***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 Declines in cognitive functioning are a normal part of aging that can affect daily functioning and quality of life . This study will examine the impact of an exercise training program , and a combined exercise and cognitive training program , on the cognitive and physical functioning of older adults . Methods / Design Fit Bodies , Fine Minds is a r and omized , controlled trial . Community-dwelling adults , aged between 65 and 75 years , are r and omly allocated to one of three groups for 16 weeks . The exercise-only group do three 60-minute exercise sessions per week . The exercise and cognitive training group do two 60-minute exercise sessions and one 60-minute cognitive training session per week . A no-training control group is contacted every 4 weeks . Measures of cognitive functioning , physical fitness and psychological well-being are taken at baseline ( 0 weeks ) , post-test ( 16 weeks ) and 6-month follop ( 40 weeks ) . Qualitative responses to the program are taken at post-test . Discussion With an increasingly aged population , interventions to improve the functioning and quality of life of older adults are particularly important . Exercise training , either alone or in combination with cognitive training , may be an effective means of optimizing cognitive functioning in older adults . This study will add to the growing evidence base on the effectiveness of these interventions .Trial Registration Australian Clinical Trials Register : Physical exercise has been shown to increase brain volume and improve cognition in r and omized trials of non-demented elderly . Although greater social engagement was found to reduce dementia risk in observational studies , r and omized trials of social interventions have not been reported . A representative sample of 120 elderly from Shanghai , China was r and omized to four groups ( Tai Chi , Walking , Social Interaction , No Intervention ) for 40 weeks . Two MRIs were obtained , one before the intervention period , the other after . A neuropsychological battery was administered at baseline , 20 weeks , and 40 weeks . Comparison of changes in brain volumes in intervention groups with the No Intervention group were assessed by t-tests . Time-intervention group interactions for neuropsychological measures were evaluated with repeated- measures mixed models . Compared to the No Intervention group , significant increases in brain volume were seen in the Tai Chi and Social Intervention groups ( p < 0.05 ) . Improvements also were observed in several neuropsychological measures in the Tai Chi group , including the Mattis Dementia Rating Scale score ( p = 0.004 ) , the Trailmaking Test A ( p = 0.002 ) and B ( p = 0.0002 ) , the Auditory Verbal Learning Test ( p = 0.009 ) , and verbal fluency for animals ( p = 0.01 ) . The Social Interaction group showed improvement on some , but fewer neuropsychological indices . No differences were observed between the Walking and No Intervention groups . The findings differ from previous clinical trials in showing increases in brain volume and improvements in cognition with a largely non-aerobic exercise ( Tai Chi ) . In addition , intellectual stimulation through social interaction was associated with increases in brain volume as well as with some cognitive improvements CONTEXT Many observational studies have shown that physical activity reduces the risk of cognitive decline ; however , evidence from r and omized trials is lacking . OBJECTIVE To determine whether physical activity reduces the rate of cognitive decline among older adults at risk . DESIGN AND SETTING R and omized controlled trial of a 24-week physical activity intervention conducted between 2004 and 2007 in metropolitan Perth , Western Australia . Assessors of cognitive function were blinded to group membership . PARTICIPANTS We recruited volunteers who reported memory problems but did not meet criteria for dementia . Three hundred eleven individuals aged 50 years or older were screened for eligibility , 89 were not eligible , and 52 refused to participate . A total of 170 participants were r and omized and 138 participants completed the 18-month assessment . INTERVENTION Participants were r and omly allocated to an education and usual care group or to a 24-week home-based program of physical activity . MAIN OUTCOME MEASURE Change in Alzheimer Disease Assessment Scale-Cognitive Subscale ( ADAS-Cog ) scores ( possible range , 0 - 70 ) over 18 months . RESULTS In an intent-to-treat analysis , participants in the intervention group improved 0.26 points ( 95 % confidence interval , -0.89 to 0.54 ) and those in the usual care group deteriorated 1.04 points ( 95 % confidence interval , 0.32 to 1.82 ) on the ADAS-Cog at the end of the intervention . The absolute