human
***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 determine whether participation in usual moderate-intensity or more-vigorous physical activity ( MVPA ) is associated with physical function performance and to identify sociodemographic , psychosocial , and disease-related covariates that may also compromise physical function performance . DESIGN Cross-sectional analysis of baseline variables of a r and omized controlled intervention trial . SETTING Four academic research centers . PARTICIPANTS Four hundred twenty-four older adults aged 70 to 89 at risk for mobility disability ( scoring < 10 on the Short Physical Performance Battery ( SPPB ) ) and able to complete the 400-m walk test within 15 minutes . MEASUREMENTS  Minutes of MVPA ( dichotomized according to above or below 150 min/wk of MVPA ) assessed according to the Community Healthy Activities Model Program for Seniors question naire , SPPB score , 400-m walk test , sex , body mass index ( BMI ) , depressive symptoms , age , and number of medications . RESULTS The SPPB summary score was associated with minutes of MVPA ( ρ=0.16 , P=.001 ) . In multiple regression analyses , age , minutes of MVPA , number of medications , and depressive symptoms were associated with performance on the composite SPPB ( P<.05 ) . There was an association between 400-m walk time and minutes of MVPA ( ρ=-0.18 ; P<.001 ) . In multiple regression analyses , age , sex , minutes of MVPA , BMI , and number of medications were associated with performance on the 400-m walk test ( P<.05 ) . CONCLUSION Minutes of MVPA , sex , BMI , depressive symptoms , age , and number of medications are associated with physical function performance and should all be taken into consideration in the prevention of mobility disability INTRODUCTION AND PURPOSE Physical inactivity in postmenopausal women contributes to a rise in atherogenic risk factors associated with the metabolic syndrome . Although regular physical activity positively contributes to health , inactivity progressively increases with age . The Dose Response to Exercise in Women aged 45 - 75 yr ( DREW ) study is design ed to investigate the effect of different amounts of exercise training on cardiorespiratory fitness and risk factors for cardiovascular disease ( CVD ) in postmenopausal women at moderately increased risk of CVD . METHODS DREW will recruit 450 sedentary , healthy , postmenopausal women with a body mass index of 25 - 40 kg.m-2 , resting systolic blood pressure ( BP ) of 120 - 159 mm Hg , and a resting diastolic BP of < or = 99 mm Hg . Laboratory and self-report measures completed at baseline and 6 months include maximal oxygen consumption ( .VO2max ) , resting BP , anthropometry , dietary habits , physical activity history , medication use , menstrual history , personal and family medical history , and fasting HDL cholesterol , LDL cholesterol , triglycerides , and glucose . Eligible participants are r and omly assigned to a nonexercise group or one of three exercise groups . Participants exercise 3 to 4x wk-1 at a heart rate equivalent to 50 % of .VO2max expending 4 , 8 , or 12 kcal.kg-1.wk-1 , depending on group assignment . This study will allow quantification of possible dose-response relations ( 50 % , 100 % , and 150 % of the consensus physical activity recommendation ) between exercise training and study outcomes . CONCLUSION DREW can make important contributions to our underst and ing of the effects of physical activity in postmenopausal women and help refine public health and clinical recommendations for this group Background Previous research has mainly targeted older people with high risk of falling . The effectiveness of exercise interventions in older people with mild levels of balance dysfunction remains unexplored . Objective This study evaluated the effectiveness of a home balance and strength exercise intervention in older people systematic ally screened as having mild balance dysfunction . Design This was a community-based , r and omized controlled trial with assessors blinded to group allocation . Participants Study participants were older people who reported concerns about their balance but remained community ambulant ( n=225 ) . After a comprehensive balance assessment , those classified as having mild balance dysfunction ( n=165 ) were r and omized into the trial . Intervention Participants in the intervention group ( n=83 ) received a 6-month physical therapist – prescribed balance and strength home exercise program , based on the