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: INTRODUCTION Resistance training has been well established as an effective treatment strategy to increase skeletal muscle mass and strength in the elderly . We assessed whether dietary protein supplementation can further augment the adaptive response to prolonged resistance-type exercise training in healthy elderly men and women . METHODS Healthy elderly men ( n = 31 , 70 ± 1 yr ) and women ( n = 29 , 70 ± 1 yr ) were r and omly assigned to a progressive , 24-wk resistance-type exercise training program with or without additional protein supplementation ( 15 g·d-1 ) . Muscle hypertrophy was assessed on a whole-body Dual-energy X-ray absorptiometry ( DXA ) , limb ( computed tomography ) , and muscle fiber ( biopsy ) level . Strength was assessed regularly by 1-repetition maximum ( RM ) strength testing . Functional capacity was assessed with a sit-to-st and and h and grip test . RESULTS One-RM strength increased by 45 % ± 6 % versus 40 % ± 3 % ( women ) and 41 % ± 4 % versus 44 % ± 3 % ( men ) in the placebo versus protein group , respectively ( P < 0.001 ) , with no differences between groups . Leg muscle mass ( women , 4 % ± 1 % vs 3 % ± 1 % ; men , 3 % ± 1 % vs 3 % ± 1 % ) and quadriceps cross-sectional area ( women , 9 % ± 1 % vs 9 % ± 1 % ; men , 9 % ± 1 % vs 10 % ± 1 % ) increased similarly in the placebo versus protein groups ( P < 0.001 ) . Type II muscle fiber size increased over time in both placebo and protein groups ( 25 % ± 13 % vs 30 % ± 9 % and 23 % ± 12 % vs 22 % ± 10 % in the women and men , respectively ) . Sit-to-st and improved by 18 % ± 2 % and 19 % ± 2 % in women and men , respectively ( P < 0.001 ) . CONCLUSION Prolonged resistance-type exercise training increases skeletal muscle mass and strength , augments functional capacity , improves glycemia and lipidemia , and reduces blood pressure in healthy elderly men and women .  Additional protein supplementation ( 15 g·d-1 ) does not further increase muscle mass , strength , and /or functional capacity Background There is emerging evidence of the role of certain nutrients as risk factors for frailty . However , people eat food , rather than nutrients , and no previous study has examined the association between dietary patterns empirically derived from food consumption and the risk of frailty in older adults . Methods This is a prospect i ve cohort study of 1,872 non-institutionalized individuals aged ≥60 years recruited between 2008 and 2010 . At baseline , food consumption was obtained with a vali date d diet history and , by using factor analysis , two dietary patterns were identified : a ‘ prudent ’ pattern , characterized by high intake of olive oil and vegetables , and a ‘ Westernized ’ pattern , with a high intake of refined bread , whole dairy products , and red and processed meat , as well as low consumption of fruit and vegetables . Participants were followed-up until 2012 to assess incident frailty , defined as at least three of the five Fried criteria ( exhaustion , weakness , low physical activity , slow walking speed , and unintentional weight loss ) . Results Over a 3.5-year follow-up , 96 cases of incident frailty were ascertained . The multivariate odds ratios ( 95 % confidence interval ) of frailty among those in the first ( lowest ) , second , and third tertile of adherence to the prudent dietary pattern were 1 , 0.64 ( 0.37–1.12 ) , and 0.40 ( 0.2–0.81 ) , respectively ; P-trend = 0.009 . The corresponding values for the Westernized pattern were 1 , 1.53 ( 0.85–2.75 ) , and 1.61 ( 0.85–3.03 ) ; P-trend = 0.14 . Moreover , a greater adherence to the Westernized pattern was associated with an increasing risk of slow walking speed and weight loss . Conclusions In older adults , a prudent dietary pattern showed an inverse dose-response relationship with the risk of frailty while a Westernized pattern had a direct relationship with some of their components . Clinical trials should test whether a prudent pattern is effective in preventing or delaying frailty Adherence to a Mediterranean-style diet is associated with a lower risk for mortality , cognitive decline , and dementia . Whether adherence to a Mediterranean-style diet protects