***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 : Cognitive decline leads to disability and increased health care expenditures . Methods : Effectiveness of an intervention to stimulate multiple cognitive domains was determined using a format combining traditional and computer-based activities ( Integrated Cognitive Stimulation and Training Program ) , 45 minutes a day , 2 days a week , for 6 weeks . Nonimpaired , mildly , and moderately-impaired participants > age 65 ( n = 32 ) were r and omly allocated into a control or experimental group . Using a repeated measures design participants were tested again postintervention and at 8 weeks follow-up . Results : Statistically significant improvement on Dementia Rating Scale scores occurred for mildly and moderately impaired treatment participants ( n = 15 ) . Statistical significance was demonstrated on subscales of the WMS-III : Logical Memory I and Logical Memory II . Conclusion : Blending computer-based with traditional cognitive stimulation activities shows promise in preserving cognitive function in elders . Future studies to explore efficacy in larger , more diverse sample s are needed Background Errorless learning ( EL ) is a method for optimizing learning , which uses feed-forward instructions in order to prevent people from making mistakes during the learning process . The majority of previous studies on EL taught patients with dementia artificial tasks of little or no relevance for their daily lives . Furthermore , only a few controlled studies on EL have so far been performed and just a h and ful of studies have examined the long-term effects of EL . Tasks were not always trained in the patients ’ natural or home environment , limiting the external validity of these studies . This multicenter parallel r and omized controlled trial examines the effects of EL compared with trial and error learning ( TEL ) on the performance of activities of daily living in persons with Alzheimer ’s or mixed-type dementia living at home . Methods Patients received nine 1-hour task training sessions over eight weeks using EL or TEL . Task performance was measured using video observations at week 16 . Secondary outcome measures were task performance measured at week 26 , satisfaction with treatment , need for assistance , challenging behavior , adverse events , re source utilization and treatment costs . Results A total of 161 participants were r and omized , of whom 71 completed the EL and 74 the TEL arm at week 11 . Sixty-nine EL patients and 71 TEL patients were assessed at the 16-week follow-up ( the primary measurement endpoint ) . Intention-to-treat analysis showed a significantly improved task performance in both groups . No significant differences between the treatment groups were found for primary or secondary outcomes . Conclusions Structured relearning improved the performance of activities of daily living . Improvements were maintained for 6 months . EL had no additional effect over TEL.Trial registration German Register of Clinical Trials DRKS00003117 . Registered 31 May 2011 [ Purpose ] The purpose of this study was to investigate the effect of cognitive rehabilitation including tasks of cognitive training on performance of everyday activities in elderly people with early-stage Alzheimer ’s disease . [ Subjects and Methods ] Forty-three elderly people ( 15 men , 28 women ) with a diagnosis of Alzheimer ’s disease who had a Mini-Mental State Examination ( MMSE ) score of 18 or above were r and omly assigned to two groups : the cognitive rehabilitation group ( experimental ) and control group . This study used a r and omized controlled trial design . Cognitive rehabilitation is consisted of 8 sessions , each lasting 60 minutes ( individual 30 min , group 30 min ) . The eight weekly individual sessions of cognitive rehabilitation were performed consisting of an individualized intervention focusing on a personally meaningful goal . The eight weekly group sessions involved practicing time- and -place orientation , matching faces and names , and learning memory and sustaining attention . [ Results ] Significant improvements were observed in rating of occupation performance and satisfaction , Quality of Life in Alzheimer ’s Disease ( QOL-AD ) , and the orientation subscale of the MMSE in the experimental group , whereas participants in the control group did not show any significant difference in any tests between before and after the intervention . [ Conclusion ] Cognitive rehabilitation including tasks of cognitive training is an effective intervention for improving performance and satisfaction with respect to activities of daily living and specific cognitive functions BACKGROUND Increasing evidence demonstrates the efficacy of cognitive stimulation ( CS ) in individuals with dementia . However , conducting studies in nursing homes engenders specific challenges that have limited the data gathered on this topic so far . OBJECTIVE The aim of this r and omized controlled trial was to investigate the effects of CS on cognition , quality of life ( QoL ) , behavioral symptoms , and activities of daily life in persons with dementia living in nursing homes . We further aim ed to identify predictors of the intervention 's benefits . METHODS Seventy-one persons with mild to moderate dementia were r and omly allocated