***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: Abstract 1680 participants were r and omized over the recruitment period in MAPT study . A total of 1290 participants were recruited in the 7 University Hospital centers , and 390 participants in the 6 memory clinics around Toulouse Gerontopole / Alzheimer Disease research clinical center . The first r and omization was on May 30 , 2008 , and the targeted number of r and omized participants was reached on February 24 , 2011 ; 2595 subjects were finally screened , of which 1680 fulfilled the eligibility criteria which represents 64.8 % . Approximately , one quarter of screened people refused to participate after the detailed presentation of the study and 4.3 % were still interested in participating but missed for unknown reasons the baseline visit even after repeated contacts . Of the 1810 subjects who signed the consent for participating to the study at the baseline visit , 130 ( 7.1 % ) were excluded because one of the eligibility criteria was not satisfied . Interestingly , the higher percentage of r and omizations compared to screened participants is the personal contact source ; almost 85 % of screened participants entered in the study . In an equivalent way , Medias and conferences are efficient recruiting sources to enrol volunteers in the study . Unexpectedly , only about 60 % of screened participants from the hospital and GP sources were r and omized and 33.2 % from health care services . Almost a quarter of the r and omized participants come from the hospital out patients clinics and approximately 20 % from public conferences . A total of 1128 contacts yielded to 556 screened volunteers and 345 r and omized participants in the coordinating center of Toulouse . Thus , 30 % of contacts were recruited Purpose To assess the effects of creatine supplementation , associated or not with strength training , upon emotional and cognitive measures in older woman . Methods This is a 24-week , parallel-group , double-blind , r and omized , placebo-controlled trial . The individuals were r and omly allocated into one of the following groups ( n=14 each ) : 1 ) placebo , 2 ) creatine supplementation , 3 ) placebo associated with strength training or 4 ) creatine supplementation associated with strength training . According to their allocation , the participants were given creatine ( 4 x 5 g/d for 5 days followed by 5 g/d ) or placebo ( dextrose at the same dosage ) and were strength trained or not .  Cognitive function , assessed by a comprehensive battery of tests involving memory , selective attention , and inhibitory control , and emotional measures , assessed by the Geriatric Depression Scale , were evaluated at baseline , after 12 and 24 weeks of the intervention . Muscle strength and food intake were evaluated at baseline and after 24 weeks . Results After the 24-week intervention , both training groups ( ingesting creatine supplementation and placebo ) had significant reductions on the Geriatric Depression Scale scores when compared with the non-trained placebo group ( p = 0.001 and p = 0.01 , respectively ) and the non-trained creatine group ( p < 0.001 for both comparison ) . However , no significant differences were observed between the non-trained placebo and creatine ( p = 0.60 ) groups , or between the trained placebo and creatine groups ( p = 0.83 ) . Both trained groups , irrespective of creatine supplementation , had better muscle strength performance than the non-trained groups . Neither strength training nor creatine supplementation altered any parameter of cognitive performance . Food intake remained unchanged . Conclusion Creatine supplementation did not promote any significant change in cognitive function and emotional parameters in apparently healthy older individuals . In addition , strength training per se improved emotional state and muscle strength , but not cognition , with no additive effects of creatine supplementation . Trial Registration Clinical trials.gov BACKGROUND Research indicates that the chronic consumption of flavonoids is associated with cognitive benefits in adults with mild cognitive impairment and neurodegenerative disease , although to our knowledge , there have been no such studies in healthy older adults . Furthermore , the effects of commonly consumed orange juice flavanones on cognitive function remain unexplored . OBJECTIVE We investigated whether 8 wk of daily flavanone-rich orange juice consumption was beneficial for cognitive function in healthy older adults . DESIGN High-flavanone ( 305 mg ) 100 % orange juice and an equicaloric low-flavanone ( 37 mg ) orange-flavored cordial ( 500 mL ) were consumed daily for 8 wk by 37 healthy older adults ( mean age : 67 y ) according to a crossover , double-blind , r and omized design separated by a 4-wk washout . Cognitive function , mood , and blood pressure were assessed at baseline and follow-up by using st and ardized vali date d tests . RESULTS Global cognitive function was significantly better after 8-wk consumption of flavanone-rich juice than after 8-wk consumption of the low-flavanone control . No significant effects on mood or blood pressure were observed . CONCLUSIONS Chronic daily consumption of flavanone-rich 100 % orange juice over 8 wk is beneficial for cognitive function in healthy older adults . The potential for flavanone-rich foods and drinks to attenuate cognitive decline in aging and the mechanisms that underlie these effects should be investigated 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 Recent epidemiological studies have indicated numerous associations between vascular and lifestyle related risk factors and incident dementia . However , evidence from r and omised controlled trials ( RCT ) showing effectiveness of interventions aim ed at these risk factors in preventing or postponing dementia onset is still lacking . Three large RCTs on multi-component interventions to prevent dementia ( preDIVA , FINGER , MAPT ) have been initiated in Europe to address these issues . Irrespective of some method ological differences , all three studies target cardiovascular and lifestyle related risk factors . Collaboration within the newly founded ' European Dementia Prevention Initiative ' ( EDPI ) will allow for a comprehensive exploration of optimal target population , intervention and outcome measures , which are currently unknown . Combining data of the ongoing studies and running simulation analyses will facilitate determining the optimal design including accurate sample -size calculations for future multi-national clinical trials on dementia prevention . Interventions aim ing at dementia prevention should be pragmatic and easy to implement on a large scale in different health care systems , without generating high additional costs or burden on participants or physicians . As the optimal age for intervention precedes the optimal age for outcome assessment , traditional trial design s might lead to suboptimal timing of either of the two . Separation of intervention and outcome assessment in time is a potential solution , but requires studies with very long follow-up . International collaboration of research groups with experience in dementia prevention studies and well-organised logistics for these major projects is pivotal to success for future large-scale dementia prevention studies . Founding of EDPI is an important first step in this direction Background and Purpose Cardiovascular risk factors are associated with an increased risk of dementia . Treatment of hypertension and hypercholesterolemia is associated with a decrease in incident dementia . Whether interventions aim ed at cardiovascular risk factors in late life also reduce dementia risk is unknown . Here , we report the outline of a pragmatic study that will attempt to answer this question and we describe the prevalence of cardiovascular risk factors in the target population . Methods We design ed a large cluster-r and omized trial with a 6-year follow-up in 3700 elderly subjects ( 70 to 78 y ) to assess whether nurse-led intensive vascular care in primary care decreases the incidence of dementia and reduces disability . Secondary outcome parameters are mortality , incidence of vascular events , and cognitive functioning .  Intensive vascular care comprises treatment of hypertension , hypercholesterolemia , diabetes and reducing overweight , smoking cessation , and stimulating physical exercise . Results Baseline data of 1004 subjects show that 87 % of the subjects have 1 or more cardiovascular risk factors and 44 % have even 2 or more risk factors amenable to treatment . Seventy-nine percent of the subjects receiving antihypertensive medication still have a systolic pressure of > 140 mm Hg . Conclusions In this older age group , the very high percentage of elderly subjects with cardiovascular risk factors illustrates the large window of opportunity for therapies directed to lower the cardiovascular risk and potentially also the risk for dementia 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 NCT 
    Output:
    
Overall , most of the nutritional interventions tested by the selected RCTs were found to produce statistically significant cognitive benefits ( defined as improved neuropsychological test scores ) .
Results of the present review suggest that several dietary patterns and nutritional components may constitute promising strategies in postponing , slowing , and preventing cognitive decline .