***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: OBJECTIVES To compare the acceptability and feasibility of computerized and pencil- and -paper tests of cognitive function in 85-year-old people . DESIGN Group comparison of participants r and omly allocated to pencil- and -paper ( Wechsler Adult Intelligence and Memory Scales ) or computerized ( Cognitive Drug Research ) tests of verbal memory and attention . SETTING The Newcastle 85 + Pilot Study was the precursor to the Newcastle 85 + Study a United Kingdom Medical Research Council/Biotechnology and Biological Sciences Research Council cohort study of health and aging in the oldest-old age group . PARTICIPANTS Eighty-one community-dwelling individuals aged 85 . MEASUREMENTS Participant and research er acceptability , completion rates , time taken , validity as cognitive measures , and psychometric utility . RESULTS Participants r and omized to computerized tests were less likely to rate the cognitive function tests as difficult ( odds ratio (OR)=0.16 , 95 % confidence interval (CI)=0.07 - 0.39 ) , stressful ( OR=0.18 , 95 % CI=0.07 - 0.45 ) , or unacceptable ( OR=0.18 , 95 % CI=0.08 - 0.48 ) than those r and omized to pencil- and -paper tests . Research ers were also less likely to rate participants as being distressed in the computer test group ( OR=0.19 , 95 % CI=0.07 - 0.46 ) . Pencil- and -paper tasks took participants less time to complete ( mean+/-st and ard deviation 18+/-4 minutes vs 26+/-4 minutes ) but had fewer participants who could complete all tasks ( 91 % vs 100 % ) . Both types of task were equally good measures of cognitive function . CONCLUSION Computerized and pencil- and -paper tests are both feasible and useful means of assessing cognitive function in the oldest-old age group . Computerized tests are more acceptable to participants and administrators Eight individuals with Alzheimer 's disease , and eight age-matched controls , were administered the MMSE , the Yesavage GDS , and a customized subset of the Automated Neuropsychological Assessment Metrics ( ANAM ) Battery .  Accuracy ( percent correct ) and efficiency ( number of correct responses per minute ) of performance on six ANAM tasks were assessed . The patients ' GDS scores indicated no depression . Although their MMSE scores ( mean approximately 25 ) were significantly lower than those of the controls , they nonetheless indicated that the patients were still functioning at a fairly high level . Analysis of  ANAM accuracy scores indicated that the patients were significantly impaired on three tasks measuring working memory . A discriminant function analysis revealed 93.8 % correct classification . Analysis of  ANAM efficiency scores revealed that except for simple reaction time , the patients were significantly impaired on all tasks . A discriminant function analysis correctly classified 100 % of the participants . Given the small size of the groups in the present study , this finding especially underscores the sensitivity of ANAM to the cognitive effects of Alzheimer 's disease , as indicated by the large effect sizes . The findings further indicate that ANAM might be capable of detecting more subtle effects of the disease at an earlier stage in its progress Tests used as outcome measures in clinical trials of antidementia agents are not typically employed as part of diagnostic evaluations , and little information exists as to the sensitivity of these tests in terms of either differentiating demented patients from normal individuals or in distinguishing dementias of various types and etiologies . Sensitivity to mild dementia and sensitivity to impairment of various neuropsychological domains are , however , prerequisites for valid use of an instrument as an outcome measure in this context . The present study was undertaken to directly compare six different tests ( three traditional psychometric tests and three clinical trial batteries ) in terms of their sensitivity to detect and distinguish between mild dementia in patients with either Alzheimer 's disease ( n = 15 ) or Huntington 's disease ( n = 15 ) , when compared to normal controls ( n = 15 ) . Tests included the  Mattis Dementia Rating Scale , the Mini-Mental State Examination , the Wechsler Memory Scale-Revised , the Alzheimer 's Disease Assessment Scale-Cognitive Subscale , the Computerized Drug Research ( CDR ) Cognitive Assessment System , and the Repeatable Battery for the Assessment of Dementia ( RBAD ) . All of the tests were roughly equivalent in terms of their ability to discriminate normal subjects from mildly demented patients . Only the CDR and RBAD , however , were able to reliably discriminate between the two patient groups . The results are discussed in terms of the applicability of these tests as outcome measures for clinical trials in dementing disorders Mild memory impairment was detected in 28 % of a sample of healthy community-dwelling older adults using the delayed recall trial of a word list learning task . Statistical analysis revealed that individuals with memory impairment also demonstrated relative deficits on other measures of memory , and tests of executive function , processing speed and global cognition , as measured by the CERAD and CogState batteries and CANTAB paired associate learning task .  