difference of the outcome measure between the intervention and control groups was -1.3 points ( 95 % confidence interval,-2.38 to -0.22 ) at the end of the intervention . At 18 months , participants in the intervention group improved 0.73 points ( 95 % confidence interval , -1.27 to 0.03 ) on the ADAS-Cog , and those in the usual care group improved 0.04 points ( 95 % confidence interval , -0.46 to 0.88 ) . Word list delayed recall and Clinical Dementia Rating sum of boxes improved modestly as well , whereas word list total immediate recall , digit symbol coding , verbal fluency , Beck depression score , and Medical Outcomes 36-Item Short-Form physical and mental component summaries did not change significantly . CONCLUSIONS In this study of adults with subjective memory impairment , a 6-month program of physical activity provided a modest improvement in cognition over an 18-month follow-up period . TRIAL REGISTRATION anzctr.org.au Identifier : ACTRN12605000136606 We examined the hypothesis that the short , intensive exercise-induced increase in circulating neutrophil counts is affected by the interaction between the endocrine and immune systems . Twelve male winter-sports athletes underwent a maximal exercise test on a treadmill . Blood sample s were collected before , immediately after ( Post ) , and 1 h ( Post 1 h ) and 2 h ( Post 2 h ) after the exercise . The neutrophil counts increased significantly at Post 1 h ( P < 0.05 ) and remained significantly high even at Post 2 h ( P < 0.05 ) , showing a leftward shift . Plasma granulocyte colony-stimulating factor ( G-CSF ) increased at Post ( P < 0.05 ) , and interleukin-6 ( IL-6 ) increased at Post 1 h ( P < 0.05 ) . Plasma G-CSF at Post significantly correlated with the numbers of both neutrophils and stab cells at Post 1 h ( P < 0.05 ) . Plasma IL-6 at Post 1 h levels also correlated significantly with the number of neutrophils at Post 2 h ( P < 0.05 ) . The increase in the levels of plasma G-CSF and IL-6 after intensive exercise may play a role in the mobilization of neutrophils into the circulatory system BACKGROUND Participation in leisure activities has been associated with a lower risk of dementia .  It is unclear whether increased participation in leisure activities lowers the risk of dementia or participation in leisure activities declines during the pre clinical phase of dementia . METHODS We examined the relation between leisure activities and the risk of dementia in a prospect i ve cohort of 469 subjects older than 75 years of age who resided in the community and did not have dementia at base line . We examined the frequency of participation in leisure activities at enrollment and derived  cognitive-activity and physical-activity scales in which the units of measure were activity-days per week . Cox proportional-hazards analysis was used to evaluate the risk of dementia according to the base-line level of participation in leisure activities , with adjustment for age , sex , educational level , presence or absence of chronic medical illnesses , and base-line cognitive status . RESULTS Over a median follow-up period of 5.1 years ,  dementia  developed in 124 subjects ( Alzheimer 's disease in 61 subjects , vascular dementia in 30 , mixed dementia in 25 , and other types of dementia in 8) . Among leisure activities , reading , playing board games , playing musical instruments , and dancing were associated with a reduced risk of dementia . A one-point increment in the cognitive-activity score was significantly associated with a reduced risk of dementia ( hazard ratio , 0.93 [ 95 percent confidence interval , 0.90 to 0.97 ] ) , but a one-point increment in the physical-activity score was not ( hazard ratio , 1.00 ) . The association with the cognitive-activity score persisted after the exclusion of the subjects with possible pre clinical dementia at base line . Results were similar for Alzheimer 's disease and vascular dementia . In linear mixed models , increased participation in cognitive activities at base line was associated with reduced rates of decline in memory . CONCLUSIONS Participation in leisure activities is associated with a reduced risk of dementia , even after adjustment for base-line cognitive status and after the exclusion of subjects with possible pre clinical dementia . Controlled trials are needed to assess the protective effect of cognitive leisure activities on the risk of dementia OBJECTIVES To primarily ascertain the effect of the Otago Exercise Program ( OEP ) on physiological falls risk , functional mobility , and executive functioning after 6 months in older adults with a recent history of falls and to ascertain the effect of the OEP on falls during a 1-year follow-up period . DESIGN R and omized controlled trial . SETTING Dedicated falls clinics . PARTICIPANTS Seventy-four