Daily Multivitamins Improve Memory, Global Cognition of Older Adults

Chirag Vyas, MBBS, MPH

Credit: Massachusetts General Hospital

A third major study found daily multivitamins provided significant benefits for the memory and global condition of older adults.¹

A meta-analysis demonstrated multivitamins improved global cognition by 7% and episodic memory by 6%.

According to the Alzheimer’s Association, nearly 1 in 4 Americans by 2060 will be in the age range with an increased risk of cognitive decline and Alzheimer’s disease. To prevent a high percentage of Americans from having cognitive decline, interventions are needed to preserve cognitive function—and that is where multivitamins come in.

“Cognitive decline is among the top health concerns for most older adults, and a daily supplement of multivitamins has the potential as an appealing and accessible approach to slow cognitive aging,” said investigator and first author Chirag Vyas, MBBS, MPH, from the department of psychiatry at Massachusetts General Hospital (MGH), in a press release.

The COcoa Supplement and Multivitamin Outcomes Study (COSMOS), a nationwide, randomized trial evaluating cocoa extract (500 mg flavanols) and multivitamin supplements, had 2 previously published cognition studies. The study sought to evaluate whether taking daily cocoa extract supplements with cocoa flavanols reduced the risk for heart disease, stroke, cancer, and other health outcomes.² The trial found cocoa flavanol supplement was linked to a 27% reduction in risk of cardiovascular death and a nonsignificant 10% reduction in total cardiovascular events during the 3.6-year follow-up.³

The 2 COSMOS trials also evaluated how flavanol affects cognition in older adults. Using telephone-based cognitive assessments (COSMOS-Mind) and online web-based cognitive assessments (COSMOS-Web), the studies found a positive effect of a daily multivitamin on global cognition over 2 years. The recent third study also found cocoa flavanol has significant benefits versus placebo for memory and global cognition.

Led by JoAnn Manson, MD, DrPH and Howard Sesso, ScD, MPH, both from the Brigham and Women’s Hospital in Boston, the team sought to investigate the longer effects of multivitamin-mineral supplements on the cognition function of older adults aged ≥ 60 years with neuropsychologic assessments. Investigators administered in-person cognitive assessments among 573 participants in the subset of COSMOS called COSMOS-Clinic.

The team also conducted a meta-analysis on 3 separate studies with 5000 non-overlapping COSMOS participants who had 2 to 3 years of treatment. Results showed how multivitamins provide benefits for global cognition and episodic memory over 2 years.

“The finding that a daily multivitamin improved memory and slowed cognitive aging in three separate placebo-controlled studies in COSMOS is exciting and further supports the promise of multivitamins as a safe, accessible and affordable approach to protecting cognitive health in older adults,” Manson said.

In the COSMOS-Clinic, investigators observed the multivitamin benefited global cognition over 2 years (mean difference, 0.06; 95% confidence interval [CI], −0.003 to 0.13) with a greater significant change in episodic memory (mean difference, 0.12; 95% CI, 0.002 to 0.23). The team did not observe significant changes in executive function and attention (mean difference, 0.04; 95% CI, −0.04 to 0.11).4

Likewise, the meta-analysis also demonstrated the multivitamins demonstrated benefits on global cognition (mean difference, 0.07; 95% CI, 0.03 to 0.11); P = .0009] and episodic memory (mean difference, 0.06; 95% CI, 0.03 to 0.10; P = .0007). They found the multivitamin had reduced cognitive aging by 2 years.

“These findings will garner attention among many older adults who are, understandably, very interested in ways to preserve brain health, as they provide evidence for the role of a daily multivitamin in supporting better cognitive aging,” said investigator Olivia Okereke, MD, in the press release.1

^References

1. ^{Third Major Study Finds Evidence that Daily Multivitamin Supplements Improve Memory and Slow Cognitive Aging in Older Adults. News Wise. January 16, 2024. https://www.newswise.com/articles/third-major-study-finds-evidence-that-daily-multivitamin-supplements-improve-memory-and-slow-cognitive-aging-in-older-adults. Accessed January 25, 2024.}
2. ^{Welcome to the COSMOS Trial! COcoa Supplement and Multivitamin Outcomes Study. https://cosmostrial.org/. Accessed January 25, 2024.}
3. ^{Campbell, P. Cocoa Flavanols Supplement Lowers Risk of Cardiovascular Death, Study Finds. HCPLive. March 18, 2022. https://www.hcplive.com/view/cocoa-flavanols-supplement-lowers-risk-of-cardiovascular-death-study-finds. Accessed January 25, 2024.}
4. ^{Vyas CM, Manson JE, Sesso HD, et al. Effect of multivitamin-mineral supplementation versus placebo on cognitive function: Results from the clinic sub-cohort of the COSMOS randomized clinical trial and meta-analysis of three cognitive studies within COSMOS. Am J Clin Nutr. Published online December 21, 2023. doi:10.1016/j.ajcnut.2023.12.011}