***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: Objective : The purpose of this r and omized-controlled pilot study was to explore the effectiveness of a home-based computerized cognitive training intervention in improving cognitive function in a population of older adults with mild cognitive impairment who are living with HIV . Methods : In all , 24 participants were enrolled in this study . All study participants were impaired [ defined as Montreal Cognitive Assessment ( MoCA ) score < 26 ] ; 12 were r and omly assigned to a computer-training intervention group and 12 to a control group .  The intervention group used a home-based computerized cognitive training program for 8 weeks , while the control group received health-related newsletter via email and follow-up phone calls .  Cognitive function was measured at study entry , immediately post intervention , and 8 and 16 weeks post intervention Results : This study achieved a 92 % retention rate , losing two persons from the intervention group . Participants in the intervention group scored significantly higher on cognitive testing immediately post intervention compared to the control group : F(1 , 19 ) = 4.92 , p = 0.04 . The partial Eta squared of 0.32 indicates a small to moderate effect size . Discussion : Cognitive improvement was seen immediately after the intervention , and cognitive improvement was still evident 16 weeks post intervention . Cognitive training could be considered as an option for older adults with HIV experiencing mild cognitive impairment ABSTRACT The objective of this study was to examine  combination speed of processing ( SOP ) cognitive remediation therapy ( CRT ) and transcranial direct stimulation ( tDCS ) as neurorehabilitation in older HIV+ adults . Thirty-three HIV+ adults aged 50 + completed neurocognitive testing and were r and omized to either active ( n = 17 ) or sham ( n = 16 ) tDCS . Both conditions received 10 1-hour sessions of SOP CRT , with either active or sham tDCS for the first 20 minutes . Participants then completed a posttest assessment . Repeated measures analysis of variance examining Time X Condition showed small-to-medium effects in the expected direction for an executive ( d = 0.36 ) , and SOP measure ( d = 0.49 ) , while medium-to-large effects were observed for an executive/attention ( d = 0.60 ) and oral reading measure ( d = 0.75 ) . The only statistically significant interaction was the oral reading measure . Small-to-medium and medium-to-large effects ( ds = 0.32 , 0.58 ) were found for two SOP measures in the opposite direction ( sham group showing greater improvements ) . Further trials of CRT and tDCS in this population are needed , including larger sample s and a nonactive control and tDCS only condition , as is determination of which parameters of each technique ( e.g. , tDCS montage , timing of tDCS , domain targeted in CRT , number of sessions ) are most effective in improving cognitive outcomes , durability of training gains , and translation to everyday functioning Nearly 50 % of adults with HIV have some form of HIV-associated neurocognitive disorder ( H AND ) , ranging from subtle to symptoms that interfere with everyday functioning and quality of life . H AND is diagnosed when a person performs more than 1 st and ard deviation below his or her normative mean on st and ardized measures in two or more cognitive domains ( e.g. , attention , speed of processing , verbal memory , executive functioning ) . As adults age with HIV , they are more likely to develop comorbidities such as cardiovascular disease , hypertension , and insulin resistance that may further contribute to poorer cognitive functioning and H AND . Certain computerized cognitive training programs may be able to improve specific cognitive domains in those with HIV . Such programs may be effective in changing the diagnosis of H AND in cognitively vulnerable adults . In this article , we describe the design and methods of TOPS-the Training On Purpose Study . In this on-going experimental study , 146 older adults ( 50 + ) with H AND are r and omized to either : ( i ) an Individualized-Targeted Cognitive Training group , or ( ii ) a no-contact control group . This study targets those cognitive domains in which participants experience a deficit and trains participants with the corresponding computerized cognitive training program for that domain . An Individualized Targeted Cognitive Training approach using cognitive-domain-specific cognitive training programs may offer symptom relief to those individuals diagnosed with H AND , which may actually reverse this diagnosis . Given that these cognitive training programs are commercially available , this approach represents a potential paradigm shift in how