Effect of multivitamin-mineral supplementation versus placebo on cognitive function: Results from the clinic sub-cohort of the COSMOS randomized clinical trial and meta-analysis of three cognitive studies within COSMOS.
Abstract
BACKGROUND
Longer effects of multivitamin-mineral (MVM) supplementation on late-life cognitive function remain untested using in-person, detailed neuropsychological assessments. Furthermore, insufficient evidence exists for healthcare providers to recommend daily MVM supplements to prevent cognitive decline.
OBJECTIVES
To: 1) test MVM effects on cognitive change using in-person, detailed neuropsychological assessments; 2) conduct a meta-analysis within COSMOS (COcoa Supplement and Multivitamin Outcomes Study) cognitive sub-studies for a robust evaluation of MVM effects on cognition.
DESIGN
COSMOS is a 2x2 factorial trial of cocoa extract [500 mg flavanols/day] and/or a daily multivitamin-mineral supplement for cardiovascular disease and cancer prevention among 21,442 US adults aged ≥60 years. There were 573 participants in the clinic sub-cohort of COSMOS (i.e., COSMOS-Clinic) who completed all cognitive tests administered at baseline. For meta-analysis, we included non-overlapping participants across three COSMOS cognitive sub-studies: COSMOS-Clinic (n=573); COSMOS-Mind (n=2158); COSMOS-Web (n=2472).
RESULTS
In COSMOS-Clinic, we observed a modest benefit of MVM, compared to placebo, on global cognition over 2 years [mean difference (95% confidence interval (CI))=0.06 standard deviation units (SU) (-0.003, 0.13)], with a significantly more favorable change in episodic memory [mean difference (95% CI)=0.12 SU (0.002, 0.23)] but not in executive function/attention [mean…
How strong is the evidence?
Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 21,442 participants or records.
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