These relative deficits can not be explained by age-related changes , education , intelligence , mood , health-related factors , or the individuals ' ApoEepsilon4 status . Memory-impaired individuals ( n = 30 ) did not recognize the extent of their memory and cognitive difficulties beyond the general complaints expressed by normal elderly ( n = 77 ) within the study and their apparent difficulties did not appear to impact on their participation in life activities . These findings suggest it is unlikely that the memory and cognitive difficulties demonstrated by individuals with mild memory impairment reflect normal aging . Rather it is possible that such impairment may signal early neurodegenerative processes worthy of further investigation Accurately documenting cognitive change is important , as neuropsychologists are routinely asked to determine cognitive change following disease progression or medical intervention . Computerized testing batteries , such as the Automated Neuropsychological Assessment Metrics ( ANAM ) , are good tools for assessing change , because they allow for r and omization of stimuli , creating near limitless alternate forms and reducing practice effects . The question remains , however , as to how best to determine reliable change in performance using ANAM . The current study compared the use of Reliable Change Index ( RCI ) and regression based methods ( REG ) calculated from 28 individuals with migraine . These methods then were applied to an independent sample of 25 individuals with migraine assessed with ANAM at baseline , headache , and following pharmacologic treatment . Traditional repeated measures analyses revealed declines in cognitive efficiency following migraine onset on two of four ANAM tasks and significant improvement on all ANAM tasks following treatment . Rates of deterioration and improvement did not significantly differ between RCI and REG methods , although were slightly different across the ANAM tasks used in this study . A combined  ANAM  score categorized the most individuals as demonstrating cognitive change , revealing that 60 % of subjects declined in performance following headache and 84 % improved following migraine treatment BMY 21,502 is a nootropic which protects memory and enhances long-term potentiation according to pre clinical findings . Alzheimer 's disease ( AD ) patients who were diagnosed by DSM-III-R and NINCDS-ADRDA criteria were enrolled in a 12-week double-blind investigation of BMY 21,502 vs. placebo at 300 mg tid . The study design included a 1-week placebo lead-in and a 4-week placebo washout in addition to the 12-week double-blind treatment period . Efficacy was assessed with the Alzheimer 's Disease Assessment Scale ( ADAS ) and the Computerized Neuropsychological Test Battery ( CNTB ) at weeks 4 , 8 , 12 , and 16 . Clinical Global Impression ( CGI ) assessment s were also performed biweekly . Sixty-nine patients ( 28 M , 41F ; mean age 72 years , range 54 to 92 years ) were enrolled in the study .  Baseline Mini-Mental Status Examination ( MMSE ) scores ranged from 16 to 26 ( mean 23.5 ) in patients on active drug ( n = 34 ) , and from 15 to 26 ( mean 22.5 ) in placebo patients ( n = 35 ) . Baseline efficacy scores were comparable for drug and placebo patients ( p > 0.05 ) . Twelve ( 35 % ) patients who received BMY 21,502 withdrew from the study , 8 ( 24 % ) due to adverse events . Three ( 9 % ) patients who received placebo withdrew from the study , all due to adverse events . Patients on active drug who were valid for analysis of efficacy ( n = 22 ) showed a mean decrease in ADAS of -1.5 at week 12 , vs. a mean change of -0.5 in patients who received placebo ( n = 32 ) , although there was no significant difference between the two ( p > 0.05 ) . Correlations between the CNTB summary scores and ADAS cognitive subscores were , nevertheless , highly significant at baseline ( r = -0.83 , p = 0.0001 ) and week 12 ( r = -0.83 , p = 0.0001 ) . Correlations between the word list learning , spatial , and naming subtests of the ADAS and CNTB were also highly significant ( p = 0.0001 ) . Although modest , the findings for active drug vs. placebo response in this study suggest that BMY 21,502 should be further investigated , with a larger study population , in order to fully determine the compound 's potential efficacy The cognitive efficacy of the M1-selective muscarinic agonist xanomeline in mild-to-moderate Alzheimer disease ( AD ) was measured using the Computerized Neuropsychological Test Battery ( CNTB ) and the Alzheimer 's Disease Assessment Scale-Cognitive Subscale ( ADAS-cog ) in this 17-center , double-blind , placebo-controlled study . Three hundred forty-three patients were r and omly assigned to receive 25 , 50 , or 75 mg xanomeline tartrate or placebo three times daily ( t.i.d . ) for 24 weeks , followed by placebo for 4 weeks in a single-blind washout phase . Cognitive function was assessed at r and omization and after 4 , 8 , 12 , 24 , and 28 weeks . Three hundred nineteen patients were included in an intent-to-treat ( ITT ) analysis ; 209 completers had evaluable data at week 24 . ITT analysis showed a significant ( p < or = 0.05 ) dose-response trend and a significant ( p < or = 0.05 ) between-group comparison favoring 75 mg t.i.d . over placebo for the CNTB summary score but not for the ADAS-cog . In the completer analysis , however , the ADAS-cog showed a significant ( p < or = 0.05 ) dose-response trend and between-group comparison , whereas the CNTB Summary Score did not . The ADAS-cog was less sensitive to treatment effects in mildly impaired patients ( ADAS-cog < 21 ) than in moderately impaired patients ( ADAS-cog > or = 21 ) , whereas the CNTB was sensitive in the entire study population ( mean ADAS-cog = 22.5+/-9.6 ) . Significant ( p < or = 0.05 ) beneficial treatment effects were seen in measures of simple reaction time and delayed verbal recall , which are included in the CNTB but not in the ADAS-cog . During the single-blind placebo washout period , the ADAS-cog score of the placebo group worsened dramatically ( change of 2.63 points ; p < or = 0.001 ) , whereas the CNTB score remained stable ( change of 1.04 points ; p=0.694 ) . Thus , the CNTB appears to be more objective than the ADAS-cog BACKGROUND Attentional deficits are described in the consensus clinical criteria for the operationalized diagnosis of dementia with Lewy bodies ( DLB ) as characteristic of the condition . In addition , preliminary studies have indicated that both attentional impairments and fluctuation of attentional impairments are more marked in patients with DLB than in patients with Alzheimer disease ( AD ) , although neuropsychological function has not previously been examined in a large prospect i ve cohort with confirmed diagnostic accuracy against postmortem diagnosis . METHODS A detailed evaluation of  attention and fluctuating attention  was undertaken in 155 patients with dementia ( 85 with DLB and 80 with AD ) from a representative hospital dementia case register and 35 elderly controls using the Cognitive Drug Research Computerized Assessment System for Dementia Patients computerized neuropsychological battery . Operationalized clinical diagnosis was made using the consensus criteria for DLB and the National Institute of Neurological and Communicative Disorders and Stroke-Alzheimer 's Disease and Related Disorders Association criteria for AD . High levels of sensitivity and specificity have been achieved for the first 50 cases undergoing postmortem examination . RESULTS The groups were well matched for severity of cognitive impairments , but the AD patients were older ( mean age , 80 vs 78 years ) and more likely to be female ( 55 % vs 40 % ) . Patients with DLB were significantly more impaired than patients with AD on all measures of attention and fluctuating attention ( for all comparisons , t > or = 2.5 , P<.001 ) , and patients from both dementia groups were significantly more impaired than elderly controls for all comparisons other than cognitive reaction time , which was significantly more impaired in DLB patients than controls but was comparable in controls and AD patients . There were , however , significant 
    Output:
    
Some , such as the Mild Cognitive Impairment Screen , adapted complicated scoring algorithms to enhance the information gathered from already existing tests .
Others , such as CogState , used unique interfaces and subtests .
We found that although basic indices of psychometric properties were typically addressed , sufficient variability exists that currently available computerized test batteries must be judged on a case-by-case basis