to the experimental group ( EG ; n = 36 ) that visited a CS program twice weekly for eight weeks or to the control group ( CG ; n = 35 ) that was receiving usual care . Neuropsychological tests  were conducted before and after the intervention period and at six-week follow-up . RESULTS There were no significant interaction effects Time × Group for the outcome measures . However , regression analysis revealed that a low cognitive baseline level predicted cognitive improvements . Furthermore , a low baseline level of QoL predicted a QoL benefit . For both findings , depression was a significant moderator , meaning that persons with fewer depressive symptoms had a higher probability of showing improvements . CONCLUSION This study provides data on profiles of patients who are most likely to profit from CS intervention in nursing-home setting s and demonstrates that treatment of depression is of the utmost relevance for a positive outcome of CS . Living conditions will have to be considered more thoroughly in future research The purpose of this study was to examine the beneficial effects of a new cognitive intervention program design ed for the care and prevention of dementia , namely Learning Therapy . The training program used systematized basic problems in arithmetic and Japanese language as training tasks . In study 1 , 16 individuals in the experimental group and 16 in the control group were recruited from a nursing home . In both groups , all individuals were clinical ly diagnosed with senile dementia of the Alzheimer type . In study 2 , we performed a single-blind , r and omized controlled trial in our cognitive intervention program of 124 community-dwelling seniors . In both studies , the daily training program using reading and arithmetic tasks was carried out approximately 5 days a week , for 15 to 20 minutes a day in the intervention groups . Neuropsychological measures were determined simultaneously in the groups both prior to and after six months of the intervention . The results of our investigations indicate that our cognitive intervention using reading and arithmetic problems demonstrated a transfer effect and they provide convincing evidence that cognitive training maintains and improves the cognitive functions of dementia patients and healthy seniors OBJECTIVE This study evaluates the efficacy at 12 months of a computer-based cognitive training ( CBCT ) program , adjunctive to traditional cognitive training ( TCT ) , on the basis of pen- and -paper exercises . METHODS Sixty patients with multi-domain mild cognitive impairment and mild Alzheimer 's disease who were already receiving cognitive training , recruited from a day hospital , were assigned into two groups following a simple r and omization procedure ( computerized r and om numbers ) : ( i ) a group that received CBCT during 3 months and TCT ( CBCT + TCT ) , n = 37 , and ( ii ) a group that received only TCT , n = 23 . Patients were assessed at baseline and after 3 and 12 months of treatment by a neuropsychologist blinded to group assignment , with a neuropsychological battery ( primary outcomes ) and measures of decision making , memory complaints , and emotional disturbances . RESULTS With the use of repeated- measures analyses of covariance , the CBCT + TCT group showed less anxiety symptoms ( F = 5.13 , p = 0.03 , d = 1.12 ) and less disadvantageous choices ( F = 4.70 , p = 0.04 , d = 0.89 ) in decision making than the TCT group at 12 months . No significant improvement or worsening was observed in the other measures examined . However , positive effect sizes favoring the CBCT + TCT group were observed in all variables . CONCLUSIONS The addition of a CBCT program was effective in anxiety and decision making but had no significant effects on outcomes in basic cognitive functions in patients who were already receiving cognitive training , possibly due to a ceiling effect . Future studies should compare the efficacy of CBCT with TCT in naïve patients Background Interventions that improve cognitive function in Alzheimer 's disease are urgently required . Aims To assess whether a novel cognitive training paradigm based on ‘ chunking ’ improves working memory and general cognitive function , and is associated with reorganisation of functional activity in prefrontal and parietal cortices ( trial registration : IS RCT N43007027 ) . Method Thirty patients with mild Alzheimer 's disease were r and omly allocated to receive 18 sessions of 30 min of either adaptive chunking training or an active control intervention over approximately 8 weeks . Pre- and post-intervention functional magnetic resonance imaging ( fMRI ) scans were also conducted . Results Adaptive chunking training led to significant improvements in verbal working memory and untrained clinical measures of general cognitive function . Further , fMRI revealed a bilateral reduction in task-related lateral prefrontal and parietal cortex activation in the training group compared with controls . Conclusions Chunking-based cognitive training is a simple and potentially scalable intervention to improve cognitive function in early Alzheimer 's disease We developed and evaluated the effect of Multimodal Cognitive Enhancement Therapy ( MCET ) consisting of cognitive training , cognitive stimulations , reality orientation , physical therapy , reminiscence therapy , and music therapy in combination in older people with mild cognitive impairment ( MCI ) or mild dementia . This study was a multi-center , double-blind , r and omized , placebo-controlled , two-period cross-over study ( two 8-week treatment phases separated by a 4-week wash-out period ) . Sixty-four participants with MCI or dementia whose Clinical Dementia Rating was 0.5 or 1 were r and omized to the MCET group or the mock-therapy ( placebo ) group .  