***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 Subjects with a mild cognitive impairment ( MCI ) have a memory impairment beyond that expected for age and education yet are not demented . These subjects are becoming the focus of many prediction studies and early intervention trials . OBJECTIVE To characterize clinical ly subjects with MCI  cross-sectionally and longitudinally . DESIGN A prospect i ve , longitudinal inception cohort . SETTING General community clinic . PARTICIPANTS A sample of 76 consecutively evaluated subjects with MCI were compared with 234 healthy control subjects and 106 patients with mild Alzheimer disease ( AD ) , all from a community setting as part of the Mayo Clinic Alzheimer 's Disease Center/Alzheimer 's Disease Patient Registry , Rochester , Minn. MAIN OUTCOME MEASURES The 3 groups of individuals were compared on demographic factors and measures of cognitive function including the  Mini-Mental State Examination , Wechsler Adult Intelligence Scale-Revised , Wechsler Memory Scale-Revised , Dementia Rating Scale , Free and Cued Selective Reminding Test , and Auditory Verbal Learning Test .  Clinical classifications of dementia and AD were determined according to the Diagnostic and Statistical Manual of Mental Disorders , Revised Third Edition and the National Institute of Neurological and Communicative Disorders and Stroke-Alzheimer 's Disease and Related Disorders Association criteria , respectively . RESULTS The primary distinction between control subjects and subjects with MCI was in the area of memory , while other cognitive functions were comparable . However , when the subjects with MCI were compared with the patients with very mild AD , memory performance was similar , but patients with AD were more impaired in other cognitive domains as well . Longitudinal performance demonstrated that the subjects with MCI declined at a rate greater than that of the controls but less rapidly than the patients with mild AD . CONCLUSIONS Patients who meet the criteria for MCI can be differentiated from healthy control subjects and those with very mild AD . They appear to constitute a clinical entity that can be characterized for treatment interventions ABSTRACT Objective : Few data are available on the Italian elderly population with regard to adherence to the Mediterranean diet ( MD ) and cognitive impairment . Our aim was to investigate adherence to the MD and its association with cognitive function  in an Italian urban sample . Methods : A cross-sectional study of 279 participants aged ≥ 65 years ( 80 men , 199 women ) was carried out at a nutritional center .  Adherence to the MD was evaluated using a 14-item question naire  . Cognitive function was assessed with the Mini-Mental State Examination ( MMSE ) . Results : The clinical and nutritional assessment s performed revealed 30.1 % to have a dietary pattern in accordance with the MD ; 13.6 % had suspected or mild cognitive impairment ( MMSE score ≤ 23 ) . The MD pattern was associated with a lower risk of cognitive impairment ( odds ratio [ OR ] = 0.39 ; 95 % confidence interval [ CI ] , 0.15–0.99 ; p = 0.045 ) , as was the consumption of wine ( OR = 0.37 ; 95 % CI , 0.16–0.84 ; p = 0.018 ) and nuts ( OR = 0.30 ; 95 % CI , 0.13–0.69 , p = 0.005 ) . No association was found with other food groups . Conclusion : A closer adherence to the MD  was associated with a better cognitive status . Further cohort studies and r and omized controlled trials are warranted Background A number of prospect i ve studies have observed inverse associations between nut consumption and chronic diseases . However , these studies have predominantly been conducted in Western countries , where nut consumption tends to be more common among individuals with healthier lifestyles . It is important to examine the association in other parts of the world , and particularly among population s with different patterns of disease , socioeconomic status , lifestyles and disease risk factors . Our objective was to examine the association between nut consumption and mortality in a population whose nut consumption does not track with a healthy lifestyle . Methods We examined the association between nut consumption and all-cause and cause-specific mortality in the 50 045 participants of the Golestan Cohort Study . Participants were aged 40 and older at baseline in 2004 , and have been actively followed since that time . Dietary data were collected using a vali date d semi-quantitative food frequency question naire that was administered at baseline . Results During 349 677 person-years of follow-up , 3981 cohort participants died , including 1732 women and 2249 men . Nut consumption was associated inversely with all-cause mortality . The pooled multivariate adjusted hazard ratios for death among participants who ate nuts , as compared with those who did not , were 0.89 [ 95 % confidence interval ( CI ) , 0.82 - 0.95 ] for the consumption of less than one serving of nuts per week , 0.75 ( 95 % CI , 0.67 - 0.85 ) for one to less than three servings per week and 0.71 ( 95 % CI , 0.58 - 0.86 ) for three or more servings per week ( P < 0.001 for trend ) . Among specific causes , significant inverse associations were observed between nut consumption and deaths due to cardiovascular disease , all cancers and gastrointestinal cancers . Conclusions This study provides evidence for an inverse association between nut consumption and mortality in a developing country , where nut consumption does not track with a healthy lifestyle . Further work is needed to establish the underlying mechanisms responsible for this association IMPORTANCE Oxidative stress and vascular impairment are believed to partly mediate age-related cognitive decline , a strong risk factor for development of dementia . Epidemiologic studies suggest that a Mediterranean diet , an antioxidant-rich cardioprotective dietary pattern , delays cognitive decline , but clinical trial evidence is lacking . OBJECTIVE To investigate whether a Mediterranean diet supplemented with antioxidant-rich foods influences cognitive function compared with a control diet . DESIGN , SETTING , AND PARTICIPANTS Parallel-group r and omized clinical trial of 447 cognitively healthy volunteers from Barcelona , Spain ( 233 women [ 52.1 % ] ; mean age , 66.9 years ) , at high cardiovascular risk were enrolled into the Prevención con Dieta Mediterránea nutrition intervention trial from October 1 , 2003 , through December 31 , 2009 . All patients underwent neuropsychological assessment at inclusion and were offered retesting at the end of the study . INTERVENTIONS Participants were r and omly assigned to a Mediterranean diet supplemented with extravirgin olive oil ( 1 L/wk ) , a Mediterranean diet supplemented with mixed nuts ( 30 g/d ) , or a control diet ( advice to reduce dietary fat ) . MAIN OUTCOMES AND MEASURES Rates of cognitive change over time based on a neuropsychological test battery : Mini-Mental State Examination , Rey Auditory Verbal Learning Test ( RAVLT ) , Animals Semantic Fluency , Digit Span subtest from the Wechsler Adult Intelligence Scale , Verbal Paired Associates from the Wechsler Memory Scale , and the Color Trail Test . We used mean z scores of change in each test to construct 3 cognitive composites : memory , frontal ( attention and executive function ) , and global . RESULTS Follow-up cognitive tests were available in 334 participants after intervention ( median , 4.1 years ) . In multivariate analyses adjusted for confounders , participants allocated to a Mediterranean diet plus olive oil scored better on the RAVLT ( P = .049 ) and Color Trail Test part 2 ( P = .04 ) compared with controls ; no between-group differences were observed for the other cognitive tests . Similarly adjusted cognitive composites ( mean z scores with 95 % CIs ) for changes above baseline of the memory composite were 0.04 ( -0.09 to 0.18 ) for the Mediterranean diet plus olive oil , 0.09 ( -0.05 to 0.23 ; P = .04 vs controls ) for the Mediterranean diet plus nuts , and -0.17 ( -0.32 to -0.01 ) for the control diet . Respective changes from baseline of the frontal cognition composite were 0.23 ( 0.03 to 0.43 ; P = .003 vs controls ) , 0.03 ( -0.25 to 0.31 ) , and -0.33 ( -0.57 to -0.09 ) . Changes from baseline of the global cognition composite were 0.05 ( -0.11 to 0.21 ; P = .005 vs controls ) for the Mediterranean diet plus olive oil , -0.05 ( -0.27 to 0.18 ) for the Mediterranean diet plus nuts , and -0.38 ( -0.57 to -0.18 ) for the control diet .  