***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: High blood pressure increases the risks of stroke , dementia , and neurocognitive dysfunction . Although aerobic exercise and dietary modifications have been shown to reduce blood pressure , no r and omized trials have examined the effects of aerobic exercise combined with dietary modification on neurocognitive functioning in individuals with high blood pressure ( ie , prehypertension and stage 1 hypertension ) . As part of a larger investigation , 124 participants with elevated blood pressure ( systolic blood pressure 130 to 159 mm Hg or diastolic blood pressure 85 to 99 mm Hg ) who were sedentary and overweight or obese ( body mass index : 25 to 40 kg/m2 ) were r and omized to the Dietary Approaches to Stop Hypertension ( DASH ) diet alone , DASH combined with a behavioral weight management program including exercise and caloric restriction , or a usual diet control group . Participants completed a battery of neurocognitive tests of executive function-memory-learning and psychomotor speed at baseline and again after the 4-month intervention . Participants on the DASH diet combined with a behavioral weight management program exhibited greater improvements in executive function-memory-learning ( Cohen 's D=0.562 ; P=0.008 ) and psychomotor speed ( Cohen 's D=0.480 ; P=0.023 ) , and DASH diet alone participants exhibited better psychomotor speed ( Cohen 's D=0.440 ; P=0.036 ) compared with the usual diet control . Neurocognitive improvements appeared to be mediated by increased aerobic fitness and weight loss . Also , participants with greater intima-medial thickness and higher systolic blood pressure showed greater improvements in executive function-memory-learning in the group on the DASH diet combined with a behavioral weight management program . In conclusion , combining aerobic exercise with the DASH diet and caloric restriction improves neurocognitive function among sedentary and overweight/obese individuals with prehypertension and hypertension AIM To assess whether an intensive multifactorial treatment can reduce cognitive decrements and cognitive decline in screen-detected type 2 diabetes . METHODS The multinational ADDITION- study , a cluster-r and omized parallel group trial in patients with screen-detected type 2 diabetes , compared the effectiveness of intensive multifactorial treatment ( IT ; lifestyle advice and strict regulation of metabolic parameters ) with routine care ( RC ) on cardiovascular outcome . In The Netherl and s r and omization was stratified according to practice organization . Allocation was concealed from patients . The present study assessed the effect of IT on cognition through two  neuropsychological assessment s ( NPA ) on two occasions . The assessment s took place three and six years after the start of the intervention . Non-diabetic controls served as reference group . The first NPA was performed in 183 patients ( IT : 97 ; RC : 86 ) and 69 controls . The second NPA was performed in 135 patients ( IT : 71 ; RC : 64 ) and 55 controls . Primary outcome was a composite score , including the domains memory , information-processing speed and attention and executive function . Comparisons between the treatment groups were performed with multi-level analyses . RESULTS The first NPA showed no differences between the treatment groups ( mean difference composite z-score : 0.00 ; 95%-CI -0.16 to 0.16 ; IT vs RC ) . Over the next three years cognitive decline in the diabetic groups was within the range of the reference group and did not differ between the treatment arms ( difference decline between diabetic groups -0.12 ; -0.24 to 0.01 ; IT vs RC ) . CONCLUSIONS Six years of IT in screen-detected type 2 diabetes had no benefit on cognitive functioning over RC Background Numerous studies have investigated the role of the monounsaturated fatty acid and other dietary factors in the prevention of cognitive decline but the short-term effect of a low dose of extravirgin olive oil on cognitive performances in the elderly have not still been investigated . Our aim was to investigate whether the replacement of all vegetable oils with a lower amount of extravirgin olive oil , in the contest of a Mediterranean Diet , would improve cognitive performances , among elderly Italian individuals . Methods 180 elderly individuals were r and omly assigned to these treatment groups for 1 year : ( 1 ) MedDiet plus extravirgin OO , 20–30 g/day ; ( 2 ) control MedDiet . The cognitive sub-test of ADAScale was used to detect cognitive decline progression over 12 months . Results ADAS-cog score variation after 1 year , adjusted for food groups which were different