***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 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 Tango-dancing and walking programs are compared in nondemented seniors at risk for falls . Fallers ( N = 30 ) age 62 - 91 were r and omly assigned to a 10-wk ( 40 hr , 2 hr 2x/wk ) tango class or walk group . The Activities-specific Balance Confidence ( ABC ) scale , sit-to-st and scores , and normal and fast walk were measured pre- , post- , and 1 month postintervention . Two-way repeated- measures ANOVAs indicated a significant main effect ( p < .01 ) for time on all measures . Group and interaction effects for ABC led to improvement only in tango because of high baseline mean for the walk group . Clinical improvements measured using Established Population s for Epidemiologic Studies of the Elderly scoring were greater for the tango group . From these preliminary results it is suggested that although both interventions are effective activities for increasing strength and walk speed , tango might result in greater improvements than walking in balance skills and in walking speed in the 10-wk intervention . The study needs to be repeated with a greater sample size to determine the effectiveness of walking on fear of falling The objective of the study was to investigate the effect of introducing a dance-based psychomotor intervention using Danzón ( Latin ballroom ) for people with dementia in care homes . This was a grounded theory qualitative study . Thirteen of the 22 participants had dementia and were care-home residents . The remaining participants were care staff and facilitators of the dance sessions .  Interviews were undertaken with seven people with dementia and nine staff , result ing in two separate sets of grounded theory method ologies . Two conceptual models , outlining positive outcomes and negative concerns of the use of Danzón were developed , depicting the experiences of people with dementia and care staff respectively . Danzón psychomotor intervention was found to enhance positive emotional states and general levels of satisfaction for both people with dementia and care staff . The details of these findings have been used to design a quantitative study The authors report the effect of a 12‐day prospect i ve , blinded dance‐learning trial in 5 patients with moderate Alzheimer 's disease ( AD ) and 5 age‐matched depressed patients . Patients with AD showed a significant effect in procedural learning whereas depressed patients did not . These findings suggest potential implication s for therapeutic interventions in patients with moderate AD . Copyright © 2002 John Wiley & Sons , Aromatherapy and massage could provide a useful addition to psychological therapeutic interventions with clients suffering from dementia . The effects of aromatherapy and massage on disturbed behaviour in four individuals with severe dementia were evaluated using a single-case research design . Each participant received 10 treatment sessions of aromatherapy , aromatherapy and massage combined , and massage alone . The effects on each individual 's behaviour in the hour following treatment were assessed against 10 ' no treatment ' control sessions . Reliable individualized disturbed behaviour scales were design ed . The effects of the treatments were mixed . The opinion of the staff providing treatment was that all participants benefited . On close scrutiny , only one of the participants benefited from the aromatherapy and massage to a degree that reached statistical significance . In two of the cases aromatherapy and massage led to an increase in agitated behaviour . The importance of the single case study approach with this client group is discussed 
    Output:
    
There was evidence that problematic behaviours decreased ; social interaction and enjoyment in both residents and care staff improved .
A few adverse effects were also acknowledged .