H AND is considered and treated Introduction Cognitive training improves cognitive performance and delays functional impairment , but its effects on dementia are not known . We examined whether three different types of cognitive training lowered the risk of dementia across 10 years of follow-up relative to control and if greater number of training sessions attended was associated with lower dementia risk . Methods The Advanced Cognitive Training in Vital Elderly ( NCT00298558 ) study was a r and omized controlled trial ( N = 2802 ) among initially healthy older adults , which examined the efficacy of three cognitive training programs ( memory , reasoning , or speed of processing ) relative to a no-contact control condition . Up to 10 training sessions were delivered over 6 weeks with up to four sessions of booster training delivered at 11 months and a second set of up to four booster sessions at 35 months . Outcome assessment s were taken immediately after intervention and at intervals over 10 years . Dementia was defined using a combination of interview- and performance-based methods . Results A total of 260 cases of dementia were identified during the follow-up . Speed training result ed in reduced risk of dementia ( hazard ratio [ HR ] 0.71 , 95 % confidence interval [ CI ] 0.50–0.998 , P = .049 ) compared to control , but memory and reasoning training did not ( HR 0.79 , 95 % CI 0.57–1.11 , P = .177 and HR 0.79 , 95 % CI 0.56–1.10 , P = .163 , respectively ) . Each additional speed training session was associated with a 10 % lower hazard for dementia ( unadjusted HR , 0.90 ; 95 % CI , 0.85–0.95 , P < .001 ) . Discussion Initially , healthy older adults r and omized to speed of processing cognitive training had a 29 % reduction in their risk of dementia after 10 years of follow-up compared to the untreated control group OBJECTIVES We evaluated the effect of cognitive training among 1,534 participants in the Advanced Cognitive Training for Independent and Vital Elderly ( ACTIVE ) r and omized controlled trial ( RCT ) on 5-year improvements in 3 cognitive-specific measures of locus of control-internal , chance , and powerful others . METHODS ACTIVE was a multisite RCT ( age > or = 65 ) , with 4 groups ( memory , reasoning , speed of processing , and no-contact control ) . Complete 5-year follow-up data were available for 1,534 ( 55 % ) of the 2,802 participants . A propensity score model was used to adjust for potential attrition bias . Clinical ly important improvements ( and decrements ) in the cognitive-specific locus of control scale scores were defined as greater than or equal to 0.5 SD ( medium ) and greater than or equal to 1.0 SD ( large ) . Multinomial logistic regression was used to simultaneously contrast those who improved and those who declined with those whose locus of control scale score was unchanged . RESULTS Statistically significant effects reflecting medium-sized ( > or = 0.5 SD ) improvements in internal locus of control between baseline and the 5-year follow-up were found for the reasoning and speed of processing intervention groups who were 76 % ( p < .01 ) and 68 % ( p < .05 ) more likely , respectively , to improve than the no-contact control group . No improvement effects were found on the chance or powerful others locus of control measures or for the memory intervention group . CONCLUSION Cognitive training that targets reasoning and speed of processing can improve the cognitive-specific sense of personal control over one 's life in older adults Purpose of the Study Driving is important for older adults ' health and well-being , yet little research has examined interventions to maintain driving mobility . As fluid cognitive abilities are strongly linked to driving , targeted cognitive training interventions may impact driving mobility longitudinally . This study assessed the effects of three different cognitive training programs ( reasoning , speed of processing , and memory ) on driving cessation in older adults across 10 years ( n = 2,390 ) . Design and Methods Cox regression analyses evaluated the impact of each program relative to a no-contact control group with intent-to-treat ( ITT ) analyses . The effects of r and omization to additional booster sessions were also examined . Sub sample analyses repeated these models in participants who were at-risk for driving mobility declines . Results There were no training ( n = 2,390 ) or booster training ( n = 1,540 ) effects on driving cessation with ITT analyses . Individuals at-risk for future mobility declines were 49 % ( Hazard Ratio ( HR ) = 0.51 , 95 % confidence interval [ CI ] : 0.28 , 0.94 ; n = 336 ) less likely to cease driving after speed of processing training and 55 % ( HR = 0.45 , 95 % CI : 0.24 , 