between groups , was − 1.6 ± 0.4 and − 3.0 ± 0.4 in the MedDiet and MedDiet plus extravirgin OO groups , respectively ( p = 0.024 ) . Extravirgin OO intake was 30 g ± 12 and 26 g ± 6 in the MedDiet and MedDiet plus extravirgin OO groups , respectively ( p = 0.044 ) . Conclusions We demonstrated the higher short-term improvement of cognitive functions scores in individuals of the MedDiet plus low dose of extravirgin olive oil rather than MedDiet alone . Extravirgin olive oil is the best quality oil and may have a neuroprotective effect 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 OBJECTIVE To assess the long-term effects of dietary interventions on glycemic control , need for diabetes medications , and remission of type 2 diabetes . RESEARCH DESIGN AND METHODS Originally , in a two-arm trial design , overweight , middle-aged men and women with newly diagnosed type 2 diabetes were r and omized to a low-carbohydrate Mediterranean diet ( LCMD ; n = 108 ) or a low-fat diet ( n = 107 ) . After 4 years , participants who were still free of diabetes medications were further followed up until the primary end point ( need of a diabetic drug ) ; remission of diabetes ( partial or complete ) and changes in weight , glycemic control , and cardiovascular risk factors were also evaluated . RESULTS The primary end point was reached in all participants after a total follow-up of 6.1 years in the low-fat group and 8.1 years in the LCMD group ; median survival time was 2.8 years ( 95 % CI 2.4–3.2 ) and 4.8 years ( 4.3–5.2 ) , respectively . The unadjusted hazard ratio for the overall follow-up was 0.68 ( 0.50–0.89 ; P < 0.001 ) . LCMD participants were more likely to experience any remission ( partial or complete ) , with a prevalence of 14.7 % ( 13.0–16.5 % ) during the first year and 5.0 % ( 4.4–5.6 % ) during year 6 compared with 4.1 % ( 3.1–5.0 % ) at year 1 and 0 % at year 6 in the low-fat diet group . CONCLUSIONS In patients with newly diagnosed type 2 diabetes , an LCMD result ed in a greater reduction of HbA1c levels , higher rate of diabetes remission , and delayed need for diabetes medication compared with a low-fat diet Flaws in the design , conduct , analysis , and reporting of r and omised trials can cause the effect of an intervention to be underestimated or overestimated . The Cochrane Collaboration ’s tool for assessing risk of bias aims to make the process clearer and more BACKGROUND Modifiable vascular and lifestyle-related risk factors have been associated with dementia risk in observational studies . In the Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability ( FINGER ) , a proof-of-concept r and omised controlled trial , we aim ed to assess a multidomain approach to prevent cognitive decline in at-risk elderly people from the general population . METHODS In a double-blind r and omised controlled trial we enrolled individuals aged 60 - 77 years recruited from previous national surveys . Inclusion criteria were CAIDE ( Cardiovascular Risk Factors , Aging and Dementia ) Dementia Risk Score of at least 6 points and cognition at mean level or slightly lower than expected for age . We r and omly assigned participants in a 1:1 ratio to a 2 year multidomain intervention ( diet , exercise , cognitive training , vascular risk monitoring ) , or a control group ( general health advice ) . Computer-generated allocation was done in blocks of four ( two individuals r and omly allocated to each group ) at each site . Group allocation was not actively disclosed to participants and outcome assessors were masked to group allocation . The primary outcome was change in cognition as measured through comprehensive neuropsychological test battery ( NTB ) Z score . Analysis was by modified intention to treat ( all participants with at least one post-baseline observation ) . This trial is registered at Clinical Trials.gov , number NCT01041989 . FINDINGS Between Sept 7 , 2009 , and Nov 24 , 2011 , we screened 2654 individuals and r and omly assigned 1260 to the intervention group ( n=631 ) or control group ( n=629 ) . 591 ( 94 % ) participants in the intervention group and 599 ( 95 % ) in the control group had at least one post-baseline assessment and were included in the modified intention-to-treat analysis . Estimated mean change in NTB total Z score at 2 years was 0·20 ( SE 0·02 , SD 0·51 ) in the intervention group and 0·16 ( 0·01 , 0·51 ) in the control group . Between-group difference in the change of NTB total score per year was 0·022 ( 95 % CI 0·002 - 0·042 , p=0·030 ) .  
    Output:
    
Current evidence is limited but indicates that diverse interventions improve nonmemory cognitive functions during normal cognitive aging .