Otago Exercise Program and the Visual Health Information Balance and Vestibular Exercise Kit . Participants in the control group ( n=82 ) continued with their usual activities . Outcome Measures Laboratory and clinical measures of balance , mobility , and strength were assessed at baseline and at a 6-month re assessment . Results After 6 months , the intervention group ( n=59 ) significantly improved relative to the control group ( n=62 ) for : the Functional Reach Test ( mean difference=2.95 cm , 95 % confidence interval [CI]=1.75 to 4.15 ) , the Step Test ( 2.10 steps/15 seconds , 95 % CI=1.17 to 3.02 ) , hip abductor strength ( 0.02 , 95 % CI=0.01 to 0.03 ) , and gait step width ( 2.17 cm , 95 % CI=1.23 to 3.11 ) . There were nonsignificant trends for improvement on most other measures . Fourteen participants in the intervention group ( 23.7 % ) achieved balance performance within the normative range following the exercise program , compared with 3 participants ( 4.8 % ) in the control group . Limitations Loss to follow-up ( 26.6 % ) was slightly higher than in some similar studies but was unlikely to have biased the results . Conclusions A physical therapist – prescribed home exercise program targeting balance and strength was effective in improving a number of balance and related outcomes in older people with mild balance impairment OBJECTIVES To reveal distinct longitudinal trajectories in episodic memory over 15 years and to identify demographic , lifestyle , health-related , and genetic predictors of stability or decline . DESIGN Prospect i ve cohort study . SETTING The Betula Project , Umeå , Sweden . PARTICIPANTS One thous and nine hundred fifty-four healthy participants aged 35 to 85 at baseline . MEASUREMENTS Memory was assessed according to vali date d episodic memory tasks in participants from a large population -based sample . Data were analyzed using a r and om-effects pattern-mixture model that considered the effect of attrition over two to four longitudinal sessions .  Logistic regression  was used to determine significant predictors of stability or decline relative to average change in episodic memory . RESULTS Of 1,558 participants with two or more test sessions , 18 % were classified as maintainers and 13 % as decliners , and 68 % showed age-typical average change . More educated and more physically active participants , women , and those living with someone were more likely to be classified as maintainers , as were carriers of the met allele of the catechol-O-methyltransferase gene . Less educated participants , those not active in the labor force , and men were more likely to be classified as decliners , and the apolipoprotein E ~4 allele was more frequent in decliners . CONCLUSION Quantitative , attrition-corrected assessment of longitudinal changes in memory can reveal substantial heterogeneity in aging trajectories , and genetic and lifestyle factors predict such heterogeneity PURPOSE This study was design ed to investigate whether , in a dose-response manner , there would be greater health benefits in a group of postmenopausal women completing 45 minute- vs. 30 minutes of moderate intensity ( 50 % maximal oxygen uptake reserve , VO2R ) exercise 5 days . wk(-1 ) . METHODS Apparently healthy but sedentary postmenopausal women ( n = 33 ) were r and omized to a nonexercise control group , a 30-minute exercise duration group , or a 45-minute exercise duration group . Exercise training was performed 5 days . wk(-1 ) for 12 weeks at 50 % VO2R . Participants were instructed to not change their usual diet throughout the study . RESULTS Twenty-six women completed the study . After 12 weeks , VO2max increased significantly ( p < 0.05 ) in both 30-minute ( 0.20 + /- 0.21 L . min(-1 ) ) and 45-minute ( 0.41 + /- 0.10 L . min(-1 ) ) groups . Repeated measures ANOVA identified a significant interaction between exercise duration and VO2max values ( F = 4.72 , p < 0.05 ) , indicating that VO2max responded differently to 30-minute and 45-minute exercise duration s. Trend analysis showed that body mass , body composition , waist circumference , and high-density lipoprotein cholesterol ( HDL-C ) changed favorably ( p < 0.05 ) across control , 30-minute , and 45-minute groups . CONCLUSIONS Although most health organizations agree that 150 min . wk(-1 ) of physical activity will reduce the risk of all-cause and cardiovascular mortality , few r and omized , controlled studies have examined whether completing more physical activity than the