All cognitive composites significantly ( P < .05 ) decreased from baseline in controls . CONCLUSIONS AND RELEVANCE In an older population , a Mediterranean diet supplemented with olive oil or nuts is associated with improved cognitive function . TRIAL REGISTRATION is rct n.org Identifier : IS RCT N35739639 The post-lunch dip in cognition is a well-established phenomenon of decreased alertness , memory and vigilance after lunch consumption . Lunch composition reportedly influences the post-lunch dip . Moreover , dieting is associated with cognitive function impairments . The negative effects of dieting have been reversed with nut-supplemented diets . The aims of this study were to ( 1 ) evaluate the acute effect of an almond-enriched high-fat lunch or high-carbohydrate lunch on the post-lunch decline in cognitive function , and ( 2 ) evaluate the effects of chronic almond consumption as part of an energy-restricted diet on the memory and attention domains of cognitive function . In total , eighty-six overweight and obese adults were r and omised to consume either an almond-enriched diet ( AED ) or a nut-free control diet ( NFD ) over a 12-week weight loss intervention . Participants were also r and omised to receive either an almond-enriched high-fat lunch ( A-HFL ) ( > 55 % energy from fat , almonds contributing 70 - 75 % energy ) or a high-carbohydrate lunch ( HCL ) ( > 85 % energy from carbohydrates ) at the beginning and end of the weight loss intervention . Memory and attention performance indices decreased after lunch consumption ( P<0·001 ) . The A-HFL group ameliorated the decline in memory scores by 57·7 % compared with the HCL group ( P=0·004 ) . Both lunch groups had similar declines in attention . Moreover , memory and attention performance indices increased after the 12-week intervention period ( P<0·05 ) with no difference between the AED and NFD groups . In conclusion , almond consumption at a midday meal can reduce the post-lunch dip in memory . However , long-term almond consumption may not further improve cognitive function outcomes in a weight loss intervention Objective : Peanuts contain bioactive nutrients beneficial for vascular function . This study investigated whether consumption of unsalted peanuts ( with skins ) would enhance cerebrovascular perfusion and cognitive performance . Method : In a r and omized crossover trial , 61 volunteers ( 29 males/32 females , 65 ± 7 years , BMI 31 ± 4 kg/m2 ) consumed their habitual diet ± high-oleic peanuts ( 56–84 g/day ) , each for 12 weeks . Nutrient intakes , vascular and cognitive function were assessed at baseline and at the end of each 12-week phase . Differences between the ends of each phase were compared by general linear repeated measures ANOVA controlling for baseline . Pearson 's correlation analyses determined relationships between differences in cerebrovascular reactivity ( CVR ) and cognitive function . Results : Intakes of bioactive nutrients increased during the peanut phase . CVR was 5 % greater in the left middle cerebral artery ( MCA ) and 7 % greater in the right MCA . Small artery elasticity was 10 % greater after peanut consumption ; large artery elasticity and blood pressure did not differ between phases . Measures of short-term memory , verbal fluency , and processing speed were also higher following the peanut phase ; other cognitive measures did not change . Differences in CVR in the left MCA correlated with differences in delayed memory and recognition . Discussion : Regular peanut consumption improved cerebrovascular and cognitive function ; increased intakes of bioactive nutrients may have mediated these improvements . This clinical trial was registered with the Australian Clinical Trials Registry ( ACTRN 12612000192886 ) Objective Nuts contain nutrients that may benefit brain health ; thus , we examined long-term intake of nuts in relation to cognition in older women . Design Population -based prospect i ve cohort study . Setting Academic research using data from the Nurses ’ Health Study . Participants Nut intake was assessed in a food-frequency question naire beginning inl980 , and approximately every four years thereafter . Between 1995–2001 , 16,010 women age 70 or older ( mean age = 74 years ) without a history of stroke were administered 4 repeated telephone-based cognitive interviews over 6 years . Our final sample included 
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In addition , the effects appear to be independent of nut type , amount of intake , age and baseline status of subjects .
In summary , these results suggest that the inclusion of daily nut consumption in the healthy diet pattern of adults could have positive effects on their cognitive function .