0
0
Date: January 20, 2024
A recent meta-analysis of the Cocoa Supplement and Multivitamin Outcomes Study (COSMOS) has generated insights into the potential benefits of daily multivitamin supplementation for the aging brain. The study, involving three separate cognition studies, indicates that a daily multivitamin containing over 20 essential micronutrients may help prevent memory loss and slow down cognitive aging. However, skepticism about the study’s methodology and interpretation of its findings has been expressed by at least one expert.
Chirag Vyas, MBBS, MPH, a study investigator affiliated with Massachusetts General Hospital and Harvard Medical School, emphasized that while they are not currently recommending multivitamin use, the evidence is compelling and supports the promise of multivitamins in preventing cognitive decline.
The COSMOS trial, a large-scale 2 x 2 factorial trial involving over 21,000 US adults aged 60 years or older, investigated the impact of cocoa extract and a daily commercial multivitamin-mineral supplement on cardiovascular disease and cancer prevention. While neither intervention significantly affected cancer or cardiovascular disease events, the cognitive substudies (COSMOS-Mind, COSMOS-Web, and COSMOS-Clinic) explored the potential cognitive benefits.
COSMOS-Mind, involving 2262 participants aged 65 or older without dementia, found no cognitive benefit from daily cocoa extract, but daily multivitamin supplementation was associated with improved global cognition, episodic memory, and executive function.
COSMOS-Web, with 3562 original participants, demonstrated improved immediate memory recall in those taking the multivitamin supplement. However, no improvement was observed in memory retention, executive function, or novel object recognition.
COSMOS-Clinic, an analysis of 573 participants who completed in-person cognitive assessments, showed a modest benefit of multivitamin supplementation on global cognition and episodic memory over 2 years.
The meta-analysis of the three cognitive substudies, involving 5200 nonoverlapping COSMOS participants, indicated “clear evidence” of multivitamin benefits on global cognition and episodic memory, with a magnitude of effect equivalent to reducing cognitive aging by 2 years.
While JoAnn Manson, MD, DrPH, chief of the Division of Preventive Medicine at Brigham and Women’s Hospital, expressed excitement over the findings, some experts urge caution. Christopher Labos, MD CM, MSc, a cardiologist and epidemiologist, pointed out that the evidence on multivitamins for memory and brain health is not overwhelmingly impressive. Labos emphasized that the COSMOS data analysis is not strictly a meta-analysis and warned against recommending multivitamins solely for brain health without considering costs and potential downsides.
Claire Sexton, DPhil, Alzheimer’s Association senior director of scientific programs and outreach, highlighted the need for independent confirmatory studies in larger, more diverse populations. While optimistic about the potential impact on public health, she emphasized the importance of ensuring that future treatments and preventions are effective across all demographics.
The Alzheimer’s Association is currently leading a 2-year clinical trial known as US POINTER, evaluating lifestyle interventions targeting multiple risk factors to protect cognition in older adults at increased risk for cognitive decline. COSMOS-Clinic and the cognition studies in the meta-analysis received support from grants and donations from Mars Edge, a segment of Mars Inc., and the National Institutes of Health.
The debate on the role of multivitamins in brain health continues, with experts emphasizing the need for further research and a cautious approach in recommending their use.
