Daily use of a multivitamin-mineral supplement was found to improve cognition in older adults, according to findings from a large, randomized 3-year trial.

The COSMOS-Mind study (ClinicalTrials.gov Identifier: NCT03035201) included 2262 participants (mean age, 73 years; 60% women) and evaluated the effects of cocoa extract and multivitamin-mineral supplementation on cognitive function. Participants were randomly assigned to 1 of 4 groups: daily cocoa extract + multivitamin-mineral (Centrum Silver), daily cocoa extract + placebo multivitamin-mineral, daily placebo cocoa extract + multivitamin-mineral, or daily placebo cocoa extract + placebo multivitamin-mineral.

The assessment was conducted via telephone at baseline and then annually for 3 years; 92% of participants completed at least 1 annual assessment. The primary endpoint of the study was the change in a composite measure that combined individual test scores of global cognitive function, memory, and executive function among participants in the cocoa extract group vs the placebo group. The effect of the multivitamin-mineral on global cognitive trajectory was designated as a secondary outcome measure.

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Findings showed no cognitive benefit with daily supplementation of cocoa extract containing 500mg of flavanols (P =.28); however, a statistically significant benefit on global cognition was observed with the daily multivitamin-mineral (P =.007). The effect of multivitamin-mineral use on cognitive function was found to be even greater in participants with a history of cardiovascular disease (CVD). The multivitamin-mineral was also linked to improvements in memory and executive function.

“Although our findings did not support a positive effect of [cocoa extract] (primary endpoint), cognition significantly benefited from 3 years of daily [multivitamin-mineral] use (secondary endpoint),” the study authors concluded. “Moreover, the results of pre-planned subgroup analyses indicated that participants with baseline history of CVD may show a more pronounced [multivitamin-mineral] benefit, suggesting either greater relative improvement or more protection from CVD-related cognitive decline.”

The authors noted that an additional trial would be needed to confirm the results as the study had several limitations including the race and ethnicity of the cohort (89% were non-Hispanic White), the method for tracking adherence (self-reporting), and the inability to determine whether specific components of the multivitamin-mineral contributed to the effect.


Baker LD, Manson JE, et al. Effects of cocoa extract and a multivitamin on cognitive function: A randomized clinical trial. Published online September 14, 2022. Alzheimer’s & Dementia. doi.org/10.1002/alz.12767

This article originally appeared on MPR