***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: The purpose of this study was to evaluate the effect of structured group reminiscence therapy on behavior competence and physical functioning and to compare effectiveness of the intervention by stage of dementia in Taiwanese elders residing in institutional setting s. A longitudinal experimental design was used . Seventy-seven Taiwanese elderly participants completed the study ; 38 in the intervention group and 39 in the control group . Participants in the intervention group received one reminiscence therapy session weekly for 8 weeks ; those in the control group received regular nursing care .  Barthel 's index ( BI ) and the Clifton Assessment Procedures for the Elderly Behavior Rating Scale ( CAPE-BRS ) were administered pre- and post-intervention . Findings indicated that no significant differences between the intervention and control groups on overall behavioral competence ( p=0.12 ) or physical functioning ( p=0.44 ) . However , slight overall improvement was identified , statistically significant for the social disturbance subscale of the CAPE-BRS was found ( p=0.011 ) . There were no significant changes in overall behavior competence ( p=0.11 ) or physical functioning ( p=0.30 ) by stage of dementia ( mild vs. moderate ) in the intervention group , counter to the hypothesis . Although our results did not demonstrate a significant effect of structured group reminiscence therapy on overall behavior competency or on physical functioning in elders with dementia , we identified issues related to future implementation of this intervention , such as study power , chosen outcome measures , intervention dose , timing of outcome measures , or cultural applicability issues Background Currently available pharmacological and non-pharmacological treatments have shown only modest effects in slowing the progression of dementia . Our objective was to assess the impact of a long-term non-pharmacological group intervention on cognitive function in dementia patients and on their ability to carry out activities of daily living compared to a control group receiving the usual care . Methods A r and omized , controlled , single-blind longitudinal trial was conducted with 98 patients ( follow-up : n = 61 ) with primary degenerative dementia in five nursing homes in Bavaria , Germany . The highly st and ardized intervention consisted of motor stimulation , practice in activities of daily living , and cognitive stimulation ( acronym MAKS ) . It was conducted in groups of ten patients led by two therapists for 2 hours , 6 days a week for 12 months . Control patients received treatment as usual .  Cognitive function was assessed using the cognitive subscale of the Alzheimer 's Disease Assessment Scale ( ADAS-Cog ) , and the ability to carry out activities of daily living using the Erlangen Test of Activities of Daily Living ( E-ADL test ) at baseline and after 12 months . Results Of the 553 individuals screened , 119 ( 21.5 % ) were eligible and 98 ( 17.7 % ) were ultimately included in the study . At 12 months , the results of the per protocol analysis ( n = 61 ) showed that cognitive function and the ability to carry out activities of daily living had remained stable in the intervention group but had decreased in the control patients ( ADAS-Cog : adjusted mean difference : -7.7 , 95 % CI -14.0 to -1.4 , P = 0.018 , Cohen 's d = 0.45 ; E-ADL test : adjusted mean difference : 3.6 , 95 % CI 0.7 to 6.4 , P = 0.015 , Cohen 's d = 0.50 ) . The effect sizes for the intervention were greater in the subgroup of patients ( n = 50 ) with mild to moderate disease ( ADAS-Cog : Cohen 's d = 0.67 ; E-ADL test : Cohen 's d = 0.69 ) . Conclusions A highly st and ardized , non-pharmacological , multicomponent group intervention conducted in a nursing-home setting was able to postpone a decline in cognitive function in dementia patients and in their ability to carry out activities of daily living for at least 12 months . Trial Registration http://www.is rct n.com Identifier : IS RCT 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 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 OBJECTIVES To evaluate whether age , sex , depression , dementia disorder , nutritional status , or level of functional balance capacity influences the effect of a high-intensity functional weight-bearing exercise program on functional balance . DESIGN Preplanned subgroup analyses of a r and omized controlled trial . SETTING Nine residential care facilities . PARTICIPANTS One hundred ninety-one people aged 65 to 100 dependent in activities of daily living and with Mini-Mental State Examination scores of 10 or greater . INTERVENTION A high-intensity functional weight-bearing exercise program or a control activity , each comprising 29 sessions over 3 months . MEASUREMENTS Functional balance capacity was assessed blindly using the Berg Balance Scale ( BBS ) at baseline , 3 months , and 6 months . The BBS consists of 14 tasks , common in everyday life , such as st and ing up from sitting and , while st and ing , reaching forward or turning 360 ° . Interactions between allocation to activity