recommended amount will yield additional benefits . Findings from the present study suggest that there is a dose-response relationship between exercise duration and numerous health outcomes in postmenopausal women , including cardiorespiratory fitness , body mass , body composition , waist circumference , and Background Decreased heart rate variability ( HRV ) is associated with a higher risk of mortality . Overall , postmenopausal women have lower levels of HRV than premenopausal women , which may be additionally complicated by lifestyle related behaviors such as physical inactivity and obesity . Though cardiorespiratory exercise training increases HRV , little is known regarding the exercise dose necessary to promote this improvement . Methodology /Principal Findings Our primary aim was to measure HRV in post-menopausal women following 6-months of exercise training . We examined supine resting HRV in 373 post-menopausal women ( 45–75 y ) after 6-months of r and omly assigned and double-blinded administered exercise training exercise training at 50 % , 100 % and 150 % of the NIH Consensus Development Panel 's recommended minimal physical activity level . This corresponded to 4 , 8 , or 12 kcal/kg per week ( KKW ) of energy expenditure . At baseline , we observed no significant differences in HRV or hormone replacement use between treatment groups . However , we did observe that Caucasian women and those taking antidepressant medications had lower levels of baseline HRV . After 6-months of exercise intervention , we observed a dose dependent increase in all parasympathetically derived time and frequency domain measurements across exercise groups after adjustment for age , ethnicity , antidepressants , and baseline rMSSD ( all , P<0.001 ) . For example , the parasympathetic index rMSSD was greater than control ( 23.19±1.0 ) for the 4-KKW ( 25.98±0.8 ; P = 0.14 ) , 8-KKW ( 27.66±1.0 ; P<0.05 ) , and 12-KKW ( 27.40±0.0 ; P<0.05 ) groups at follow-up . Conclusions / Significance Moderate intensity exercise training exercise is sufficient to improve HRV in previously sedentary postmenopausal women in a dose-dependent manner , as 4-KKW is insufficient to improve parasympathetic indices of HRV , while 12-KKW conferred no greater improvement than 8-KKW . Trial Registration Clinical trials.gov NCT Background Physical activity is associated with improved overall health in those people who survive to older ages , otherwise conceptualised as healthy ageing . Previous studies have examined the effects of mid-life physical activity on healthy ageing , but not the effects of taking up activity later in life . We examined the association between  physical activity  and healthy ageing over 8 years of follow-up . Methods Participants were 3454 initially disease-free men and women ( aged 63.7±8.9 years at baseline ) from the English Longitudinal Study of Ageing , a prospect i ve study of community dwelling older adults .  Self-reported physical activity was assessed at baseline ( 2002–2003 ) and through follow-up .  Healthy ageing , assessed at 8 years of follow-up ( 2010 - 2011 ) , was defined as those participants who survived without developing major chronic disease , depressive symptoms , physical or cognitive impairment . Results At follow-up , 19.3 % of the sample was defined as healthy ageing . In comparison with inactive participants , moderate ( OR , 2.67 , 95 % CI 1.95 to 3.64 ) , or vigorous activity ( 3.53 , 2.54 to 4.89 ) at least once a week was associated with healthy ageing , after adjustment for age , sex , smoking , alcohol , marital status and wealth . Becoming active ( multivariate adjusted , 3.37 , 1.67 to 6.78 ) or remaining active ( 7.68 , 4.18 to 14.09 ) was associated with healthy ageing in comparison with remaining inactive over follow-up . Conclusions Sustained physical activity in older age is associated with improved overall health . Significant health benefits were even seen among participants 
    Output:
    
agent
In this review we found that exercise interventions ( or lifestyle activities ) that improved cardiorespiratory exercise capacity showed the most positive impact on physical health .
CONCLUSIONS Findings suggest that programs should facilitate and support women to participate in regular exercise by embedding physical activity programs in public health initiatives , by developing home-based exercise programs that require few re sources and by creating interventions that can incorporate physical activity within a healthy lifestyle .
