***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 Increasing incidences of dementia necessitate the improvement of supportive measures for patients suffering from this disease and their proxies . Clinicians without psychiatric background s and others involved in appraising the supportive needs of dementia patients , such as those who allocate nursing insurance , base their appraisal s on the ability of patients to perform basic and instrumental activities of daily living ( B-ADL , iADL ) . Our aim was to investigate whether a reduced ability of the patient to perform ADL is sufficient to adequately assess the supportive needs of family caregivers . Methods Cross-sectional baseline data were obtained from  dementia patients and their proxies  in the context of a nationwide prospect i ve cohort study on non-pharmacological treatment of dementia . To our knowledge , the present study is the first country-wide study to assess patients and proxies in their domestic surroundings ( e.g.  Mini-Mental State Examination ( MMSE ) Behave-AD , B-ADL and iADL for patients ; Quality of Life ( QOL ) and depression of the proxy ) . Results Logistic and linear regression analysis show that the allocation of nursing care allowance provided by German m and atory nursing insurance is associated with scores on the B-ADL- and iADL scales , but not with the severity of behavioural symptoms or the supportive time the proxies spend on caring . However , the severity of cognitive and non-cognitive symptoms of dementia patients , correlate with each other and both parameters correlate with the time the proxy spends on caring . The time spent on caring is associated with an increase in depression and a reduction in the quality of life of the proxy . Conclusions Basic and instrumental activities of daily living do not sufficiently reflect the perceived burden of care experienced by the proxy who has to cope with the imposition of the dementia patients ’ behavioural symptoms . When allocating nursing care , patients ’ behavioural symptoms should also be taken into consideration , because depressive symptoms of proxies are linked to non-cognitive symptoms in dementia patients . To provide better health care , it is necessary to identify and treat psychiatric symptoms in proxies who care for dementia patients as early as possible BACKGROUND AND PURPOSE The interpretation of patient scores on clinical tests of physical mobility is limited by a lack of data describing the range of performance among people without disabilities . The purpose of this study was to provide data for 4 common clinical tests in a sample of community-dwelling older adults . SUBJECTS Ninety-six community-dwelling elderly people ( 61 - 89 years of age ) with independent functioning performed 4 clinical tests . METHODS Data were collected on the  Six-Minute Walk Test ( 6MW ) , Berg Balance Scale ( BBS ) , and Timed Up & Go Test ( TUG ) and during comfortable- and fast-speed walking ( CGS and FGS ) . Intraclass correlation coefficients ( ICCs ) were used to determine the test-retest reliability for the 6MW , TUG , CGS , and FGS measurements . Data were analyzed by gender and age ( 60 - 69 , 70 - 79 , and 80 - 89 years ) cohorts , similar to previous studies . Means , st and ard deviations , and 95 % confidence intervals for each measurement were calculated for each cohort . RESULTS The 6MW , TUG , CGS , and FGS measurements showed high test-retest reliability ( ICC [2,1]=.95-.97 ) . Mean test scores showed a trend of age-related declines for the 6MW , BBS , TUG , CGS , and FGS for both male and female subjects . DISCUSSION AND CONCLUSION Preliminary descriptive data suggest that physical therapists should use age-related data when interpreting patient data obtained for the 6MW , BBS , TUG , CGS and FGS . Further data on these clinical tests with larger sample sizes are needed to serve as a reference for patient comparisons Objective : To evaluate the feasibility and safety of a home-based exercise programme for people with Alzheimer ’s disease , and to provide preliminary evidence of programme effectiveness in improving balance and mobility and reducing falls risk . Design : A r and omized controlled trial . Setting : Community . Participants : Forty people with mild to moderate Alzheimer ’s disease ( mean age 81.9 , SD 5.72 ; 62.5 % female ) . Interventions : Participants were r and omized to a six-month home-based individually tailored balance , strengthening and walking exercise programme ( physiotherapist ) or a six-month home-based education programme ( control ) ( occupational therapist ) . Both programmes provided six home-visits and five follow-up phone calls . Main measures : Balance , mobility , falls and falls risk were measured at baseline and programme completion . Intention-to-treat analysis using a generalized linear model with group allocation as a predictor variable was performed to evaluate programme effectiveness . Feasibility and adverse events