Multivitamins, but Not Cocoa, Linked to Slow Brain Aging

Taking a daily multivitamin for 3 years is associated with a 60% slowdown in cognitive aging, with the effects particularly pronounced in patients with cardiovascular disease (CVD), new research suggests.

In addition to testing the effect of daily multivitamin on cognition the COSMOS-Mind study also examined the effect of cocoa flavonols, but showed no beneficial effect.

The findings “may have important public health implications, particularly for brain health, given the accessibility of multivitamins and minerals, and their low cost and safety,” said researcher Laura D. Baker, PhD, professor, Gerontology and Geriatric Medicine, Wake Forest . School of Medicine, Winston-Salem, North Carolina.

The findings were presented at the 14th Clinical Trials on Alzheimer’s Disease (CTAD) conference.

Placebo-Controlled Study

The study is a substitution of a large parental trial that compared the effects of cocoa extract (500 mg / day cocoa flavanols) and standard multivitamin mineral (MVM) to placebo on cardiovascular and cancer outcomes in more than 21,000 older participants.

Dr. Laura Baker

COSMOS-Mind included 2262 adults aged 65 and over without dementia who underwent cognitive tests at baseline and annually for 3 years. The average age at baseline was 73 years, and 40.4% were men. Most participants (88.7%) were non-Hispanic whites and nearly half (49.2%) had some post-college education.

All study groups were balanced with respect to demographics, CVD history, diabetes, depression, smoking status, alcohol consumption, chocolate consumption, and previous multivitamin use. Baseline cognitive scores were also similar between study groups. Researchers had complete data on 77% of study participants.

The main point was the effect of cocoa extract (CE) versus placebo on the synthetic score of Global Cognitive Function. The secondary outcome was the effect of MVM versus placebo on global cognitive function.

Additional findings included the effect of supplements on executive function and memory and the treatment effects for predetermined subgroups, including issues with a history of CVD.

Using a graph of change over time, Baker showed that there is no effect of cocoa on global cognitive function (effect: 0.03; 95% CI, -0.02 to 0.08; P = .28). “We are seeing the expected practical effects, but there is no separation between the active and placebo groups,” she said.

It was a different story for MVM. Here, there was the same practical effect, but the graph showed the lines separated for a global cognitive function composite score (effect: 0.07; 95% CI, 0.02 – 0.12; P = .007).

“We see a positive effect of multivitamins for the active group relative to placebo, peaking at 2 years and then remaining stable over time,” Baker said.

There were similar findings with MVM for the memory-composed score, and the executive function score. “We have meaning in all three where the two lines separate over the practical effects,” Baker said..

New Index

Investigators found a baseline history of CVD, including transient ischemic attack, obstructive heart failure, coronary artery bypass graft, skin translucent coronary angioplasty, and stent, but not myocardial infarction or stroke because these were excluded in the parental test because they affected the response to. multivitamins.

As expected, those with CVD had lower cognitive scores at baseline. “But after an initial swelling due to a practical effect, at year 1, people with a history of cardiovascular disease continue to benefit from multivitamins, while those who received placebo multivitamins continue to decline over time,” Baker said.

Based on information from baseline prevalence of cognitive function scores by age, the modeling of the study estimated that the multivitamin treatment effect had a positive benefit of .028 standard deviations (SD) per year.

“Daily multivitamin-mineral supplementation appears to slow cognitive aging by 60% or by 1.8 years,” Baker added.

To date, the effect of MVM supplementation on cognition has been tested in only one large randomized clinical trial – the Physicians for Health Study II. That study showed no effect, but included only older male doctors – and cognitive testing began 2.5 years after randomization, Baker said.

“Our study provides new evidence that daily multivitamin supplementation may benefit cognitive function in older women and men, and the multivitamin effects may be more pronounced in participants with cardiovascular disease.”

On effects of multivitamins on the prevalence and progression of Alzheimer’s disease, “stay tuned,” Baker concluded.

After the presentation, co-chair of the session Suzanne Schindler, MD, PhD, instructor, Department of Neurology, Washington University School of Medicine, St. Louis, Missouri, said she and her colleagues “always monitor vitamin B12 levels” in patients with memory and cognitive impairments and wondered whether study subjects with low levels or lack of vitamin B12 would benefit from the intervention.

“We ask ourselves that too,” Baker said.

“Some of this is work in progress,” Baker added. “We still have to look at that more deeply to understand if it could be a mechanism for improvement. I think the results are still out on that issue.”

The study received support from the NIH / NIA. Pfizer Consumer Healthcare (now GSK Consumer Healthcare) provided study pills and packaging. Baker did not disclose any relevant financial relationships.

14th Clinical Trials on Alzheimer’s Disease (CTAD) conference: Oral Communications (OC) # 4. Presented November 10, 2021.

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