Laura D. Baker, PhD, a professor of gerontology and geriatric medicine at Wake Forest University, and colleagues assessed whether the daily administration of cocoa extract - containing 500 mg of flavanols - as well as the daily administration of a commercial multivitamin-mineral improved cognition in older adults.
Baker and colleagues conducted a large randomized two-by-two factorial 3-year trial that included 2,262 participants (mean age, 73 years; 60% female).
Primary outcomes were assessed through a global cognition composite formed from mean standardized scores from individual tests, including telephone interviews of cognitive status, word list and story recall, oral trail-making, verbal fluency, number span and digit ordering. Secondary outcomes were evaluated by change in composite with 3 years of multivitamin supplementation.
The researchers reported cocoa extract had no effect on global cognition (mean change score, 0.03; 95% CI, -0.02 to 0.08).
However, daily multivitamin supplementation, compared with placebo, showed a statistically significant benefit on global cognition (mean change score, 0.07; 95% CI, 0.02-0.12), and was most pronounced in those with a history of cardiovascular disease (no history, 0.06; 95% CI, 0.01-0.11; history, 0.14; 95% CI, -0.02 to 0.31).
Additionally, daily multivitamin supplementation was linked to relative improvements for both episodic memory (mean change score, 0.06; 95% CI, 0.002-0.13) and executive function (0.06; 95% 0.01-0.11).
According to Alzheimer's Association Chief Science Officer Maria C. Carrillo, PhD, this is the first positive, large-scale, long-term study that shows daily multivitamin supplementation may slow cognitive aging in older adults.
"While the Alzheimer's Association is 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," Carrillo said in a released statement that accompanied the study. "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."
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