against age-related frailty is unclear . Therefore , our objective was to examine the association between a Mediterranean-style diet with the risk of frailty in community-dwelling older persons . We conducted longitudinal analyses using data from 690 community-living persons ( ≥65 y ) who were r and omly selected from a population registry in Tuscany , Italy . Participants of the Invecchiare in Chianti study of aging completed the baseline examination in 1998 - 2000 and were re-examined at least once over 6 y. Adherence to a Mediterranean-style diet ( scored 0 - 9 , modeled categorically as ≤3 , 4 - 5 , and ≥6 ) was computed from the European Prospect i ve Investigation into Cancer and nutrition FFQ previously vali date d in this cohort . Frailty was defined as having at least 2 of the following criteria : poor muscle strength , feeling of exhaustion , low walking speed , and low physical activity . After a 6-y follow-up , higher adherence ( score ≥6 ) to a Mediterranean-style diet was associated with lower odds of developing frailty [ OR = 0.30 ( 95 % CI : 0.14 , 0.66 ) ] compared with those with lower adherence ( score ≤3 ) . A higher adherence to a Mediterranean-style diet at baseline was also associated with a lower risk of low physical activity ( OR = 0.62 ; 95 % CI : 0.40 , 0.96 ) and low walking speed [ OR = 0.48 ( 95 % CI : 0.27 , 0.86 ) ] but not with feelings of exhaustion and poor muscle strength . In community-dwelling older adults , higher adherence to a Mediterranean-style diet was inversely associated with the development of frailty OBJECTIVE To determine the validity and reliability of a rapidly administered neurocognitive screening battery consisting of 4 brief tests ( Enhanced Cued Recall , Temporal Orientation , Verbal Fluency , and Clock Drawing ) to distinguish between patients with probable Alzheimer 's disease ( AD ) and healthy control subjects . SUBJECTS Sixty successive referrals to the Memory Disorders Clinic at Southwestern Vermont Medical Center , Bennington , who were diagnosed as having probable AD and 60 community-dwelling volunteers of comparable age , sex distribution , and education . DESIGN Interrater and test-retest reliability , intergroup comparisons between patients with AD and control subjects on the 4 individual tests , and determination of probability of dementia for patients with AD and control subjects using the entire battery of tests . SETTING Outpatient care . MAIN OUTCOME MEASURE Comparison of the probability of dementia on the 7 Minute Screen  with the criterion st and ard of clinical diagnosis established by examination and laboratory studies . SECONDARY OUTCOME MEASURES Test-retest and interrater reliability ( correlation coefficients ) , time for administration . RESULTS Mean time of administration was 7 minutes 42 seconds . Mean scores for patients with AD and control subjects on all 4 individual tests were significantly different ( for each , P<.001 ) . When the 4 tests were combined in a logistic regression , the battery had a sensitivity of 100 % and a specificity of 100 % . A series of 1000 repeated r and om sample s of 30 patients with AD and 30 control subjects taken from the overall sample of 60 patients with AD and 60 control subjects had a mean sensitivity of 92 % and a mean specificity of 96 % . The battery was equally sensitive to patients with mild AD as demonstrated by correctly classifying all 13 patients with AD using Mini-Mental State Examination scores of 24 or higher . Neither age nor education was a statistically significant factor when added as a covariate . Test-retest reliabilities for individual tests ranged from 0.83 to 0.93 . Test-retest reliability for the entire battery was 0.91 . Interrater reliability for the entire battery was 0.92 . CONCLUSIONS The 7 Minute Screen appears highly sensitive to AD and may be useful in helping to make initial distinctions between patients experiencing cognitive changes related to the normal aging process and those experiencing cognitive deficits related to dementing disorders such as AD . It has reasonable interrater and test-retest reliability , can be administered in a brief period , and requires no clinical judgment and minimal training BACKGROUND Adherence to a Mediterranean diet may improve longevity , but relevant data are limited . METHODS We conducted a population -based , prospect i ve investigation involving 22,043 adults in Greece who completed an extensive , vali date d , food-frequency question naire at base line .  