Summary: Researchers found significant cognitive benefits for older adults who took daily multivitamin-mineral supplements.
Source: Alzheimer’s Association
Alzheimer’s & Dementia: The Journal of the Alzheimer’s Association has published “Effects of cocoa extract and a multivitamin on cognitive function: a randomized clinical trial.”
The three-year study of more than 2,200 older adults found that daily multivitamin-mineral supplementation resulted in a statistically significant cognitive benefit.
Cocoa extract had no effect on global cognition.
Maria C. Carrillo, Ph.D., Alzheimer’s Association chief science officer, said of the study: “This is the first positive, large-scale, long-term study to show that multivitamin-mineral supplementation for older adults may slow cognitive aging. While the Alzheimer’s Association is encouraged by these results, we are not ready to recommend widespread use of a multivitamin supplement to reduce risk of cognitive decline in older adults.”
“Independent confirmatory studies are needed in larger, more diverse study populations. It is critical that future treatments and preventions are effective in all populations.”
“For now, and until there is more data, people should talk with their health care providers about the benefits and risks of all dietary supplements, including multivitamins.”
“We envision a future where there are multiple treatments and risk reduction strategies available that address cognitive aging and dementia in multiple ways — like heart disease and cancer — and that can be combined into powerful combination therapies… in conjunction with brain-healthy guidelines for lifestyle factors like diet and physical activity.”
Effects of cocoa extract and a multivitamin on cognitive function: A randomized clinical trial
Dietary supplements are touted for cognitive protection, but supporting evidence is mixed. COSMOS-Mind tested whether daily administration of cocoa extract (containing 500 mg/day flavanols) versus placebo and a commercial multivitamin-mineral (MVM) versus placebo improved cognition in older women and men.
COSMOS-Mind, a large randomized two-by-two factorial 3-year trial, assessed cognition by telephone at baseline and annually. The primary outcome was a global cognition composite formed from mean standardized (z) scores (relative to baseline) from individual tests, including the Telephone Interview of Cognitive Status, Word List and Story Recall, Oral Trail-Making, Verbal Fluency, Number Span, and Digit Ordering. Using intention-to-treat, the primary endpoint was change in this composite with 3 years of cocoa extract use. The pre-specified secondary endpoint was change in the composite with 3 years of MVM supplementation. Treatment effects were also examined for executive function and memory composite scores, and in pre-specified subgroups at higher risk for cognitive decline.
A total of 2262 participants were enrolled (mean age = 73y; 60% women; 89% non-Hispanic White), and 92% completed the baseline and at least one annual assessment. Cocoa extract had no effect on global cognition (mean z-score = 0.03, 95% CI: -0.02 to 0.08; P = .28). Daily MVM supplementation, relative to placebo, resulted in a statistically significant benefit on global cognition (mean z = 0.07, 95% CI 0.02 to 0.12; P = .007), and this effect was most pronounced in participants with a history of cardiovascular disease (no history: 0.06, 95% CI 0.01 to 0.11; history: 0.14, 95% CI -0.02 to 0.31; interaction, nominal P = .01). Multivitamin-mineral benefits were also observed for memory and executive function. The cocoa extract by MVM group interaction was not significant for any of the cognitive composites.
Cocoa extract did not benefit cognition. However, COSMOS-Mind provides the first evidence from a large, long-term, pragmatic trial to support the potential efficacy of a MVM to improve cognition in older adults. Additional work is needed to confirm these findings in a more diverse cohort and to identify mechanisms to account for MVM effects.