Daily Multivitamin Use May Support Cognitive Health in Older Adults

Research from the Wake Forest University School of Medicine demonstrates that daily multivitamin-mineral supplementation for 3 years supports global cognition, episodic memory, and executive function in older adults. This study used a multivitamin-mineral that contains 24 micronutrients. The multivitamin-mineral benefit appeared to be greater for adults with cardiovascular conditions. This study provides the first evidence from a large, long-term, pragmatic trial to support the potential efficacy of a multivitamin-mineral to improve cognition in older adults.

“This is the first positive, large-scale, long-term study to show that multivitamin-mineral supplementation for older adults may slow cognitive aging,” said Maria C. Carrillo, Ph.D.

A Myriad of Vitamins and Minerals

The constantly expanding universe of vitamins and minerals for you to choose from for daily supplementation can be overwhelming. There’s a cornucopia of individual micronutrients that target multiple biologic pathways to support body and brain function. Studies of single nutrients — such as folic acid with or without other B vitamins, omega-3 fatty acids, and vitamin D — on cognition have yielded mixed results, which could reflect either no benefit or study design issues that impede cross-study comparisons.

Some of these issues relate to the specific micronutrients tested (alone or in combination), the specific cognitive tests administered, the outcome measure (single test vs. composite score), and participant demographics and nutritional status. Although not without controversy, the conclusion of cross-study comparisons is that the evidence is insufficient to encourage care providers to recommend using individual nutrient supplements for brain health.

Multivitamin-Minerals May Support Cognition in Older Adults

But what about multivitamins-minerals? There is some interesting, albeit very limited, data on multivitamins-minerals supplementation and cognition. Longer-term daily intake (>12 months) of a multivitamin-mineral alone or with other dietary supplements to enhance global cognitive function in older adults (≥65 years) has been examined in just one large randomized controlled trial, which included only male physicians.

For these reasons, Laura Baker and colleagues designed a clinical study to test whether daily treatment with a multivitamin-mineral supplement for 3 years protected cognitive function in older adults. The trial, called COSMOS-Mind, was a large simple pragmatic randomized clinical trial in older adults conducted by mail and telephone. The trial assessed the treatment effects of two different interventions within a single large study.

A total of 2262 participants were enrolled (average age 73), most of which were non-hispanic white (89%). Daily multivitamin-mineral supplementation resulted in a statistically significant benefit on global cognition, and this effect was most pronounced in participants with a history of cardiovascular conditions. Multivitamin-mineral benefits were also observed for memory and executive function.

Additional work is needed to confirm these findings in a more diverse cohort and identify mechanisms for multivitamin-mineral effects. Specifically, an additional trial is needed to confirm these findings in a more representative cohort and to explore potential mechanisms for cognitive benefit.

“While [we are] encouraged by these results, we are not ready to recommend widespread use of a multivitamin supplement to reduce risk of cognitive decline in older adults,” said Carrillo. “Independent confirmatory studies are needed in larger, more diverse study populations. It is critical that future treatments and preventions are effective in all populations. For now, and until there is more data, people should talk with their health care providers about the benefits and risks of all dietary supplements, including multivitamins,” said Carrillo.

Yet, this work may ultimately have important public health implications for the standard of care to improve or protect cognitive function in older adults. “We envision a future where there are multiple treatments and risk reduction strategies available that address cognitive aging … and that can be combined into powerful combination therapies … in conjunction with brain-healthy guidelines for lifestyle factors like diet and physical activity,” said Carrillo.

References:

Baker LD, Manson JE, Rapp SR, et al. Effects of cocoa extract and a multivitamin on cognitive function: A randomized clinical trial. Alz Dement. 2022;10.1002/alz.12767. doi:10.1002/alz.12767