The review also suggests that clinicians should consider prescribing exercise in a tailored manner for older women to ensure that it is of a high enough intensity to obtain the positive sustained effects of exercise
***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 determine whether participation in usual moderate-intensity or more-vigorous physical activity ( MVPA ) is associated with physical function performance and to identify sociodemographic , psychosocial , and disease-related covariates that may also compromise physical function performance . DESIGN Cross-sectional analysis of baseline variables of a r and omized controlled intervention trial . SETTING Four academic research centers . PARTICIPANTS Four hundred twenty-four older adults aged 70 to 89 at risk for mobility disability ( scoring < 10 on the Short Physical Performance Battery ( SPPB ) ) and able to complete the 400-m walk test within 15 minutes . MEASUREMENTS  Minutes of MVPA ( dichotomized according to above or below 150 min/wk of MVPA ) assessed according to the Community Healthy Activities Model Program for Seniors question naire , SPPB score , 400-m walk test , sex , body mass index ( BMI ) , depressive symptoms , age , and number of medications . RESULTS The SPPB summary score was associated with minutes of MVPA ( ρ=0.16 , P=.001 ) . In multiple regression analyses , age , minutes of MVPA , number of medications , and depressive symptoms were associated with performance on the composite SPPB ( P<.05 ) . There was an association between 400-m walk time and minutes of MVPA ( ρ=-0.18 ; P<.001 ) . In multiple regression analyses , age , sex , minutes of MVPA , BMI , and number of medications were associated with performance on the 400-m walk test ( P<.05 ) . CONCLUSION Minutes of MVPA , sex , BMI , depressive symptoms , age , and number of medications are associated with physical function performance and should all be taken into consideration in the prevention of mobility disability INTRODUCTION AND PURPOSE Physical inactivity in postmenopausal women contributes to a rise in atherogenic risk factors associated with the metabolic syndrome . Although regular physical activity positively contributes to health , inactivity progressively increases with age . The Dose Response to Exercise in Women aged 45 - 75 yr ( DREW ) study is design ed to investigate the effect of different amounts of exercise training on cardiorespiratory fitness and risk factors for cardiovascular disease ( CVD ) in postmenopausal women at moderately increased risk of CVD . METHODS DREW will recruit 450 sedentary , healthy , postmenopausal women with a body mass index of 25 - 40 kg.m-2 , resting systolic blood pressure ( BP ) of 120 - 159 mm Hg , and a resting diastolic BP of < or = 99 mm Hg . Laboratory and self-report measures completed at baseline and 6 months include maximal oxygen consumption ( .VO2max ) , resting BP , anthropometry , dietary habits , physical activity history , medication use , menstrual history , personal and family medical history , and fasting HDL cholesterol , LDL cholesterol , triglycerides , and glucose . Eligible participants are r and omly assigned to a nonexercise group or one of three exercise groups . Participants exercise 3 to 4x wk-1 at a heart rate equivalent to 50 % of .VO2max expending 4 , 8 , or 12 kcal.kg-1.wk-1 , depending on group assignment . This study will allow quantification of possible dose-response relations ( 50 % , 100 % , and 150 % of the consensus physical activity recommendation ) between exercise training and study outcomes . CONCLUSION DREW can make important contributions to our underst and ing of the effects of physical activity in postmenopausal women and help refine public health and clinical recommendations for this group Background Previous research has mainly targeted older people with high risk of falling . The effectiveness of exercise interventions in older people with mild levels of balance dysfunction remains unexplored . Objective This study evaluated the effectiveness of a home balance and strength exercise intervention in older people systematic ally screened as having mild balance dysfunction . Design This was a community-based , r and omized controlled trial with assessors blinded to group allocation . Participants Study participants were older people who reported concerns about their balance but remained community ambulant ( n=225 ) . After a comprehensive balance assessment , those classified as having mild balance dysfunction ( n=165 ) were r and omized into the trial . Intervention Participants in the intervention group ( n=83 ) received a 6-month physical therapist – prescribed balance and strength home exercise program , based on the Otago Exercise Program and the Visual Health Information Balance and Vestibular Exercise Kit . Participants in the control group ( n=82 ) continued with their usual activities . Outcome Measures Laboratory and clinical measures of balance , mobility , and strength were assessed at baseline and at a 6-month re assessment . Results After 6 months , the intervention group ( n=59 ) significantly improved relative to the control group ( n=62 ) for : the Functional Reach Test ( mean difference=2.95 cm , 95 % confidence interval [CI]=1.75 to 4.15 ) , the Step Test ( 2.10 steps/15 seconds , 95 % CI=1.17 to 3.02 ) , hip abductor strength ( 0.02 , 95 % CI=0.01 to 0.03 ) , and gait step width ( 2.17 cm , 95 % CI=1.23 to 3.11 ) . There were nonsignificant trends for improvement on most other measures . Fourteen participants in the intervention group ( 23.7 % ) achieved balance performance within the normative range following the exercise program , compared with 3 participants ( 4.8 % ) in the control group . Limitations Loss to follow-up ( 26.6 % ) was slightly higher than in some similar studies but was unlikely to have biased the results . Conclusions A physical therapist – prescribed home exercise program targeting balance and strength was effective in improving a number of balance and related outcomes in older people with mild balance impairment OBJECTIVES To reveal distinct longitudinal trajectories in episodic memory over 15 years and to identify demographic , lifestyle , health-related , and genetic predictors of stability or decline . DESIGN Prospect i ve cohort study . SETTING The Betula Project , Umeå , Sweden . PARTICIPANTS One thous and nine hundred fifty-four healthy participants aged 35 to 85 at baseline . MEASUREMENTS Memory was assessed according to vali date d episodic memory tasks in participants from a large population -based sample . Data were analyzed using a r and om-effects pattern-mixture model that considered the effect of attrition over two to four longitudinal sessions .  Logistic regression  was used to determine significant predictors of stability or decline relative to average change in episodic memory . RESULTS Of 1,558 participants with two or more test sessions , 18 % were classified as maintainers and 13 % as decliners , and 68 % showed age-typical average change . More educated and more physically active participants , women , and those living with someone were more likely to be classified as maintainers , as were carriers of the met allele of the catechol-O-methyltransferase gene . Less educated participants , those not active in the labor force , and men were more likely to be classified as decliners , and the apolipoprotein E ~4 allele was more frequent in decliners . CONCLUSION Quantitative , attrition-corrected assessment of longitudinal changes in memory can reveal substantial heterogeneity in aging trajectories , and genetic and lifestyle factors predict such heterogeneity PURPOSE This study was design ed to investigate whether , in a dose-response manner , there would be greater health benefits in a group of postmenopausal women completing 45 minute- vs. 30 minutes of moderate intensity ( 50 % maximal oxygen uptake reserve , VO2R ) exercise 5 days . wk(-1 ) . METHODS Apparently healthy but sedentary postmenopausal women ( n = 33 ) were r and omized to a nonexercise control group , a 30-minute exercise duration group , or a 45-minute exercise duration group . Exercise training was performed 5 days . wk(-1 ) for 12 weeks at 50 % VO2R . Participants were instructed to not change their usual diet throughout the study . RESULTS Twenty-six women completed the study . After 12 weeks , VO2max increased significantly ( p < 0.05 ) in both 30-minute ( 0.20 + /- 0.21 L . min(-1 ) ) and 45-minute ( 0.41 + /- 0.10 L . min(-1 ) ) groups . Repeated measures ANOVA identified a significant interaction between exercise duration and VO2max values ( F = 4.72 , p < 0.05 ) , indicating that VO2max responded differently to 30-minute and 45-minute exercise duration s. Trend analysis showed that body mass , body composition , waist circumference , and high-density lipoprotein cholesterol ( HDL-C ) changed favorably ( p < 0.05 ) across control , 30-minute , and 45-minute groups . CONCLUSIONS Although most health organizations agree that 150 min . wk(-1 ) of physical activity will reduce the risk of all-cause and cardiovascular mortality , few r and omized , controlled studies have examined whether completing more physical activity than the recommended amount will yield additional benefits . Findings from the present study suggest that there is a dose-response relationship between exercise duration and numerous health outcomes in postmenopausal women , including cardiorespiratory fitness , body mass , body composition , waist circumference , and Background Decreased heart rate variability ( HRV ) is associated with a higher risk of mortality . Overall , postmenopausal women have lower levels of HRV than premenopausal women , which may be additionally complicated by lifestyle related behaviors such as physical inactivity and obesity . Though cardiorespiratory exercise training increases HRV , little is known regarding the exercise dose necessary to promote this improvement . Methodology /Principal Findings Our primary aim was to measure HRV in post-menopausal women following 6-months of exercise training . We examined supine resting HRV in 373 post-menopausal women ( 45–75 y ) after 6-months of r and omly assigned and double-blinded administered exercise training exercise training at 50 % , 100 % and 150 % of the NIH Consensus Development Panel 's recommended minimal physical activity level . This corresponded to 4 , 8 , or 12 kcal/kg per week ( KKW ) of energy expenditure . At baseline , we observed no significant differences in HRV or hormone replacement use between treatment groups . However , we did observe that Caucasian women and those taking antidepressant medications had lower levels of baseline HRV . After 6-months of exercise intervention , we observed a dose dependent increase in all parasympathetically derived time and frequency domain measurements across exercise groups after adjustment for age , ethnicity , antidepressants , and baseline rMSSD ( all , P<0.001 ) . For example , the parasympathetic index rMSSD was greater than control ( 23.19±1.0 ) for the 4-KKW ( 25.98±0.8 ; P = 0.14 ) , 8-KKW ( 27.66±1.0 ; P<0.05 ) , and 12-KKW ( 27.40±0.0 ; P<0.05 ) groups at follow-up . Conclusions / Significance Moderate intensity exercise training exercise is sufficient to improve HRV in previously sedentary postmenopausal women in a dose-dependent manner , as 4-KKW is insufficient to improve parasympathetic indices of HRV , while 12-KKW conferred no greater improvement than 8-KKW . Trial Registration Clinical trials.gov NCT Background Physical activity is associated with improved overall health in those people who survive to older ages , otherwise conceptualised as healthy ageing . Previous studies have examined the effects of mid-life physical activity on healthy ageing , but not the effects of taking up activity later in life . We examined the association between  physical activity  and healthy ageing over 8 years of follow-up . Methods Participants were 3454 initially disease-free men and women ( aged 63.7±8.9 years at baseline ) from the English Longitudinal Study of Ageing , a prospect i ve study of community dwelling older adults .  Self-reported physical activity was assessed at baseline ( 2002–2003 ) and through follow-up .  Healthy ageing , assessed at 8 years of follow-up ( 2010 - 2011 ) , was defined as those participants who survived without developing major chronic disease , depressive symptoms , physical or cognitive impairment . Results At follow-up , 19.3 % of the sample was defined as healthy ageing . In comparison with inactive participants , moderate ( OR , 2.67 , 95 % CI 1.95 to 3.64 ) , or vigorous activity ( 3.53 , 2.54 to 4.89 ) at least once a week was associated with healthy ageing , after adjustment for age , sex , smoking , alcohol , marital status and wealth . Becoming active ( multivariate adjusted , 3.37 , 1.67 to 6.78 ) or remaining active ( 7.68 , 4.18 to 14.09 ) was associated with healthy ageing in comparison with remaining inactive over follow-up . Conclusions Sustained physical activity in older age is associated with improved overall health . Significant health benefits were even seen among participants 
    Output:
    