***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 Diabetes mellitus is associated with cognitive dysfunction , but it is not clear whether the disorder increases the risk of conversion from mild cognitive impairment to dementia . AIMS To determine the association between diabetes mellitus and dementia conversion in people with mild cognitive impairment ( Peterson 's criteria ) in a prospect i ve community-based study . METHOD People over 65 years old were approached through primary care practice s in south London , UK , and those with mild cognitive impairment ( n = 103 ) were followed up for 4 years . Presence of diabetes was established from self-report and information from general practitioners . RESULTS Nineteen participants  progressed to dementia , with the predominant diagnosis being probable or possible Alzheimer 's disease ( in 84 % ) . Only diabetes mellitus was associated with progression to dementia ( hazard ratio 2.9 , 95 % CI 1.1 - 7.3 ) after adjustment for sociodemographic factors , APOE4 , premorbid IQ and other health conditions . CONCLUSIONS Diabetes mellitus increases not only the risks of dementia and mild cognitive impairment but also the risk of progression from such impairment to dementia OBJECTIVE The effect of diabetes on  mild cognitive impairment ( MCI ) and its conversion to dementia remains controversial . We sought to examine whether diabetes and pre-diabetes are associated with MCI and accelerate the progression from MCI to dementia . RESEARCH DESIGN AND METHODS In the Kungsholmen Project , 963 cognitively intact participants and 302 subjects with MCI ( 120 with amnestic MCI [ aMCI ] and 182 with other cognitive impairment no dementia [ oCIND ] ) age ≥75 years were identified at baseline . The two cohorts were followed for 9 years to detect the incident MCI and dementia following international criteria . Diabetes was ascertained based on a medical examination , hypoglycemic medication use , and r and om blood glucose level ≥11.0 mmol/l . Pre-diabetes was defined as r and om blood glucose level of 7.8–11.0 mmol/l in diabetes-free participants . Data were analyzed using st and ard and time-dependent Cox proportional-hazards models . RESULTS During the follow-up period , in the cognitively intact cohort , 182 people developed MCI ( 42 aMCI and 140 oCIND ) , and 212 developed dementia . In the MCI cohort , 155 subjects progressed to dementia , the multi-adjusted hazard ratio ( 95 % CI ) of dementia was 2.87 ( 1.30–6.34 ) for diabetes , and 4.96 ( 2.27–10.84 ) for pre-diabetes . In a Kaplan-Meier survival analysis , diabetes and pre-diabetes accelerated the progression from MCI to dementia by 3.18 years . Diabetes and pre-diabetes were neither cross-sectionally nor longitudinally associated with  MCI . CONCLUSIONS Diabetes and pre-diabetes substantially accelerate the progression from MCI to dementia , and anticipate dementia occurrence by more than 3 years in people with MCI . The association of diabetes with the development of MCI is less evident in old people BACKGROUND People with intellectual disabilities ( ID ) are rarely asked about their experiences as users of psychological services and little is known about the views of clients with ID who have undergone cognitive behavioural therapy ( CBT ) .  This study aim ed to gather the views of adults with ID who had recently taken part in a cluster r and omised control trial ( RCT ) of a staff-delivered manualised CBT anger management group intervention .  METHOD A qualitative method , Interpretative Phenomenological Analysis ( IPA ) , was employed and eleven participants were interviewed . The interviews took place after the intervention , within two weeks of the end of the group , to gain an underst and ing of service users ' experiences of participating in a CBT group . RESULTS IPA of the interview transcripts indicated that the intervention was experienced as effective and enjoyable and a number of themes were identified including : ' the importance of relationships ' , ' a new me ' , ' new and improved relationships ' , ' presenting myself in a positive light ' and ' what the group did n't change ' . CONCLUSIONS The results will be discussed in the context of applying group CBT for adults with ID and implication s for service development Objective To estimate the percentage reduction in incidence of dementia that would be obtained if specific risk factors were eliminated . Design Prospect i ve seven year cohort