Adherence to the traditional Mediterranean diet was assessed by a 10-point Mediterranean-diet scale that incorporated the salient characteristics of this diet ( range of scores , 0 to 9 , with higher scores indicating greater adherence ) . We used proportional-hazards regression to assess the relation between adherence to the Mediterranean diet and total mortality , as well as mortality due to coronary heart disease and mortality due to cancer , with adjustment for age , sex , body-mass index , physical-activity level , and other potential confounders . RESULTS During a median of 44 months of follow-up , there were 275 deaths . A higher degree of adherence to the Mediterranean diet was associated with a reduction in total mortality ( adjusted hazard ratio for death associated with a two-point increment in the Mediterranean-diet score , 0.75 [ 95 percent confidence interval , 0.64 to 0.87 ] ) . An inverse association with greater adherence to this diet was evident for both death due to coronary heart disease ( adjusted hazard ratio , 0.67 [ 95 percent confidence interval , 0.47 to 0.94 ] ) and death due to cancer ( adjusted hazard ratio , 0.76 [ 95 percent confidence interval , 0.59 to 0.98 ] ) . Associations between individual food groups contributing to the Mediterranean-diet score and total mortality were generally not significant . CONCLUSIONS Greater adherence to the traditional Mediterranean diet is associated with a significant reduction in total mortality CONTEXT Higher adherence to a Mediterranean-type diet is linked to lower risk for mortality and chronic diseases , but its association with cognitive decline is unclear . OBJECTIVE To investigate the association of a Mediterranean diet with change in cognitive performance and risk for dementia in elderly French persons . DESIGN , SETTING , AND PARTICIPANTS Prospect i ve cohort study of 1410 adults ( > or = 65 years ) from Bordeaux , France , included in the Three-City cohort in 2001 - 2002 and reexamined at least once over 5 years .  Adherence to a Mediterranean diet ( scored as 0 to 9 ) was computed from a food frequency question naire and 24-hour recall . MAIN OUTCOME MEASURES Cognitive performance was assessed on 4 neuropsychological tests : the Mini-Mental State Examination ( MMSE ) , Isaacs Set Test ( IST ) , Benton Visual Retention Test ( BVRT ) , and Free and Cued Selective Reminding Test ( FCSRT ) . Incident cases of dementia ( n = 99 ) were vali date d by an independent expert committee of neurologists . RESULTS Adjusting for age , sex , education , marital status , energy intake , physical activity , depressive symptomatology , taking 5 medications/d or more , apolipoprotein E genotype , cardiovascular risk factors , and stroke , higher Mediterranean diet score was associated with fewer MMSE errors ( beta = -0.006 ; 95 % confidence interval [ CI ] , -0.01 to -0.0003 ; P = .04 for 1 point of the Mediterranean diet score ) . Performance on the IST , BVRT , or FCSRT over time was not significantly associated with Mediterranean diet adherence . Greater adherence as a categorical variable ( score 6 - 9 ) was not significantly associated with fewer MMSE errors and better FCSRT scores in the entire cohort , but among individuals who remained free from dementia over 5 years , the association for the highest compared with the lowest group was significant ( adjusted for all factors , for MMSE : beta = -0.03 ; 95 % CI , -0.05 to -0.001 ; P = .04 ; for FCSRT : beta = 0.21 ; 95 % CI , 0.008 to 0.41 ; P = .04 ) . Mediterranean diet adherence was not associated with the risk for incident dementia ( fully adjusted model : hazard ratio , 1.12 ; 95 % CI , 0.60 to 2.10 ; P = .72 ) , although power to detect a difference was limited . CONCLUSIONS Higher adherence to a Mediterranean diet was associated with slower MMSE cognitive decline but not consistently with other cognitive tests . Higher adherence was not associated 
    Output:
    
agent
