Taking a daily multivitamin may improve cognitive function in older people, a study in Alzheimer’s & Dementia has found. Taking a cocoa supplement, however, does not appear to slow cognitive decline.
“There is an urgent need to identify effective strategies to preserve cognitive function to mitigate the heavy societal burden associated with Alzheimer’s disease and related dementia, which affect more than 46 million people worldwide,” wrote Laura D. Baker, Ph.D., of Wake Forest University School of Medicine and colleagues. Cocoa extract is rich in compounds called flavanols, and previous small studies suggest that these compounds may positively impact cognition.
Baker and colleagues analyzed data from 2,262 people aged 65 years or older who enrolled in the COcoa Supplement and Multivitamin Outcomes Study for the Mind (COSMOS-Mind) between August 2016 and August 2017. COSMOS-Mind is an ancillary study to a larger trial that investigated whether taking a daily cocoa extract supplement or a daily multivitamin-mineral supplement reduces the risk of developing heart disease, stroke, cancer, and other health outcomes. In the parent study, participants were randomized to one of four groups: Cocoa extract and placebo, multivitamin and placebo, cocoa extract and multivitamin, or placebo and placebo.
Participants in the COSMOS-Mind study (60% women, 89% non-Hispanic White), completed a baseline cognitive assessment over the phone and were scored on their verbal fluency, ability to recall stories, ability to put numbers in order, and other skills. The researchers then followed the participants with yearly cognitive assessments over the phone for three years. Of the enrolled participants, 92% completed the cognitive assessment at Year 1, 84% at Year 2, 79% at year three, and 77% in all three years.
Cognitive decline slowed 60%, or by 1.8 years, in participants who took the multivitamin compared with those who did not, the researchers estimated. Furthermore, the benefits of taking the multivitamin were more pronounced in people who had significant cardiovascular disease (CVD), a population that already has an above-average risk for cognitive decline, compared with people who did not have CVD.
“One account for this finding relates to the potential treatment-related improvement in micronutrient levels in CVD-compromised individuals, which could, in turn, have beneficial consequences for brain health,” Baker and colleagues wrote. They noted that people with CVD often have deficiencies in vitamin D, which predicts the severity of CVD, and vitamin K, which is linked to coronary artery calcification and increased risk of CVD-related death.
“COSMOS-Mind provides the first evidence from a large-scale, long-term, pragmatic [randomized, controlled trial] to suggest that daily use of a safe, readily accessible, and relatively low-cost [multivitamin] supplement has the potential to improve or protect cognitive function for older women and men,” the researchers wrote. “An additional trial is needed to confirm these findings in a more representative cohort and to explore potential mechanisms for cognitive benefit.”
For related information, see The American Journal of Psychiatry article “Dementia Is More Than Memory Loss: Neuropsychiatric Symptoms of Dementia and Their Nonpharmacological and Pharmacological Management.”
(Image: iStock/stefanamer)
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