0.86 ; n = 324 ) less likely to quit driving subsequent to reasoning training . Additional booster sessions for speed of processing training result ed in a 70 % reduction of driving cessation ( HR = 0.30 , 95 % CI : 0.11 , 0.82 ; n = 252 ) in the sub sample analyses . There were no significant effects of memory training . Implication s Some cognitive interventions transfer to maintained driving among those at-risk for mobility declines due to cognitive impairment . Future research should identify moderators and mediators of training and transfer effects OBJECTIVE We evaluated the ability of the three cognitive training interventions ( memory , reasoning , or speed of processing ) fielded in the Advanced Cognitive Training for Independent and Vital Elderly ( ACTIVE ) multisite r and omized controlled trial to protect against two thresholds of extensive decline in health-related quality of life ( HRQoL ) at 2 and 5 years post-training . METHOD Adults aged 65 years or older ( 2802 ) were enrolled and r and omized to three cognitive interventions or a no-contact control group .  Data on 1804 participants were available at both the 2- and 5-year follow-ups . HRQoL was measured by the eight MOS 36-Item Short-Form Health Survey ( SF-36 ) scales . Clinical ly relevant decline on each scale was defined as a drop of > or = 0.5 st and ard deviations from baseline . Extensive HRQoL decline was defined as clinical ly relevant drops on ( i ) > or = 4 SF-36 scales , and ( ii ) > or = 3 SF-36 scales , and was assessed using multiple logistic regressions , weighted to adjust for potential attrition bias . Results . At 2 years post-training , 23.7 % and 36.6 % had clinical ly relevant drops on > or = 4 and > or = 3 SF-36 scales , respectively . At 5 years post-training , 32.9 % and 47.3 % had clinical ly relevant drops on > or = 4 and > or = 3 SF-36 scales , respectively . Participants in the speed of processing intervention arm were significantly less likely to have extensive HRQoL decline compared to participants in the control group regardless of the threshold or time period , whereas participants in the memory and reasoning intervention arms were significantly less like to have extensive HRQoL decline only at 5 years post-training and only at the lower threshold . Conclusion . The effect of the speed of processing intervention was stronger and evident earlier than those for the memory and reasoning interventions . This result stems from the speed of processing intervention being the most procedural intervention , operating through sensory-motor elaboration and repetition , bringing about a broader pattern of regional brain activation . At 5 years post-training , however , all three interventions were successful in protecting against a lower threshold of age-related extensive declines in Background Health care expenditures for older adults are disproportionately high and increasing at both the individual and population levels . We evaluated the effects of the three cognitive training interventions ( memory , reasoning , or speed of processing ) in the ACTIVE study on changes in predicted medical care expenditures . Methods ACTIVE was a multisite r and omized controlled trial of older adults ( ≥ 65 ) . Five-year follow-up data were available for 1,804 of the 2,802 participants . Propensity score weighting was used to adjust for potential attrition bias . Changes in predicted annualmedical expenditures were calculated at the first and fifth annual follow-up assessment s using a new method for translating functional status scores . Multiple linear regression methods were used in this cost-offset analysis . Results At one and five years post-training , annual predicted expenditures declinedby $ 223 ( p = .024 ) and $ 128 ( p = .309 ) , respectively , in the speed of processing treatment group , but there were no statistically significant changes in the memory or reasoning treatment groups compared to the no-contact control group at either period . Statistical adjustment for age , race , education , MMSE scores , ADL and IADL performance scores , EPT scores , chronic condition counts , and the SF-36 PCS and MCS scores at baseline did not alter the one-year ( $ 244 ; p = .012 ) or five-year ( $ 143 ; p = .250 ) expenditure declines in the speed of processing treatment group . Conclusion The speed 
    Output:
    
Results suggest that cognitive training may improve the cognitive domain that is the target of training .
Although greater evidence is needed to establish treatment guidelines , current evidence suggests that cognitive training  improves cognitive function , which translates to more optimal everyday functioning ( i.e. , driving ) , improved mood , greater locus of control , and enhanced quality of life