***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: INTRODUCTION Resistance training has been well established as an effective treatment strategy to increase skeletal muscle mass and strength in the elderly . We assessed whether dietary protein supplementation can further augment the adaptive response to prolonged resistance-type exercise training in healthy elderly men and women . METHODS Healthy elderly men ( n = 31 , 70 ± 1 yr ) and women ( n = 29 , 70 ± 1 yr ) were r and omly assigned to a progressive , 24-wk resistance-type exercise training program with or without additional protein supplementation ( 15 g·d-1 ) . Muscle hypertrophy was assessed on a whole-body Dual-energy X-ray absorptiometry ( DXA ) , limb ( computed tomography ) , and muscle fiber ( biopsy ) level . Strength was assessed regularly by 1-repetition maximum ( RM ) strength testing . Functional capacity was assessed with a sit-to-st and and h and grip test . RESULTS One-RM strength increased by 45 % ± 6 % versus 40 % ± 3 % ( women ) and 41 % ± 4 % versus 44 % ± 3 % ( men ) in the placebo versus protein group , respectively ( P < 0.001 ) , with no differences between groups . Leg muscle mass ( women , 4 % ± 1 % vs 3 % ± 1 % ; men , 3 % ± 1 % vs 3 % ± 1 % ) and quadriceps cross-sectional area ( women , 9 % ± 1 % vs 9 % ± 1 % ; men , 9 % ± 1 % vs 10 % ± 1 % ) increased similarly in the placebo versus protein groups ( P < 0.001 ) . Type II muscle fiber size increased over time in both placebo and protein groups ( 25 % ± 13 % vs 30 % ± 9 % and 23 % ± 12 % vs 22 % ± 10 % in the women and men , respectively ) . Sit-to-st and improved by 18 % ± 2 % and 19 % ± 2 % in women and men , respectively ( P < 0.001 ) . CONCLUSION Prolonged resistance-type exercise training increases skeletal muscle mass and strength , augments functional capacity , improves glycemia and lipidemia , and reduces blood pressure in healthy elderly men and women .  Additional protein supplementation ( 15 g·d-1 ) does not further increase muscle mass , strength , and /or functional capacity Background There is emerging evidence of the role of certain nutrients as risk factors for frailty . However , people eat food , rather than nutrients , and no previous study has examined the association between dietary patterns empirically derived from food consumption and the risk of frailty in older adults . Methods This is a prospect i ve cohort study of 1,872 non-institutionalized individuals aged ≥60 years recruited between 2008 and 2010 . At baseline , food consumption was obtained with a vali date d diet history and , by using factor analysis , two dietary patterns were identified : a ‘ prudent ’ pattern , characterized by high intake of olive oil and vegetables , and a ‘ Westernized ’ pattern , with a high intake of refined bread , whole dairy products , and red and processed meat , as well as low consumption of fruit and vegetables . Participants were followed-up until 2012 to assess incident frailty , defined as at least three of the five Fried criteria ( exhaustion , weakness , low physical activity , slow walking speed , and unintentional weight loss ) . Results Over a 3.5-year follow-up , 96 cases of incident frailty were ascertained . The multivariate odds ratios ( 95 % confidence interval ) of frailty among those in the first ( lowest ) , second , and third tertile of adherence to the prudent dietary pattern were 1 , 0.64 ( 0.37–1.12 ) , and 0.40 ( 0.2–0.81 ) , respectively ; P-trend = 0.009 . The corresponding values for the Westernized pattern were 1 , 1.53 ( 0.85–2.75 ) , and 1.61 ( 0.85–3.03 ) ; P-trend = 0.14 . Moreover , a greater adherence to the Westernized pattern was associated with an increasing risk of slow walking speed and weight loss . Conclusions In older adults , a prudent dietary pattern showed an inverse dose-response relationship with the risk of frailty while a Westernized pattern had a direct relationship with some of their components . Clinical trials should test whether a prudent pattern is effective in preventing or delaying frailty Adherence to a Mediterranean-style diet is associated with a lower risk for mortality , cognitive decline , and dementia . Whether adherence to a Mediterranean-style diet protects against age-related