adults aged 70 and older who presented to a healthcare professional after a fall . INTERVENTION The OEP , a home-based program that consists of resistance training and balance training exercises . MEASUREMENTS Physiological falls risk was assessed using the Physiological Profile Assessment . Functional mobility was assessed using the Timed Up and Go Test . Three central executive functions were assessed : set shifting , using the Trail Making Test Part B ; updating , using the verbal digits backward test ; and response inhibition , using the Stroop Color-Word Test . Falls were prospect ively monitored using daily calendars . RESULTS At 6 months , there was no significant between-group difference in physiological falls risk or functional mobility ( P > or= .33 ) . There was a significant between-group difference in response inhibition ( P=.05 ) . A falls histogram revealed two outliers . With these cases removed , using negative binomial regression , the unadjusted incidence rate ratio of falls in the OEP group compared with the control group was 0.56 . The adjusted incidence rate ratio was 0.47 . CONCLUSION The OEP may reduce falls by improving cognitive performance Background Although basic research has uncovered biological mechanisms by which exercise could maintain and enhance adult brain health , experimental human studies with older adults have produced equivocal results . Purpose This r and omized clinical trial aim ed to investigate the hypotheses that ( a ) the effects of exercise training on the performance of neurocognitive tasks in older adults is selective , influencing mainly tasks with a substantial executive control component and ( b ) performance in neurocognitive tasks is related to cardiorespiratory fitness . Methods Fifty-seven older adults ( 65–79 years ) participated in aerobic or strength- and -flexibility exercise training for 10 months . Neurocognitive tasks were selected to reflect a range from little ( e.g. , simple reaction time ) to substantial ( i.e. , Stroop Word – Color conflict ) executive control . Results Performance in tasks requiring little executive control was unaffected by participating in aerobic exercise .  Improvements in Stroop Word – Color task performance were found only for the aerobic exercise group . Changes in aerobic fitness were unrelated to changes in neurocognitive function . Conclusions Aerobic exercise in older adults can have a beneficial effect on the performance of speeded tasks that rely heavily on executive control . Improvements in aerobic fitness do not appear to be a prerequisite for this beneficial effect BACKGROUND Data regarding the relationship between physical activity and  cognitive impairment  are limited and controversial . We examined whether physical activity is associated with incident cognitive impairment during follow-up . METHODS As part of a community-based prospect i ve cohort study in southern Bavaria , Germany , 3903 participants older than 55 years were enrolled between 2001 and 2003 and followed up for 2 years .  Physical activity ( classified as no activity , moderate activity [ <3 times/wk ] , and high activity [ > or =3 times/wk ] ) , cognitive function ( assessed by the 6-Item Cognitive Impairment Test )  , and potential confounders were evaluated . The main outcome measure was incident cognitive impairment after 2 years of follow-up . RESULTS At baseline , 418 participants ( 10.7 % ) had cognitive impairment . After a 2-year follow-up , 207 of 3485 initially unimpaired subjects ( 5.9 % ) developed incident cognitive impairment . Compared with participants without physical activity , fully adjusted multiple logistic regression analysis showed a significantly reduced risk of incident cognitive impairment after 2 years for participants with moderate or high physical activity at baseline ( odds ratio [ OR ] , 0.57 ; 95 % confidence interval [ CI ] , 0.37 - 0.87 [ P = .01 ] ; and OR , 0.54 ; 95 % CI , 0.35 - 0.83 [ P = .005 ] ; respectively ) . Further sub analysis including participants ( n = 2029 ) without functional impairment and without prodromal phase of dementia result ed in an even higher reduction of risk of incident cognitive impairment for participants with moderate or high physical activity ( OR , 0.44 ; 95 % CI , 0.24 - 
    Output:
    
The preponderance of evidence suggests that physical activity is beneficial for cognitive function in the elderly .
Larger r and omized controlled trials are needed to clarify the association between  exercise  and cognitive function and to determine which types of exercise have the greatest benefit on specific cognitive domains .
Despite these caveats , the current evidence suggests that physical activity may help to improve cognitive function and , consequently , delay the progression of cognitive impairment in the elderly