study . Setting General population , Montpellier , France . Participants 1433 people aged over 65 with a mean baseline age of 72.5 ( SD 5.1 ) years . Main outcome measures Diagnosis of mild cognitive impairment or dementia established by a st and ardised neurological examination . Results Cox models were constructed to derive hazard ratios and determine confounding and interaction effects for potentially modifiable risk factors for dementia . Mean percentage population attributable fractions were calculated with 95 % confidence intervals derived from bootstrapping for seven year incidence of mild cognitive impairment or dementia . The final model retained crystallised intelligence ( population attributable fraction 18.11 % , 95 % confidence interval 10.91 % to 25.42 % ) , depression ( 10.31 % , 3.66 % to 17.17 % ) , fruit and vegetable consumption ( 6.46 % , 0.15 % to 13.06 % ) , diabetes ( 4.88 % , 1.87 % to 7.98 % ) , and apolipoprotein E ε4 allele ( 7.11 % , 2.44 % to 11.98 % ) . Conclusions Increasing crystallised intelligence and fruit and vegetable consumption and eliminating depression and diabetes are likely to have the biggest impact on reducing the incidence of dementia , outweighing even the effect of removing the principal known genetic risk factor . Although causal relations can not be concluded with certainty , the study suggests priorities that may inform public health programmes OBJECTIVES To examine the incidence of dementia in subjects with mild cognitive impairment ( MCI ) in the Cardiovascular Health Study Cognition Study . DESIGN Prospect i ve epidemiological study . SETTING The Cardiovascular Health Study Cognition Study of Pittsburgh , Pa , was conducted from 2002 through 2003 to determine the incidence of dementia in participants classified as having MCI in 1998 and 1999 . Subjects There were 136 subjects with MCI . Mild cognitive impairment was subclassified as MCI amnestic type and MCI multiple cognitive deficits type ( MCI-MCDT ) ; subjects with MCI-MCDT were also grouped based on the presence of a memory impairment . Subjects with MCI were classified as possible when there were comorbidities that could explain the subjects ' cognitive deficits and as probable when there were none . Main Outcome Measure Dementia . RESULTS The incidence of all dementias in the subjects with MCI was 147 per 1000 person-years ( mean follow-up overall , 4.3 years ) . Of the 136 subjects with MCI , 69 ( 51 % ) in 1998 through 1999 progressed to dementia ( 57 [ 83 % ] to Alzheimer disease [ AD ] ) , but 25 ( 18 % ) returned to normal . Of the 10 subjects with probable MCI amnestic type , 7 ( 70 % ) progressed to dementia ( all of them to AD ) and none returned to normal , whereas 7 ( 41 % ) of the 17 subjects with possible MCI amnestic type became demented ( 6 [ 86 % ] to AD ) and 3 ( 18 % ) returned to normal . Of the 40 subjects with probable MCI-MCDT , 21 ( 52 % ) progressed to dementia ( 17 [ 81 % ] to AD ) and 2 ( 5 % ) returned to normal . Of the 69 subjects with possible MCI-MCDT , 34 ( 49 % ) progressed to dementia ( 28 [ 82 % ] to AD ) and 20 ( 29 % ) returned to normal . Among the subjects with probable MCI-MCDT , 15 ( 54 % ) of 28 with and 6 ( 50 % ) of 12 without memory deficits progressed to dementia . CONCLUSIONS Subjects with MCI are at high risk for dementia . The probable MCI diagnosis identified individuals in the earliest stages of dementia , usually AD , whereas the possible MCI diagnosis identified a more heterogeneous group . However , this latter group had only a slightly lower rate of conversion to dementia than the group with probable MCI , suggesting that even with comorbid conditions , there is a high likelihood of the presence of a progressive dementing disorder Objective : To examine risk factors for  mild cognitive impairment ( MCI ) and progression to dementia in a prospect i ve community-based study of subjects aged 65 years and over . Methods : 6892 participants who were over 65 and without dementia were recruited from a population -based cohort in three French cities . Cognitive performance , clinical diagnosis of dementia , and clinical and environmental risk factors were evaluated at baseline and 2-year and 4-year follow-ups . Results : 42 % of the population were classified as having MCI at baseline . After adjustment for confounding with logistic regression models , men and women classified as having MCI were more likely to have depressive symptomatology and to be taking anticholinergic drugs .  