Multivitamin-Multimineral Supplements Might Improve Cognitive Functioning in Elderly Adults

Multivitamin-multimineral supplements might improve cognitive functioning in elderly adults

 

• Results of a large study published in the American Journal of Clinical Nutrition reported that taking multivitamin-multimineral supplements for two years somewhat improved cognitive functioning in elderly adults.
• The most favorable change compared to placebo was in episodic memory, which corresponds to 4.8 years of fewer aging years.
• The effect on global cognition was more modest and equivalent to reducing cognitive aging by two years.

We are all aware that people of advanced age can often be forgetful, and their memory is no longer what it used to be. Tasks requiring speed and quick reactions are more difficult. Is there a way to prevent this?

Cognition and age

Cognitive changes occur throughout the entire lifespan, starting from infancy and continuing into old age. In early childhood, our cognitive abilities develop rapidly. Language, memory, and problem-solving skills improve quickly, particularly in the earliest years of life. During adolescence and young adulthood, cognitive functions such as processing speed, working memory, and executive functions reach their peak (e.g., R. Siegler, 2024).

However, from the mid-20s to the 30s, subtle declines in processing speed and memory begin. By the time individuals reach their 60s and beyond, more noticeable declines in cognitive functions, such as short-term memory, attention, and executive functions, are visible (e.g., Williams & Kemper, 2010). Despite this, certain cognitive abilities like emotional regulation and some aspects of long-term memory can remain stable or even improve with age (Isaacowitz, 2022) (see Figure 1).

 

Figure 1. Cognition and age

 

In the 1960s, the famous psychologist Raymond Cattell proposed a theory that differentiated between cognitive abilities that remain stable or even improve as we age and those that decline with age. He called them crystalized and fluid intelligence. Crystallized intelligence refers to the accumulation of knowledge and skills acquired through experience and education, such as vocabulary and general knowledge. Fluid intelligence, on the other hand, encompasses the ability to reason, think abstractly, and solve problems in novel situations. Later studies confirmed that some abilities do not decline until very advanced age and start visibly declining much earlier (e.g., Murman, 2015) (see Figure 2).

 

Figure 2. Crystallized intelligence vs. fluid intelligence

 

Raymond Cattell proposed a theory that differentiated between cognitive abilities that remain stable or improve as we age and those that decline

 

What causes cognitive decline?

There are many causes of age-related cognitive decline. Some of them are genetic; others have to do with changes that our brain undergoes as we age. Biochemical processes such as oxidative stress contribute, and changes in neurotransmitter levels have a similar effect (Raz & Rodrigue, 2006; Wilson et al., 2010).

Research also indicates that some factors can reduce the rate of cognitive decline and even prevent it in some aspects. These include education, being cognitively active, healthy lifestyle habits, good physical health, and good nutritional choices (Williams & Kemper, 2010).

The current study

Study author Chirag M. Vyas and his colleagues conducted a large-scale longitudinal study on older adults called COSMOS (COcoa Supplement and Multivitamin Outcomes Study). The study explored the effects of cocoa extract (500 mg flavanols) and multivitamin-multimineral supplements (Haleon; Centrum Silver®) on preventing cardiovascular disease and cancer. It also focused on age-related cognitive decline.

The COSMOS study consisted of three parts: an experiment called COSMOS-clinic, involving 573 participants; COSMOS-Mind, a study involving annual telephone-based cognitive assessments for three years (2158 participants); and COSMOS-Web, involving annual computer-based cognitive assessments for three years (2472 participants). 

In this analysis, the study authors focused on COSMOS-clinic. Around 50% of participants in the COSMOS-clinic study were males, and over 50% had post-college education. Their average body mass index was around 27, meaning they were overweight. Around 32% reported taking alcohol daily.