group and each subgroup were evaluated according to the intention-to-treat principle . RESULTS The subgroup analyses revealed no statistically significant interaction for age , sex , depression , dementia disorder , nutritional status , or level of functional balance capacity at 3 ( P=.65 , .65 , .51 , .78 , .09 , .67 , respectively ) or 6 ( P=.69 , .62 , .20 , .94 , .48 , .85 , respectively ) months . In addition , at 3 and 6 months there was no significant interaction for cognitive level ( P=.28 , .47 , respectively ) or number of depressive symptoms ( P=.85 , .49 , respectively ) . CONCLUSION Older age , female sex , depression , mild to moderate dementia syndrome , malnutrition , and severe physical impairment do not seem to have a negative effect on functional balance from a high-intensity functional weight-bearing exercise program . Consequently , people with these characteristics in residential care facilities should not be excluded from offers of rehabilitation including high-intensity exercises 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 This study evaluated the efficacy of two different group procedures of non-pharmacological treatment in mild-to-moderate Alzheimer 's disease ( AD ) . Thirty-two patients entered the study and were divided in groups of four subjects . We compared recreational activities ( ‘ global ’ stimulation ) with a combination of procedural memory training on activities of daily living and neuropsychological rehabilitation of ‘ residual ’ functions ( ‘ cognitive-specific ’ ) .  All patients and caregivers were ensured psychological support . Both group treatments were delivered for six weeks . Multidimensional efficacy assessment of functional , behavioural and neuropsychological aspects was performed . Patients receiving ‘ global ’ stimulation showed a substantial reduction in behavioural disturbances ( Neuropsychiatric Inventory [ NPI ] : frequency p = 0.034 ; severity p = 0.012 ) ; Revised Memory Behaviour Problems Checklist ( frequency p = 0.008 ; reaction p = 0.027 ) , and better performance in the Functional Living Skills Assessment ( FLSA ) , a st and ardized direct measure of performance in everyday life ( p = 0.021 ) and Verbal Fluency for Letters ( p = 0.000 ) . Patients receiving ‘ cognitive-specific ’ treatment improved only on the scale evaluating functional competence in daily living ( Nurses ’ Observation Scale for Geriatric Patients [ NOSGER ] p = 0.018 ) . At follow-up ( six months later ) , compared with baseline , patients following the ‘ global ’ stimulation treatment showed an improvement at caregiver distress on NPI ( p = 0.04 ) . No other significant difference was detected . Our results support the contention that a ‘ global ’ treatment can lead to a significant improvement in AD patients , both for behavioural and functional aspects . The ‘ cognitive-specific ’ treatment we used in this research did not show better efficacy Background Improving the situation in older adults with cognitive decline and evidence of cognitive rehabilitation is considered crucial in long-term care of the elderly . The objective of this study was to implement a computerized errorless learning-based memory training program ( CELP ) for persons with early Alzheimer ’s disease , and to compare the training outcomes of a CELP group with those of a therapist-led errorless learning program ( TELP ) group and a waiting-list control group . Methods A r and omized controlled trial with a single-blind research design was used in the study . Chinese patients with early Alzheimer ’s disease screened by the Clinical Dementia Rating ( score of 1 ) were recruited . The subjects were r and omly assigned to CELP ( n = 6 ) , TELP ( n = 6 ) , and waiting-list control ( n = 7 ) groups . Evaluation of subjects before and after testing , and at three-month follow-up was achieved using primary outcomes on the Chinese Mini-Mental State Examination , Chinese Dementia Rating Scale , Hong Kong List Learning Test , and the Brief Assessment of Prospect i ve Memory-Short Form . Secondary outcomes were the Modified Barthel Index , Hong Kong Lawton Instrumental Activities of Daily Living Scale , and Geriatric Depression Scale-Short Form . The data were analyzed using Friedman ’s test for time effect and the Kruskal-Wallis test for treatment effect . Results Positive treatment effects on cognition were found in two errorless learning-based memory groups ( ie , computer-assisted and therapist-led ) . Remarkable changes were shown in cognitive function for subjects receiving CELP and emotional/daily functions in those receiving TELP . Conclusion Positive changes in the cognitive function of Chinese patients with early Alzheimer ’s disease were initially found after errorless training through CELP . Further enhancement 
    Output:
    
Strong evidence supports the benefits of occupation-based interventions , physical exercise , and  error-reduction learning .
Occupational therapy practitioners should integrate daily occupations , physical exercise , and error-reduction techniques into the daily routine of adults with AD to enhance occupational performance and delay functional decline .