were systematic ally recorded at each contact . Results : Fifty-eight per cent of the exercise group finished the programme , completing an average of 83 % of prescribed sessions , with no adverse events reported . Functional Reach improved significantly ( P = 0.002 ) in the exercise group ( mean ( SD ) , 2.28 ( 4.36 ) ) compared to the control group ( –2.99 ( 4.87 ) ) . Significant improvement was also observed for the Falls Risk for Older People – Community score ( P = 0.008 ) and trends for improvement on several other balance , mobility , falls and falls risk measures for the exercise group compared to the control group . Conclusions : The exercise programme was feasible and safe and may help improve balance and mobility performance and reduce falls risk in people with Alzheimer ’s disease RATIONALE Dementia is a common neurodegenerative condition in older age associated with functional decline across multiple domains . This decline impacts not only on the person with dementia , but also on their informal carers and health and aged care systems . With the number of people with dementia rapidly increasing and few effective treatments , there is now a critical need for interventions to improve functional ability in those with the condition . AIMS AND OBJECTIVE This study assesses the effectiveness of a community-based home exercise programme in improving cognitive and physical function and independence in activities of daily living ( ADL ) in people with Alzheimer 's disease , the most common form of dementia . METHODS In a 4-month r and omized controlled trial , 40 community-dwelling patients diagnosed with Alzheimer 's disease and their informal carers were r and omly allocated to either the treatment ( exercise plus usual treatment ) or control ( usual treatment ) group . The exercise programme consisted of daily exercises and walking under the supervision of their carer . Patients were assessed at baseline and 4-months follow-up by a blinded assessor on primary outcome measures of cognitive and physical function and ADL using st and ardized assessment scales . RESULTS Sixteen men and 24 women diagnosed with Alzheimer 's disease participated in the study . They had a mean age of 74.1 years ( range 51 - 89 ) and a mean Mini Mental State Examination score of 22.0 ( range 10 - 28 ) , indicating mild to moderate dementia . At 4-months follow-up , patients who exercised , compared with controls , had improved cognition ( increased Mini Mental State Examination scores by 2.6 points , p < 0.001 ) , better mobility ( 2.9 seconds faster on Timed Up and Go , p = 0.004 ) and increased Instrumental Activities of Daily Living scores by 1.6 ( p = 0.007 ) . CONCLUSION This study suggests that participation in a community-based exercise programme can improve cognitive and physical function and independence in ADL in people with Alzheimer 's disease OBJECTIVE : To analyze the effects of motor intervention on the neuropsychiatric symptoms of Alzheimer 's disease and on the caregivers ' burden .  DESIGN : This is a controlled trial evaluating the effects of a motor intervention program on the neuropsychiatric symptoms . SETTING : The intervention was performed on community patients from two university centers specializing in physical exercise for the elderly . SUBJECTS : Patients with Alzheimer 's disease were divided into two groups : sixteen received the motor intervention and sixteen controls ( five controls were excluded because of clinical intercurrences ) . INTERVENTIONS : Aerobic exercises ( flexibility , strength , and agility ) and functional balance exercises were conducted over six months for 60 minutes three times per week . MAIN MEASURES : Psychopathological features of patients were evaluated with the Neuropsychiatric Inventory and Cornell Scale for Depression in Dementia . Caregivers were evaluated using the Neuropsychiatric Inventory-Distress and Burden Interview . A two-way analysis of variance ( ANOVA ) was applied to observe interactions ( pre- vs. post-intervention ; participants vs. controls ) . RESULTS : Patients from the intervention presented a significant reduction in neuropsychiatric conditions when compared to controls ( Neuropsychiatric Inventory : F∶11.12 ; p = 0.01 ; Cornell Depression scale : F∶11.97 ; p = 0.01 ) . The burden and stress of caregivers responsible for patients who participated in the intervention significantly decreased when compared to caregivers responsible for controls ( Neuropsychiatric Inventory-Distress : F : 9.37 ; p = 0.01 ; Burden Interview : F : 11.28 ; p = 0.01 ) . CONCLUSIONS : Aerobic exercise was associated with a reduction in the neuropsychiatric symptoms and contributed to attenuate the caregivers ' burden . However , the research ers were not blinded to the patient 's intervention status , which constitutes an important limitation of this study Several data suggest that physical activity and cognitive stimulation have a positive effect on the quality of life ( QoL ) of people with Alzheimer ’s disease ( AD ) , slowing the decline due to the disease . A pilot project was undertaken to assess the effect of cognitive stimulation , physical activity , and socialization on patients with AD and their informal caregiver ’s QoL and mood . Fourteen patients with AD were r and omly divided into active treatment group and control group . At the end of treatment , a significant improvement in apathy , anxiety , depression , and QoL in the active treatment group was found . Considering caregivers , those of the active treatment group exhibited a significant improvement in their mood and in their perception of patients ’ QoL. This study provides evidence that a combined approach based on cognitive stimulation , physical activity , and socialization is a feasible tool to improve mood and QoL in patients with AD and their caregivers We evaluated the efficacy of a stimulation program mainly based on recreational and occupational activities , associated with a brief cycle of support psychotherapy for patients and caregivers , in mild to moderate Alzheimer Disease ( AD ) associated or not with cerebrovascular lesions . Sixty-seven patients and 31 controls from 2 Italian towns entered the study . The control group was comprised of AD subjects who voluntarily declined to participate in the program for practical reasons . Patients were divided in groups of 4 subjects : treatment was delivered for 6 weeks . Multidimensional efficacy assessment of functional , behavioral , and neuropsychologic aspects was performed . When comparing baseline with posttraining condition , patients displayed a substantial reduction in disruptive behavior , and a tendency to a general reduction of behavioral symptoms compared with controls ( Revised Memory and Behavior Problems Checklist — RMBPC — symptoms frequency-total P=0.07 ; frequency of disruptive behavior P=0.008 ) . This reduction was mirrored by a significant reduction of caregiver reaction to behavioral disturbances ( RMBPC caregiver reaction-total P=0.035 ; reaction to disruptive behavior , P=0.011 ) . At 3 months follow-up , the reduction of caregiver reaction to behavioral symptoms results was confirmed ( RMBPC caregiver reaction-total P=0.014 , caregiver reaction to disruptive behavior P=0.028 ) . No other significant difference was detected . These results partially confirm findings of previous studies , showing that AD patients treated with similar techniques demonstrated an improvement in behavioral disturbances Objective : To determine whether an activity specific exercise program could improve ability to perform basic mobility activities in long-term care residents with Alzheimer disease ( AD ) . Design : R and omized , controlled , single-blinded clinical trial . Setting : Residents of 7 long-term care facilities . Participants : Eighty-two long-term care residents with mild to severe AD . Intervention : An activity specific exercise program was compared to a walking program and to an attention control . Measurements : Ability to perform bed mobility and transfers was assessed using the subscales of the Acute Care Index of Function ; functional mobility was measured using the 6-Minute Walk test . Results : Subjects receiving the activity specific exercise program improved in ability to perform transfers , whereas subjects in the other 2 groups declined Aerobic exercise is a promising behavioral therapy for Alzheimer ’s disease ( AD ) , yet few studies have investigated the effect of aerobic exercise on cognition in AD . The purpose of this pilot study was to examine the effect of 6-month aerobic exercise on the change in executive function , global cognition , quality of life ( QOL ) , and depression in community-dwelling older adults with mild to moderate AD . A single group , repeated measures design with outcomes measured at baseline , 3 months , and 6 months was used . Results show that there were no significant changes in any measures except for depression ( p = .026 ) . There was a trend toward improvement in executive function and QOL with moderate effect sizes ( ESs ) and a trend toward deterioration in global cognition with moderate to large ESs . R and omized controlled trials are needed to evaluate the therapeutic effect of aerobic exercise in older adults with AD OBJECTIVES To investigate the effectiveness of an exercise program in improving ability to perform activities of daily living ( ADLs ) , physical performance , and nutritional status and decreasing behavioral disturbance and depression in patients with Alzheimer 's disease ( AD ) . DESIGN R and omized , controlled trial . SETTING Five nursing 
    Output:
    
The available data indicate that physiotherapy intervention may have benefits in AD .
However , current data are not definitive ; more carefully design ed and conducted observational studies are needed to definitively establish that whether physiotherapy intervention can effectively alleviate symptoms of AD