Multivitamin-Mineral Supplementation Prevents Cognitive Decline in Older Adults

Multivitamin-mineral supplements vs placebo are beneficial in preventing cognitive decline among older adults, according to study findings published in the American Journal of Clinical Nutrition.

There is currently a lack of evidence on the long-term effects of multivitamin-mineral supplementation on cognitive function, assessed using detailed neuropsychologic assessments.

Using data from the Cocoa Supplement and Multivitamin Outcomes Study (COSMOS, COSMOS-Mind, and COSMOS-Web; ClinicalTrials.gov Identifiers: NCT02422745, NCT03035201, and NCT04582617, respectively), researchers evaluated the role of multivitamin-mineral supplementation in cognition among older adults.

The COSMOS trials included participants aged 60 and older who were randomly assigned to receive a cocoa extract (500 mg flavanols/day) and/or a daily multivitamin-mineral supplement for the prevention of cardiovascular disease and cancer.

Participants from the COSMOS trials who completed cognitive tests and received detailed neuropsychologic evaluations were included in the current analysis (COSMOS-Clinic). In addition, the researchers conducted a meta-analysis that included nonoverlapping participants across 3 COSMOS substudies (COSMOS-Clinic, -Mind, and -Web).  

Primary study outcome was cognition scores; secondary outcomes were episodic memory and executive function/attention scores.

A total of 573 of the 603 participants enrolled in the COSMOS-Clinic substudy completed the neuropsychologic evaluations at baseline, of whom 492 (85.9%) completed all assessments at 2 years, as well. Of the 573 participants, 272 received multivitamin-mineral supplements and 301 received placebo. Mean age of participants was 69, and the majority in both groups were men.

Compared with participants who received placebo, those who received multivitamin-mineral supplements had favorable changes in global cognition at 2 years from baseline (mean difference, 0.06 standard deviation units [SU]; 95% CI, -0.003 to 0.13 SU).

Treatment with multivitamin-mineral supplements vs placebo also led to statistically significant changes from baseline to 2 years in episodic memory (mean difference, 0.12 SU; 0.002-0.23 SU), but not executive function (mean difference, 0.04 SU; 95% CI, -0.04 to 0.11 SU).

As age is a predictor of cognitive decline, the researchers conducted a multivariable analysis that showed multivitamin-mineral supplements vs placebo for 2 years resulted in 4.8 years lesser aging in episodic memory.

A total of 573, 2158, and 2472 participants from the COSMOS-Clinic, -Mind, and -Web substudies, respectively, were included in the meta-analysis.

Multivitamin-mineral supplementation was superior to placebo in both global cognition and episodic memory (mean difference, 0.07 SU; 0.03-0.11 SU and 0.06 SU; 0.03-0.10 SU; P <.0009 and P <.0007, respectively).

Study limitations included the lack of generalizability; the inability to determine whether specific vitamins or minerals contributed to cognition; and the lack of controlling for errors in secondary outcomes and subgroup analyses in COSMOS-Clinic.

“Our findings warrant consideration by clinical guidelines committees for the role of daily MVM [multivitamin-mineral] use in preventing cognitive decline in older adults,” the researchers concluded.

Disclosure: Multiple study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of the authors’ disclosures.