***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: CONTEXT Laboratory findings have suggested that oxidative stress may contribute to the pathogenesis of Alzheimer disease . Therefore , the risk of Alzheimer disease might be reduced by intake of antioxidants that counteract the detrimental effects of oxidative stress . OBJECTIVE To determine whether dietary intake of antioxidants is related to risk of Alzheimer disease . DESIGN AND SETTING The Rotterdam Study , a population -based , prospect i ve cohort study conducted in the Netherl and s. PARTICIPANTS A total of 5395 participants who , at baseline ( 1990 - 1993 ) , were aged at least 55 years , free of dementia , and noninstitutionalized and had reliable dietary assessment . Participants were reexamined in 1993 - 1994 and 1997 - 1999 and were continuously monitored for incident dementia . MAIN OUTCOME MEASURES Incidence of Alzheimer disease , based on Diagnostic and Statistical Manual of Mental Disorders , Revised Third Edition ( DSM-III-R ) criteria and National Institute of Neurological and Communicative Disorders and Stroke and Alzheimer Disease and Related Disorders Association ( NINCDS-ADRDA ) criteria , associated with dietary intake of beta carotene , flavonoids , vitamin C , and vitamin E. RESULTS After a mean follow-up of 6 years , 197 participants developed dementia , of whom 146 had Alzheimer disease . When adjustments were made for age , sex , baseline Mini-Mental State Examination score , alcohol intake , education , smoking habits , pack-years of smoking , body mass index , total energy intake , presence of carotid plaques , and use of antioxidative supplements , high intake of vitamin C and vitamin E was associated with lower risk of Alzheimer disease ( rate ratios [ RRs ] per 1-SD increase in intake were 0.82 [ 95 % confidence interval [ CI ] , 0.68 - 0.99 ] and 0.82 [ 95 % CI , 0.66 - 1.00 ] , respectively ) . Among current smokers , this relationship was most pronounced ( RRs , 0.65 [ 95 % CI , 0.37 - 1.14 ] and 0.58 [ 95 % CI , 0.30 - 1.12 ] , respectively ) and also was present for intake of beta carotene ( RR , 0.49 [ 95 % CI , 0.27 - 0.92 ] ) and flavonoids ( RR , 0.54 [ 95 % CI , 0.31 - 0.96 ] ) . The associations did not vary by education or apolipoprotein E genotype . CONCLUSION High dietary intake of vitamin C and vitamin E may lower the risk of Alzheimer disease BACKGROUND Few studies have investigated the effects of dietary fats on the development of Alzheimer disease . We examined the associations between intake of specific types of fat and incident Alzheimer disease in a biracial community study . METHODS We performed clinical evaluations on a stratified r and om sample of 815 community residents aged 65 years and older who were unaffected by Alzheimer disease at baseline and who completed a food-frequency question naire a mean of 2.3 years before clinical evaluation . RESULTS After a mean follow-up of 3.9 years , 131 persons developed Alzheimer disease . Intakes of saturated fat and trans-unsaturated fat were positively associated with risk of Alzheimer disease , whereas intakes of omega-6 polyunsaturated fat and monounsaturated fat were inversely associated . Persons in the upper fifth of saturated-fat intake had 2.2 times the risk of incident Alzheimer disease compared with persons in the lowest fifth in a multivariable model adjusted for age , sex , race , education , and apolipoprotein E epsilon4 allele status ( 95 % confidence interval , 1.1 - 4.7 ) . Risk also increased with consumption of trans-unsaturated fats , beginning with the second fifth of intake ( relative risk , 2.4 compared with the lowest fifth ; 95 % confidence interval , 1.1 - 5.3 ) . We observed linear inverse associations between Alzheimer disease and vegetable fat ( P = .002 ) , and , after further adjustment for other types of fat , marginally significant associations with intake of omega-6 polyunsaturated fat ( P = .10 for trend ) and monounsaturated fat ( P = .10 for trend ) . Intakes of total fat , animal fat , and dietary cholesterol were not associated with Alzheimer disease . CONCLUSION High intake of unsaturated , unhydrogenated fats may be protective against Alzheimer disease , whereas intake of saturated or trans-unsaturated ( hydrogenated ) fats may increase risk BACKGROUND Subjects with a mild cognitive impairment ( MCI ) have a memory impairment beyond that expected for age and education yet are not demented . These subjects are becoming the focus of many prediction studies and early intervention trials . OBJECTIVE To characterize clinical ly subjects with MCI  cross-sectionally and longitudinally . DESIGN A prospect i ve , longitudinal inception cohort . SETTING General community clinic . PARTICIPANTS A sample of 76 consecutively evaluated subjects with MCI were compared with 234 healthy control subjects and 106 patients with mild Alzheimer disease ( AD ) , all from a community setting as part of the Mayo Clinic Alzheimer 's Disease Center/Alzheimer 's Disease Patient Registry , Rochester , Minn. MAIN OUTCOME MEASURES The 3 groups of individuals were compared on demographic factors and measures of cognitive function including the  Mini-Mental State Examination , Wechsler Adult Intelligence Scale-Revised , Wechsler Memory Scale-Revised , Dementia Rating Scale , Free and Cued Selective Reminding Test , and Auditory Verbal Learning Test .  Clinical classifications of dementia and AD were determined according to the Diagnostic and Statistical Manual of Mental Disorders , Revised Third Edition and the National Institute of Neurological and Communicative Disorders and Stroke-Alzheimer 's Disease and Related Disorders Association criteria , respectively . RESULTS The primary distinction between control subjects and subjects with MCI was in the area of memory , while other cognitive functions were comparable . However , when the subjects with MCI were compared with the patients with very mild AD , memory performance was similar , but patients with AD were more impaired in other cognitive domains as well . Longitudinal performance demonstrated that the subjects with MCI declined at a rate greater than that of the controls but less rapidly than the patients with mild AD . CONCLUSIONS Patients who meet the criteria for MCI can be differentiated from healthy control subjects and those with very mild AD . They appear to constitute a clinical entity that can be characterized for treatment interventions BACKGROUND The Rotterdam Study previously found that higher dietary intakes of vitamins E and C related to lower risk of dementia and Alzheimer disease ( AD ) over 6 years of follow-up . OBJECTIVE To study consumption of major dietary antioxidants relative to long-term risk of dementia . DESIGN Population -based prospect i ve cohort study . SETTING The Rotterdam Study in the Netherl and s. PARTICIPANTS A total of 5395 participants , 55 years and older , who were free of dementia and provided dietary information at study baseline . MAIN OUTCOME MEASURES Incidence of dementia and AD , based on internationally accepted criteria , relative to dietary intake of vitamin E , vitamin C , beta carotene , and flavonoids . RESULTS During a mean follow-up period of 9.6 years , dementia developed in 465 participants , of whom 365 were diagnosed as having AD . In multivariate models adjusted for age , education , apolipoprotein E epsilon4 genotype , total energy intake , alcohol intake , smoking habits , body mass index , and supplement use , higher intake of vitamin E at study baseline was associated with lower long-term risk of dementia ( P = .02 for trend ) . Compared with participants in the lowest tertile of vitamin E intake , those in the highest tertile were 25 % less likely to develop dementia ( hazard ratio , 0.75 ; 95 % confidence interval , 0.59 - 0.95 with adjustment for potential confounders ) . Dietary intake levels of vitamin C , beta carotene , and flavonoids were not associated with dementia risk after multivariate adjustment ( P > .99 for trend for vitamin C and beta carotene and P = .60 for trend for flavonoids ) . Results were similar when risk for AD was specifically assessed . CONCLUSION Higher intake of foods rich in vitamin E may modestly reduce long-term risk of dementia and AD Background : Cross-sectional reports suggest that  statin users are less likely to have  Alzheimer disease ( AD ) .  