The study procedure

COSMOS-clinic participants were divided into four groups. One group was taking multivitamin-multimineral supplements and cocoa extracts, another was taking cocoa extracts and a placebo instead of multivitamin-multimineral supplements, the third group was taking placebo instead of cocoa extract and (real) multivitamin-multimineral supplements, and the fourth group was taking placebo instead of both substances. The look of placebo capsules was identical to that of capsules containing cocoa extract or multivitamin-multimineral supplements, with the difference that they contained no active ingredients (i.e., did not contain any cocoa extract,  vitamins, and minerals). Around 90-91% of participants reported adhering to the treatment regimen, i.e., taking the assigned pills as required by the study protocol.

Participants completed cognitive assessments at the study authors’ clinic before and after two years of taking their assigned treatments (depending on the group) (see Figure 3).

 

Figure 3. Study Procedure (Vyas et al., 2024)

 

Multivitamin-multimineral supplements improved episodic memory

Results showed that participants assigned to the groups taking multivitamin-multimineral treatments had a bit better global cognition after two years compared to groups taking placebo. Effects on episodic memory were much better, showing a higher average difference from the placebo group.

When study authors compared these changes to typical changes caused by age, the improvement in episodic memory was equivalent to 4.8 years less aging compared to placebo groups. Effects on global cognition amounted to 2.4 years less aging. This sample did not affect executive functions or attention (see Figure 4).

 

Figure 4. Results

 

Multivitamin-multimineral supplements improved global cognition across all three studies

 

The study authors also conducted a metanalysis of the results of all three COSMOS studies together. In this analysis, multivitamin-multimineral supplements had a clear positive effect on global cognition and episodic memory in particular.

Looking at the difference’s magnitude, global cognition’s effect amounted to around two years less aging. Results were similar across the three studies.

Conclusion

Results of these studies showed that taking multivitamin-multimineral supplements might slow down the cognitive decline that occurs with aging. The effects were the strongest on episodic memory, while executive functioning and attention were unaffected.

The observed effects are small, but taking supplements is easy and practically does not require changes to daily life habits. This is particularly the case when comparing them to other prospective methods of slowing cognitive decline. This means that this kind of supplement could be a useful addition to programs aimed at preventing age-related cognitive decline.

The paper “Effect of multivitamin-mineral supplementation versus placebo on cognitive function: results from the clinic subcohort of the COcoa Supplement and Multivitamin Outcomes Study (COSMOS) randomized clinical trial and meta-analysis of 3 cognitive studies within COSMOS” was authored by Chirag M Vyas, JoAnn E Manson, Howard D Sesso, Nancy R Cook, Pamela M Rist, Alison Weinberg, Vinayaga Moorthy, Laura D Baker, Mark A Espeland, Lok-Kin Yeung, Adam M Brickman, and Olivia I Okereke.

 

References

 

Isaacowitz, D. M. (2022). What do we know about aging and emotion regulation? Perspectives on Psychological Science : A Journal of the Association for Psychological Science, 17(6), 1541–1555. https://doi.org/10.1177/17456916211059819

Murman, D. L. (2015). The Impact of Age on Cognition. Seminars in Hearing, 36(3), 111–121. https://doi.org/10.1055/s-0035-1555115

Siegler. (2024). Cognitive Development in Childhood. In R. Biswas-Diener & E. Diener (Eds). Noba textbook series: Psychology. IL: DEF publishers. http://noba.to/8uv4fn9h

Raz, N., & Rodrigue, K. M. (2006). Differential aging of the brain: Patterns, cognitive correlates and modifiers. Neuroscience & Biobehavioral Reviews, 30(6), 730–748. https://doi.org/10.1016/j.neubiorev.2006.07.001

Williams, K., & Kemper, S. (2010). Exploring Interventions to Reduce Cognitive Decline in Aging. Journal of Psychosocial Nursing and Mental Health Services, 48(5), 42–51. https://doi.org/10.3928/02793695-20100331-03

Wilson, R. S., Leurgans, S. E., Boyle, P. A., Schneider, J. A., & Bennett, D. A. (2010). Neurodegenerative basis of age-related cognitive decline. Neurology, 75(12), 1070–1078. https://doi.org/10.1212/WNL.0b013e3181f39adc