Third COSMOS study links daily multivitamin supplementation to cognitive benefits
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Key takeaways:
- The findings are consistent with those from two previous substudies.
- Daily supplementation could be a “safe and accessible” approach to support cognitive function, an expert said.
Daily multivitamin supplementation was linked to benefits in both memory and cognition, according to a study published in the American Journal of Clinical Nutrition.
“Preserving memory and cognition is a major priority for most older adults,” Chirag M. Vyas, MBBS, MPH, an instructor in clinical investigation at Massachusetts General Hospital, told Healio. “This study found that multivitamin supplements show promise as a safe and accessible approach to supporting cognitive function in aging.”
According to Vyas, the findings are consistent with those previously reported in two separately conducted substudies of the Cocoa Supplement and Multivitamin Outcomes Study (COSMOS), which examined the effects of multivitamin supplementation on cognition through telephone- and web-based assessments.
In the latest study, the researchers evaluated a COSMOS subcohort of 573 participants aged 60 years and older — known as COSMOS-Clinic — who conducted in-person cognitive assessments at baseline and at 2 years.
Vyas and colleagues also conducted a meta-analysis that included more than 5,000 nonoverlapping participants across the three substudies “to evaluate the strength of evidence.”
Among COSMOS-Clinic participants, multivitamin supplementation had “modest” beneficial effects on global cognition scores over 2 years, with a mean difference (MD) in standard deviation units (SU) of 0.06 (95% CI, –0.003 to 0.13) compared with placebo. However, they found “a significantly more favorable change” in episodic memory scores (MD = 0.12 SU [95% CI, 0.002-0.23]).
These benefits were not seen in executive function and attention, they said.
Meanwhile, the meta-analysis confirmed clear benefits of multivitamin supplementation on global cognition scores (MD = 0.07 SU; 95% CI, 0.03-0.11) and episodic memory scores (MD = 0.06 SU; 95% CI, 0.03-0.1).
The researchers explained that there is “biological plausibility” behind the findings: “combinations of vitamins and minerals interact with multiple biological pathways that support cognitive health, and nutritional and micronutrient deficiencies in older adults may elevate risk of cognitive decline,” they said.
Vyas and colleagues explained that the study had its limitations. For example, the cohort had “relatively low racial and ethnic diversity,” limiting the generalizability of the findings. Additionally, whether the benefits derived from the multivitamin supplements used in COSMOS — Centrum Silver — can be seen in other supplements is unknown.
Vyas concluded that further research is warranted to determine who would benefit the most from multivitamins, and to identify “the specific micronutrients contributing the most to the observed benefits and to explore the underlying mechanisms.”
References:
- Third major study finds evidence that daily multivitamin supplements improve memory and slow cognitive aging in older adults. https://www.massgeneralbrigham.org/en/about/newsroom/press-releases/multivitamins-improve-memory-and-slow-cognitive-aging. Published Jan. 18, 2023. Accessed Jan. 18, 2023.
- Vyas C, et al. Am J Clin Nutr. 2024;doi:10.1016/j.ajcnut.2023.12.011.
Perspective
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According to this study's findings, it appears that daily multivitamin supplementation was able to help slow cognitive aging in more than 570 participants. This study was also able to use in-person cognitive assessments, which can pick up smaller changes in cognitive function compared with other more remote methods. Based on the findings from other recent research in this area, this continues to affirm the lifestyle and dietary changes that can help reduce age-related cognitive decline. More specifically, this study showed that multivitamins can benefit both global cognition (executive function, verbal memory, complex attention) and episodic memory (the ability to learn, store and retrieve information throughout the day).
There are, however, some limitations to this study. Based on the population sampled, there does appear to be a lack of racial diversity, which can make it difficult to generalize these findings to the wider population. Another limitation would be the length of this study, because 2 years is a relatively small amount of time when looking at changes in cognitive health. In future research, it would be important to study what specific vitamins and minerals may be contributing to the benefits seen in these findings.
Based on these findings, there is decent preliminary evidence that supplementing with a multivitamin may help older adults' cognitive function. This is something clinicians can have a conversation with patients about, particularly if these patients may struggle to get quality nutrition. Although it's worth considering multivitamins, this should still be seen as a supportive approach to other lifestyle interventions like exercise, stress reduction and staying socially active. It's also important to note that supplementation is not something that should completely replace a healthy, well-balanced diet.
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