frailty is unclear . Therefore , our objective was to examine the association between a Mediterranean-style diet with the risk of frailty in community-dwelling older persons . We conducted longitudinal analyses using data from 690 community-living persons ( ≥65 y ) who were r and omly selected from a population registry in Tuscany , Italy . Participants of the Invecchiare in Chianti study of aging completed the baseline examination in 1998 - 2000 and were re-examined at least once over 6 y. Adherence to a Mediterranean-style diet ( scored 0 - 9 , modeled categorically as ≤3 , 4 - 5 , and ≥6 ) was computed from the European Prospect i ve Investigation into Cancer and nutrition FFQ previously vali date d in this cohort . Frailty was defined as having at least 2 of the following criteria : poor muscle strength , feeling of exhaustion , low walking speed , and low physical activity . After a 6-y follow-up , higher adherence ( score ≥6 ) to a Mediterranean-style diet was associated with lower odds of developing frailty [ OR = 0.30 ( 95 % CI : 0.14 , 0.66 ) ] compared with those with lower adherence ( score ≤3 ) . A higher adherence to a Mediterranean-style diet at baseline was also associated with a lower risk of low physical activity ( OR = 0.62 ; 95 % CI : 0.40 , 0.96 ) and low walking speed [ OR = 0.48 ( 95 % CI : 0.27 , 0.86 ) ] but not with feelings of exhaustion and poor muscle strength . In community-dwelling older adults , higher adherence to a Mediterranean-style diet was inversely associated with the development of frailty OBJECTIVE To determine the validity and reliability of a rapidly administered neurocognitive screening battery consisting of 4 brief tests ( Enhanced Cued Recall , Temporal Orientation , Verbal Fluency , and Clock Drawing ) to distinguish between patients with probable Alzheimer 's disease ( AD ) and healthy control subjects . SUBJECTS Sixty successive referrals to the Memory Disorders Clinic at Southwestern Vermont Medical Center , Bennington , who were diagnosed as having probable AD and 60 community-dwelling volunteers of comparable age , sex distribution , and education . DESIGN Interrater and test-retest reliability , intergroup comparisons between patients with AD and control subjects on the 4 individual tests , and determination of probability of dementia for patients with AD and control subjects using the entire battery of tests . SETTING Outpatient care . MAIN OUTCOME MEASURE Comparison of the probability of dementia on the 7 Minute Screen  with the criterion st and ard of clinical diagnosis established by examination and laboratory studies . SECONDARY OUTCOME MEASURES Test-retest and interrater reliability ( correlation coefficients ) , time for administration . RESULTS Mean time of administration was 7 minutes 42 seconds . Mean scores for patients with AD and control subjects on all 4 individual tests were significantly different ( for each , P<.001 ) . When the 4 tests were combined in a logistic regression , the battery had a sensitivity of 100 % and a specificity of 100 % . A series of 1000 repeated r and om sample s of 30 patients with AD and 30 control subjects taken from the overall sample of 60 patients with AD and 60 control subjects had a mean sensitivity of 92 % and a mean specificity of 96 % . The battery was equally sensitive to patients with mild AD as demonstrated by correctly classifying all 13 patients with AD using Mini-Mental State Examination scores of 24 or higher . Neither age nor education was a statistically significant factor when added as a covariate . Test-retest reliabilities for individual tests ranged from 0.83 to 0.93 . Test-retest reliability for the entire battery was 0.91 . Interrater reliability for the entire battery was 0.92 . CONCLUSIONS The 7 Minute Screen appears highly sensitive to AD and may be useful in helping to make initial distinctions between patients experiencing cognitive changes related to the normal aging process and those experiencing cognitive deficits related to dementing disorders such as AD . It has reasonable interrater and test-retest reliability , can be administered in a brief period , and requires no clinical judgment and minimal training BACKGROUND Adherence to a Mediterranean diet may improve longevity , but relevant data are limited . METHODS We conducted a population -based , prospect i ve investigation involving 22,043 adults in Greece who completed an extensive , vali date d , food-frequency question naire at base line .  