Memory boosted with daily multivitamins

Multivitamin supplementation slowed cognitive decline in the elderly, COSMOS Web study showed.

Compared to placebo, participants who took a daily multivitamin/multimineral supplement had significantly better immediate recall at 1 year (P=0.025) and over 4 years of follow-up on average (P=0.011), reported Adam Brickman, PhD, of Columbia University in New York, and co-authors of the American Journal of Clinical Nutrition.

The multivitamins improved memory performance compared to the placebo by the equivalent of 3.1 years of age-related memory change, the researchers estimated. The effect was more pronounced in people with underlying cardiovascular disease.

The results are consistent with data from COSMOS-Spirit, another ancillary COSMOS study which showed that daily multivitamin use led to improved cognition, episodic memory, and executive function. The effects in COSMOS-Mind were also more pronounced in people with a history of cardiovascular disease.

“There is some evidence that people with cardiovascular disease may have lower micronutrient levels that multivitamins can correct, but we don’t really know at this time why the effect is stronger in this group,” Brickman said in a statement.

“Supplementation of any kind should not replace more holistic ways of getting the same micronutrients,” he cautioned. “Although multivitamins are generally safe, people should always consult a doctor before taking them.”

COSMOS-Web was designed to examine the effects of dietary flavanol or multivitamin supplementation on hippocampal-mediated cognition in older adults after 1 year.

“There is converging work that the hippocampus is particularly sensitive to the effects of normal aging and our previous intervention studies with dietary supplements have shown a positive effect on the hippocampus, indexed by both neuroimaging and neuropsychological assessment,” Brickman and colleagues wrote.

The COSMOS-Web cognitive battery included neuropsychological outcome measures designed to be sensitive to cognitive changes typically seen in older adults, they added.

COSMOS-Web has been integrated into the parent COSMOS trial, which tested cocoa flavanols extract versus placebo or Centrum Silver daily multivitamin versus placebo in people 60 years of age and older. (Data on flavanols will be reported in a separate article, the authors noted.) Randomization took place between April 2016 and March 2018.

The primary outcome of COSMOS-Web was performance after 1 year on modified Rey auditory verbal learning (ModRey) immediate recall test of 20 words. Secondary outcomes included change in immediate recall performance of ModRey after 2 and 3 years, retention of ModRey (ratio of delayed recall to immediate recall, which relates to entorhinal cortex function), and performance on tests of recognition of novel objects and executive function. The tests were administered via a web-based platform.

The intention-to-treat analysis included 3,562 participants randomized to receive a multivitamin or placebo who completed at least one follow-up measurement at year 1, 2, or 3. Demographic characteristics and baseline performance measures were similar between groups.

Pill compliance was 94.4% at 6 months and 91.8% at 1 year. In a small subset, researchers evaluated blood samples and confirmed increases in serum folate, vitamin B12, and 25(OH)vitamin D with multivitamin supplementation compared to a placebo.

Compared to those on placebo, participants receiving multivitamin supplementation showed significantly greater improvement in ModRey immediate recall memory from baseline to Year 1. In the multivitamin group, performance improved from an average of 7.10 words at baseline to 7.81 words at 1 year; in the placebo group, it went from 7.21 words to 7.65 words.

Mean memory improvement compared to placebo appeared to be maintained for at least 3 years after baseline. Secondary outcomes did not differ significantly between groups over the years of follow-up.

In participants with a history of cardiovascular disease, the effect versus placebo on ModRey scores was greater at 1 year (mean difference 1.24 words, P=0.009) than for people without underlying cardiovascular disease.

The data confirms growing evidence that nutrition can play a role in brain health.

“The finding that a daily multivitamin improved memory in two separate cognition studies in the COSMOS randomized trial is remarkable, suggesting that multivitamin supplementation holds promise as a safe, accessible and affordable approach to protecting cognitive health. of the elderly,” the co-author said. JoAnn Manson, MD, of Brigham and Women’s Hospital in Boston.

The findings may not apply to all older adults, the researchers acknowledged. The sample consisted primarily of white, educated adults. People had to have a computer and an Internet connection to participate in the study.