Prospect i ve studies have provided inconsistent evidence . Moreover , it is unclear whether the association differs for lipohilic statins , those that could more easily pass the blood – brain barrier and hydrophilic statins . Objectives : To prospect ively evaluate whether use of statins is associated with the risk of AD , and to determine whether associations differ for lipophilic and hydrophilic statins . Method : 6992 participants of the prospect i ve , population -based Rotterdam Study were followed , from baseline ( 1990–1993 ) until January 2005 for incident AD . Data on all filled prescriptions came from pharmacy records . For each date on which each event occurred , cholesterol-lowering drug use for the person who experienced the event and all remaining persons in the cohort was categorised as “ any ” or “ never ” use . A distinction was made between statin , lipophilic and hydrophilic statins , and non-statin cholesterol-lowering drugs . Data were analysed with the Cox regression analysis , adjusting for sex , age and potential confounders . Results : During follow-up ( mean 9 years ) , 582 persons developed AD . Compared with never use of cholesterol-lowering drugs , statin use was associated with a decreased risk of AD ( HR 0.57 ; 95 % CI 0.37 to 0.90 ) , but non-statin cholesterol-lowering drug use was not ( HR 1.05 ; 95 % CI 0.45 to 2.44 ) . HRs were equal for lipophilic ( HR 0.54 ; 95 % CI 0.32 to 0.89 ) and hydrophilic statins ( HR 0.54 ; 95 % CI 0.26 to 1.11 ) . Conclusion : In the general population , the use of statins , but not of non-statin cholesterol-lowering drugs , was associated with a lower risk of AD compared with never use of cholesterol-lowering drugs . The protective effect was independent of the lipophilicity of statins There is evidence from a population -based study of an inverse relationship between monounsaturated fatty acids ( MUFA ) energy intake and age-related cognitive decline ( ARCD ) , while high polyunsaturated fatty acids ( PUFA ) intake was positively associated with cognitive impairment in elderly subjects . We investigated the possible role of MUFA and PUFA on age-related cognitive changes . A population -based , prospect i ve study was carried out on 278 , 186 , and 95 nondemented elderly subjects ( 65 - 84 years ) evaluated for global cognitive functions ( Mini-Mental State Examination , MMSE ) at the first ( 1992 - 1993 ) , second ( 1995 - 1996 ) , and third survey ( 2000 - 2001 ) , respectively , from the r and omized cohort of Casamassima , Bari , Italy ( n=704 ) , one of the eight centers of the Italian Longitudinal Study on Aging ( ILSA ) .  MUFA and PUFA intakes were assessed at baseline with a semi-quantitative food frequency question naire . High MUFA and PUFA energy intakes and total energy intake were significantly associated with a better cognitive performance in a 8.5-year follow-up . In this prospect i ve population -based study on older nondemented subjects with a typical Mediterranean diet , high MUFA and PUFA intakes appeared to be protective against ARCD OBJECTIVES To prospect ively assess effects of select dietary fats on  cognitive decline . DESIGN Prospect i ve observational ; 3-year follow-up . SETTING Northwestern University . PARTICIPANTS Four hundred eighty-two women aged 60 and older who participated in the Women 's Health Initiative ( WHI ) Observational Study or in the control group of the WHI Diet Modification arm .  MEASUREMENTS Dietary intake from a vali date d food frequency question naire ( FFQ ) administered twice ( mean 2.7 years apart ) before baseline cognitive assessment ( mean 2.9 years after second FFQ ) was averaged . Testing of memory , vision , executive function , language , and attention was performed twice , 3 years apart . A global Z-score was created for both time points by averaging all Z-scores for each participant , and global cognitive change was defined as the difference between follow-up and baseline Z-scores . RESULTS Median intake of saturated fat ( SFA ) , trans-fat , ( TFA ) , dietary cholesterol ( DC ) , and monounsaturated fat ( MUFA ) was 18.53 , 3.45 , 0.201 , and 19.39 g/d , respectively . There were no associations between degree of cognitive decline and intake 
    Output:
    
Several , although not all , prospect i ve studies indicate relationships between saturated and trans fat intake and risk of cognitive disorders