Men were also more likely to have a higher body mass index , diabetes and stroke , whereas women were more likely to have poor subjective health , to be disabled , to be socially isolated , and to suffer from insomnia . The principal adjusted risk factors for men for progression from MCI to dementia in descending order were ApoE4 allele ( OR = 3.2 , 95 % CI 1.7 to 5.7 ) , stroke ( OR = 2.8 , 95 % CI 1.2 to 6.9 ) , low level of education ( OR = 2.3 , 95 % CI 1.3 to 4.1 ) , loss of Instrumental Activities of Daily Living ( IADL ) ( OR = 2.2 , 95 % CI 1.1 to 4.5 ) and age ( OR = 1.2 , 95 % CI 1.1 to 1.2 ) . In women , progression is best predicted by IADL loss ( OR = 3.5 , 95 % CI 2.1 to 5.9 ) , ApoE4 allele ( OR = 2.3 , 95 % CI 1.4 to 4.0 ) , low level of education ( OR = 2.2 , 95 % CI 1.3 to 3.6 ) , sub clinical depression ( OR = 2.0 , 95 % CI 1.1 to 3.6 ) , use of anticholinergic drugs ( OR = 1.8 , 95 % CI 1.0 to 3.0 ) and age ( OR = 1.1 , 95 % CI 1.1 to 1.2 ) . Conclusions : Men and women have different risk profiles for both MCI and progression to dementia . Intervention programmes should focus principally on risk of stroke in men and depressive symptomatology and use of anticholinergic medication in women Objective : Growing evidence suggests that vascular risk factors ( VRF ) contribute to cognitive decline . The aim of this study was to investigate the impact of VRF on the conversion from mild cognitive impairment ( MCI ) to Alzheimer disease ( AD ) dementia . Methods : A total of 837 subjects with MCI were enrolled at baseline and followed up annually for 5 years . The incidence of AD dementia was investigated . A mixed r and om effects regression model was used to analyze the association between VRF and the progression of MCI assessed with Mini-Mental State Examination and instrumental Activities of Daily Living . Cox proportional hazard models were used to identify the association between VRF and dementia conversion , and to examine whether treatment of VRF can prevent dementia conversion . Results : At the end of the follow-up , 298 subjects converted to AD dementia , while 352 remained MCI . Subjects with VRF had a faster progression in cognition and function relative to subjects without . VRF including hypertension , diabetes , cerebrovascular diseases , and hypercholesterolemia increased the risk of dementia conversion . Those subjects with MCI in whom all VRF were treated had a lower risk of dementia than those who had some VRF treated . Treatment of individual VRF including hypertension , diabetes , and hypercholesterolemia was associated with the reduced risk of AD conversion . Conclusion : VRF increased the risk of incident AD dementia . Treatment of VRF was associated with a reduced risk of incident AD dementia . Although our findings are observational , they suggest active intervention for VRF might reduce progression in MCI to AD dementia OBJECTIVE The authors conducted a prospect i ve cohort study to estimate the risk of incident mild cognitive impairment in cognitively normal elderly ( aged ≥70 years ) individuals with or without neuropsychiatric symptoms at baseline . The research was conducted in the setting of the population -based Mayo Clinic Study of Aging . METHOD A classification of normal cognitive aging , mild cognitive impairment , and dementia was adjudicated by an expert consensus panel based on published criteria . 
    Output:
    
Diabetes was also associated with increased risk of conversion from any-type or nonamnestic MCI to all-cause dementia .
Metabolic syndrome and prediabetes predicted all-cause dementia in people with amnestic and any-type MCI , respectively .
Mediterranean diet decreased the risk of conversion to Alzheimer 's dementia .
The presence of neuropsychiatric symptoms or lower serum folate levels predicted conversion from any-type MCI to all-cause dementia , but less formal education did not .
Depressive symptoms predicted conversion from any-type MCI to all-cause dementia in epidemiological but not clinical studies .
Diabetes increased the risk of conversion to dementia .
Other prognostic factors that are potentially manageable are prediabetes and the metabolic syndrome , neuropsychiatric symptoms , and low dietary folate .
Dietary interventions and interventions to reduce neuropsychiatric symptoms , including depression , that increase risk of conversion to dementia may decrease new incidence of dementia