , but not memory , training result ed in improved targeted cognitive abilities for 10 years OBJECTIVE The role of cognition-focused interventions in reducing cognitive decline in older people remains uncertain . This study aim ed to clarify whether a group cognitive activity ( CA ) strategy -training program would decrease the 2-year rate of cognitive decline of people with mild cognitive impairment ( MCI ) . DESIGN R and omized controlled trial . SETTING One study site . PARTICIPANTS 160 older adults with MCI ≥65 years of age ( mean : 75 , SD : 5.8 ) . INTERVENTION Five-week CA strategy training or a control nonspecific educational program . The primary outcome measure was change from baseline in the total score on the Cambridge Cognitive Examination-Revised ( CAMCOG-R ) . Secondary outcomes of interest included changes in memory , attention , executive functions , mood , and quality of life . Endpoints were collected 10 , 52 , and 104 weeks post baseline . RESULTS Intention to treat analysis identified no significant difference in CAMCOG-R scores over time between the two groups ( mean difference : -0.36 , 95 % CI : -1.02,0.29 ) or across secondary outcome measures . The exceptions were better performance of the CA group on immediate attention ( Digit Span Forwards , adjusted mean difference : 0.15 , 95 % CI : 0.01,0.30 ) and better quality of life ( adjusted mean difference : 0.57 , 95 % CI : 0.10,1.04 ) compared with controls . CONCLUSION The devised program of CA did not improve general cognitive performance of older adults with MCI over a period of 2 years . Although favorable , the beneficial effects of the intervention on attention and quality of life were small , and of uncertain significance OBJECTIVES Research indicates an association between stimulating mental activities and better memory performance as people age , but studies on computerized mental stimulation programs are limited . We explored whether computerized brain training exercises improved cognitive performance in older adults . METHODS In local retirement communities , a convenience sample was r and omized into an intervention group ( N = 36 ) , who used a computer program 5 days a week for 20 - 25 minutes each day , or a wait-list control group ( N = 33 ) . All were older adults without dementia ( mean age : 81.8 years ; SD : 6.1 ; 67 % female ) .  Neuropsychological testing was completed at baseline ( Time 1 ) , 2 months ( Time 2 ) , and 6 months ( Time 3 ) . Three cognitive domains ( Immediate Memory , Delayed Memory , Language ) were compared in the two groups as a function of time using mixed models . RESULTS The intervention group used the computerized program ( Brain Fitness , Dakim Inc. , Santa Monica , CA ) for an average of 43 ( SD : 4.4 ) sessions by Time 2 and 81 ( SD : 37.5 ) sessions by Time 3 . Mixed models examining cognitive domains as function of time revealed significant group differences in Delayed Memory ( F(2,72 ) = 4.7 , p = 0.01 ) but not Immediate Memory and Language ; no significant improvements were noted for the control group . Among all participants , anyone playing at least 40 sessions over the 6 months improved in all three domains ( Immediate Memory , Delayed Memory , and Language ) . CONCLUSION Participating in a computerized brain exercise program over 6 months improves cognitive abilities in older adults . These results extend literature indicating the benefit of training exercises , whether in a classroom format or via a computerized self-paced program BACKGROUND Several reports suggest beneficial impacts of either physical or mental activity on cognitive function  in old age . However , the differential effects of complex mental and physical activities on cognitive performance in humans remain to be clarified . METHODS This r and omized controlled trial evaluates a cognitive and a physical st and ardized 6-month activity intervention ( 3 x 1.5 h/wk ) conducted in Berlin ( Germany ) . Two hundred fifty nine healthy women aged 70 - 93 years were r and omized to a computer course ( n = 92 ) , an exercise course ( n = 91 ) , or a control group ( n = 76 ) , of whom 230 completed the 6-month assessment . Group differences in change over a period of 6 months in episodic memory ( story recall , possible range , 0 - 21 ; word recall , possible range , 0 - 16 ) , executive control ( working memory , ie , time quotient of Trail Making Tests B/A ) , and verbal fluency were evaluated by analyses of covariance ( intention to treat ) adjusting for baseline , fluid intelligence , and educational level . RESULTS In contrast to the control group , both the exercise group , DeltaM ( SD ) = 2.09 ( 2.66 ) , p < .001 , and the computer group , DeltaM ( SD ) = 1.89 ( 2.88 ) , p < .001 , showed improved delayed story recall . They maintained performance in delayed word recall and working memory ( time measure ) as opposed to the control group that showed a decline , DeltaM ( SD ) = -0.91 ( 2.15 ) , p = .001 , and DeltaM ( SD ) = 0.24 ( 0.68 ) , p = .04 , respectively . CONCLUSIONS In healthy older women , participation in new stimulating activities contributes to cognitive fitness and might delay cognitive decline .  Exercise and computer classes seem to generate equivalent beneficial effects OBJECTIVE This study examines the short-term and long-term effects of a cognitive training ( CT ) program in enhancing cognitive function of older people with subjective memory complaints .  METHODS A single-blind r and omized placebo-controlled trial was carried out in a sample of 223 older adults aged 65 years or above with subjective memory complaints in Hong Kong . They were r and omly assigned to either receive CT ( intervention group , N = 111 ) or attend health-related educational lectures only ( control group , N = 112 ) . Participants ' cognitive abilities were assessed by the Chinese version of Mattis Dementia Rating Scale at baseline , immediately after the training , and nine months after the training . RESULTS Significant interaction effect of  CT and education was detected on participants ' CT gains at both T2 ( F(2 , 200 ) = 6.329 , p = 0.002 , η(2 ) = 0.060 ) and T3 ( F(2 , 189 ) = 3.294 , p = 0.039 , η( 
    Output:
    
For cognitively normal adults , moderate-strength evidence suggests that cognitive training in a particular domain improves performance in that domain compared with inactive or attention control population s. These results are driven largely by the results from the ACTIVE ( Advanced Cognitive Training for Independent and Vital Elderly ) trial .
Low-strength evidence suggests that for persons with MCI , cognitive training in a particular domain does not improve performance in that domain compared with controls .
The MCI trials have more limitations and are less precise than the studies conducted with cognitively normal participants .
Evidence is insufficient for incident MCI or ADRD outcomes .
At 2 years , ACTIVE participants showed improvement in the cognitive domains in which they were trained ( for example , those who received memory training improved on memory-related tasks compared with control participants ) , but no statistically significant differences were found among groups with regard to other cognitive outcomes ( for example , persons who received training in memory did not do better than control participants on reasoning tasks ) .
One year after training , both intervention groups showed statistically significant improvement in the primary outcome of the Useful Field of View test compared with the attention control group .