Adherence to the traditional Mediterranean diet was assessed by a 10-point Mediterranean-diet scale that incorporated the salient characteristics of this diet ( range of scores , 0 to 9 , with higher scores indicating greater adherence ) . We used proportional-hazards regression to assess the relation between adherence to the Mediterranean diet and total mortality , as well as mortality due to coronary heart disease and mortality due to cancer , with adjustment for age , sex , body-mass index , physical-activity level , and other potential confounders . RESULTS During a median of 44 months of follow-up , there were 275 deaths . A higher degree of adherence to the Mediterranean diet was associated with a reduction in total mortality ( adjusted hazard ratio for death associated with a two-point increment in the Mediterranean-diet score , 0.75 [ 95 percent confidence interval , 0.64 to 0.87 ] ) . An inverse association with greater adherence to this diet was evident for both death due to coronary heart disease ( adjusted hazard ratio , 0.67 [ 95 percent confidence interval , 0.47 to 0.94 ] ) and death due to cancer ( adjusted hazard ratio , 0.76 [ 95 percent confidence interval , 0.59 to 0.98 ] ) . Associations between individual food groups contributing to the Mediterranean-diet score and total mortality were generally not significant . CONCLUSIONS Greater adherence to the traditional Mediterranean diet is associated with a significant reduction in total mortality CONTEXT Higher adherence to a Mediterranean-type diet is linked to lower risk for mortality and chronic diseases , but its association with cognitive decline is unclear . OBJECTIVE To investigate the association of a Mediterranean diet with change in cognitive performance and risk for dementia in elderly French persons . DESIGN , SETTING , AND PARTICIPANTS Prospect i ve cohort study of 1410 adults ( > or = 65 years ) from Bordeaux , France , included in the Three-City cohort in 2001 - 2002 and reexamined at least once over 5 years .  Adherence to a Mediterranean diet ( scored as 0 to 9 ) was computed from a food frequency question naire and 24-hour recall . MAIN OUTCOME MEASURES Cognitive performance was assessed on 4 neuropsychological tests : the Mini-Mental State Examination ( MMSE ) , Isaacs Set Test ( IST ) , Benton Visual Retention Test ( BVRT ) , and Free and Cued Selective Reminding Test ( FCSRT ) . Incident cases of dementia ( n = 99 ) were vali date d by an independent expert committee of neurologists . RESULTS Adjusting for age , sex , education , marital status , energy intake , physical activity , depressive symptomatology , taking 5 medications/d or more , apolipoprotein E genotype , cardiovascular risk factors , and stroke , higher Mediterranean diet score was associated with fewer MMSE errors ( beta = -0.006 ; 95 % confidence interval [ CI ] , -0.01 to -0.0003 ; P = .04 for 1 point of the Mediterranean diet score ) . Performance on the IST , BVRT , or FCSRT over time was not significantly associated with Mediterranean diet adherence . Greater adherence as a categorical variable ( score 6 - 9 ) was not significantly associated with fewer MMSE errors and better FCSRT scores in the entire cohort , but among individuals who remained free from dementia over 5 years , the association for the highest compared with the lowest group was significant ( adjusted for all factors , for MMSE : beta = -0.03 ; 95 % CI , -0.05 to -0.001 ; P = .04 ; for FCSRT : beta = 0.21 ; 95 % CI , 0.008 to 0.41 ; P = .04 ) . Mediterranean diet adherence was not associated with the risk for incident dementia ( fully adjusted model : hazard ratio , 1.12 ; 95 % CI , 0.60 to 2.10 ; P = .72 ) , although power to detect a difference was limited . CONCLUSIONS Higher adherence to a Mediterranean diet was associated with slower MMSE cognitive decline but not consistently with other cognitive tests . Higher adherence was not associated 
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