Habitual Multivitamin Supplementation May Maintain Cognitive Health in Older Adults

by | Jul 5, 2023 | 2023, Aging, Brain Health, Cognitive Health, Vitamins

Written by Taylor Woosley, Science Writer. Results of the study using data from the COSMOS trial shows that subjects consuming a daily multivitamin supplement had significant improvements in ModRey immediate recall memory scores between baseline and year 1 compared to placebo. 

Aging womanThe global population of people aged 65 and older will dramatically increase between 2019 and 2050, with an estimated increase to reach 1.5 billion by 20501. Around 10-15% of the population over the age of 60 experience mild cognitive impairment, referring to cognitive decline from a previous level of functioning both subjectively and by objective evidence2. The prevalence of MCI increases with age and those with MCI are at a higher risk of progressing to dementia3.

It is necessary to understand the interplay between diet and cognition to reveal the mechanisms involved in cognitive decline in aging4. Nutritional formulations, such as multivitamins, offer opportunity to compensate for nutritional inadequacies with growing evidence that they may also optimize psychological functioning into older age5. Studies investigating brain mapping following supplementation indicate increased functional activity in brain regions related to processing of attention and working memory during cognitive tasks6.

Yeung et al. conducted a study to report on the effects of a multivitamin intervention and multivitamin supplementation on hippocampus-mediated cognition in older adults following 1 year of intervention using data from the COSMOS-Web. The COSMOS-Web study is an ancillary study to the COSMOS trial, which focused on observing the effects of daily multivitamin supplementation and cocoa extract for 3 years. The primary outcome of the COSMOS-Web study was changes in performance on the immediate recall trial of the ModRey test following 1 year of intervention. Secondary outcomes were changes in ModRey immediate recall performance after 2 and 3 years, ModRey retention, performance on tests of novel object recognition, and executive function.

Participants in the study completed a baseline COSMOS-Web assessment during the placebo run-in period to analyze compliance and eligibility before randomization. Subjects were randomly assigned to either the multivitamin intervention (n = 1962) or the placebo intervention (n = 1998). Annual assessment follow-ups were completed for 3 years after the baseline assessment. Self-administered COSMOS-Web cognitive battery tests were collected to measure neuropsychological outcomes. Three neuropsychological instruments were utilized and included the one-trial ModRey using recall tasks to measure episodic memory, the short-form ModBent which tests for novel object recognition, and the Color/Directional Flanker to measure executive control.

An intention-to-treat (ITT) analysis was utilized and included randomly assigned participants (n=3562, 90.0%) who had a baseline plus ≥1 follow-up measurement. The ratio of subjects included in the ITT analysis was similar between treatment groups [n = 1758 of 1962 (89.6%) multivitamin group; n = 1804 of 1998 (90.3%) placebo group]. Completion of follow-up measurements for ModRey at years 1, 2, and 3 among the ITT sample was 95.3%, 87.3%, and 82.9%. Linear mixed-effects models were utilized for differences between treatment groups in changes in the primary outcome from baseline to 1 year follow-up visit within the ITT sample, the nonoverlapping sample, and the per-protocol sample. A linear regression model tested the association between age and baseline ModRey immediate recall scores to estimate the expected memory decline for each year of aging. Significant findings of the study are as follows:

  • Participants in the multivitamin supplementation group had significantly greater improvement in ModRey immediate recall memory between baseline and year 1 compared with the placebo group. The contrast estimate of the multivitamin compared with placebo effect averaged across all 3 years of follow-up shows a significant effect of the multivitamin intervention, suggesting sustained memory improvement of, on average, over ≥3 years post-baseline.
  • Every year of aging was associated with a baseline ModRey immediate recall memory reduction of 0.074 words (B= -0.074; 95%CI: 0.056, 0.092; B= -0.110, p < 0.001).

Results of the study show that daily multivitamin supplementation in older adults for one year improved immediate recall memory. The effect of multivitamin supplementation on memory was shown to be sustained over the 3 years of the study. Study limitations include the lack of generalizability of results to a more diverse population and the inability to perform a comprehensive clinical assessment of cognitive status at baseline of the study.

Source: Yeung LK, Alschuler DM, Wall M, Luttmann-Gibson H, Copeland T, Hale C, Sloan RP, Sesso HD, Manson JE, Brickman AM. Multivitamin Supplementation Improves Memory in Older Adults: A Randomized Clinical Trial. Am J Clin Nutr. 2023 May 24:S0002-9165(23)48904-6. doi: 10.1016/j.ajcnut.2023.05.011. Epub ahead of print. PMID: 37244291.

© 2023 American Society for Nutrition. Published by Elsevier Inc. All rights reserved.

Click here to read the full text study.

Posted July 5, 2023.

Taylor Woosley studied biology at Purdue University before becoming a 2016 graduate of Columbia College Chicago with a major in Writing. She currently resides in Glen Ellyn, IL.

References:

  1. Tse ZCK, Cao Y, Ogilvie JM, Chau BKH, Ng DHC, Shum DHK. Prospective Memory Training in Older Adults: A Systematic Review and Meta-Analysis. Neuropsychol Rev. Jun 2023;33(2):347-372. doi:10.1007/s11065-022-09536-5
  2. Jia X, Wang Z, Huang F, et al. A comparison of the Mini-Mental State Examination (MMSE) with the Montreal Cognitive Assessment (MoCA) for mild cognitive impairment screening in Chinese middle-aged and older population: a cross-sectional study. BMC Psychiatry. Oct 4 2021;21(1):485. doi:10.1186/s12888-021-03495-6
  3. Li H, Su W, Dang H, et al. Exercise Training for Mild Cognitive Impairment Adults Older Than 60: A Systematic Review and Meta-Analysis. Journal of Alzheimer’s disease : JAD. 2022;88(4):1263-1278. doi:10.3233/jad-220243
  4. Denniss RJ, Barker LA, Day CJ. Improvement in Cognition Following Double-Blind Randomized Micronutrient Interventions in the General Population. Frontiers in behavioral neuroscience. 2019;13:115. doi:10.3389/fnbeh.2019.00115
  5. Young LM, Gauci S, Arnoldy L, et al. Investigating the Effects of a Multinutrient Supplement on Cognition, Mood and Biochemical Markers in Middle-Aged Adults with ‘Optimal’ and ‘Sub-Optimal’ Diets: A Randomized Double Blind Placebo Controlled Trial. Nutrients. Nov 29 2022;14(23)doi:10.3390/nu14235079
  6. Sarris J, Mehta B, Óvári V, Ferreres Giménez I. Potential mental and physical benefits of supplementation with a high-dose, B-complex multivitamin/mineral supplement: What is the evidence? Nutr Hosp. Dec 9 2021;38(6):1277-1286. Posibles beneficios mentales y físicos de la suplementación con un preparado multivitamínico/mineral del complejo B en dosis altas: ¿Qué evidencia hay? doi:10.20960/nh.03631