Outcomes were measured at baseline , week 9 , and week 21 . Fifty-five patients completed the study .  Mini-Mental State Examination ( effect size = 0.47 , p = 0.013 ) and Alzheimer 's Disease Assessment Scale-Cognitive Subscale ( effect size = 0.35 , p = 0.045 ) scores were significantly improved in the MCET compared with mock-therapy group . Revised Memory and Behavior Problems Checklist frequency ( effect size = 0.38 , p = 0.046 ) and self-rated Quality of Life - Alzheimer 's Disease ( effect size = 0.39 , p = 0.047 ) scores were significantly improved in the MCET compared with mock-therapy . MCET improved cognition , behavior , and quality of life in people with MCI or mild dementia more effectively than conventional cognitive enhancing activities did BACKGROUND Cognitive Rehabilitation for Alzheimer 's disease ( AD ) is an integrative multimodal intervention . It aims to maintain autonomy and quality of life by enhancing the patients ' abilities to compensate for decreased cognitive functioning . OBJECTIVE We evaluated the feasibility of a group-based Cognitive Rehabilitation approach in mild AD dementia and assessed its effect on activities of daily living ( ADL ) . METHODS We included 16 patients with AD dementia in a controlled partial-r and omized design . We adapted the manual-guided Cognitive Rehabilitation program ( CORDIAL ) to a group setting . Over the course of three months , one group received the Cognitive Rehabilitation intervention ( n = 8) , while the other group received a st and ardized Cognitive Training as an active control condition ( n = 8) . ADL-competence was measured as primary outcome . The secondary outcome parameters included cognitive abilities related to daily living , functional cognitive state , and non-cognitive domains , e.g. , quality of life . For each scale , we assessed the interaction effect ' intervention by time ' , i.e. , from pre-to post-intervention . RESULTS We found no significant interaction effect of intervention by time on the primary outcome ADL-competence . The interaction effect was significant for quality of life ( Cohen 's d : -1.43 ) , showing an increase in the intervention group compared with the control group . CONCLUSIONS Our study demonstrates the feasibility of a group-based Cognitive Rehabilitation program for patients with mild AD dementia . The Cognitive Rehabilitation showed no significant effect on ADL , possibly reflecting a lack of transfer between the therapy setting and real life . However , the group setting enhanced communication skills and coping mechanisms . Effects on ADL may not have reached statistical significance due to a limited sample size . Furthermore , future studies might use an extended duration of the intervention and integrate caregivers to a greater extent to increase transfer to activities of daily living Background : Cognitive rehabilitation ( CR ) is a cognitive intervention for patients with Alzheimer ’s disease ( AD ) that aims to maintain everyday competences . The analysis of functional connectivity ( FC ) in resting-state functional MRI has been used to investigate the effects of cognitive interventions . Objectives : We evaluated the effect of CR on the default mode network FC in a group of patients with mild AD , compared to an active control group . Methods : We performed a three-month interventional study including 16 patients with a diagnosis of AD . The intervention group ( IG ) consisted of eight patients , performing twelve sessions of CR . The active control group ( CG ) performed a st and ardized cognitive training . We used a seed region placed in the posterior cingulate cortex ( PCC ) for FC analysis , comparing scans acquired before and after the intervention . Effects were thresholded at a significance of p < 0.001 ( uncorrected ) and a minimal cluster size of 50 voxels . Results : The interaction of group by time showed a higher increase 
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In relation to many other outcomes , including our second primary outcome of clinical disease severity in the medium term , the quality of evidence was very low , so we were unable to determine whether CT was associated with any meaningful gains .
The quality of evidence in relation to many other outcomes at end of treatment and in the medium term was too low for us to determine whether CT was associated with any gains , but we are moderately confident that CT did not lead to any gains in mood , behavioural and psychological symptoms , or capacity to perform activities of daily living .
AUTHORS ' CONCLUSIONS Relative to a control intervention , but not to a variety of alternative treatments , CT is probably associated with small to moderate positive effects on global cognition and verbal semantic fluency at end of treatment , and these benefits appear to be maintained in the medium term .