Multivitamin and Cognitive Function

Keeping the mind sharp is crucial for older adults, but effective ways to slow cognitive decline are limited. While multivitamin supplementation is commonly used for overall health, its impact on cognitive function in older age and healthy young people is uncertain in many people’s views.

The COSMOS-Web study investigated the effects of multivitamins on cognition and involved 3562 older adults, who were randomly assigned to take a daily multivitamin (Centrum Silver) or a placebo. Over 3 years, participants underwent annual evaluations using online neuropsychological tests. The focus was the change in episodic memory, specifically immediate recall on the ModRey test after 1 year (1).

Results showed that compared to the placebo, those taking multivitamins had significantly better immediate recall at 1 year and consistently over the 3 years. Performance on the ModRey  (recall of a total 20 words) improved from a mean of 7.10 words at baseline to 7.81 words after 1 year in the multivitamin supplementation group and from an average of 7.21 words at baseline to 7.65 words after 1 year in the placebo group. The contrast estimate of the multivitamin compared with the placebo effect averaged across all 3 y of follow-up demonstrated a significant effect of the multivitamin intervention, suggesting that the memory improvement is sustained over 3 years of the study. Analyzing the data, the improvement in memory performance due to multivitamin supplementation was estimated to be equivalent to reversing 3.1 years of age-related memory decline (1).

The COSMOS-Mind study investigated the impact of daily cocoa extract, multivitamin-mineral supplementation, or placebos on cognition in older adults involving 2262 participants (aged 73 on average) for 3 years. The primary outcome was a global cognition composite measured through standardized tests. Cocoa extract (500 mg flavanols/day) and multivitamin-mineral were compared against placebos. The effects were also examined in subgroups at higher risk for cognitive decline (2).

Results showed that Cocoa extract did not affect cognition. Multivitamin-mineral supplementation showed a significant benefit to global cognition, especially in those with a history of cardiovascular disease. Benefits were also observed for memory and executive function. This trial provided evidence supporting the efficacy of multivitamin-mineral supplementation in improving cognition in older adults, with greater benefits for those with cardiovascular disease (2).

Another study examined the impact of multivitamin-mineral and cocoa extract supplements on the development of mild cognitive impairment (MCI) and probable dementia in the COSMOS-Mind trial of 2262 participants. The telephone-based cognitive assessments were used annually for 3 years. Incidence rates of mild cognitive impairment (MCI) and dementia were compared between treatment groups using statistical analysis (3).

Over 3 years, there were 110 new cases of mild cognitive impairment (MCI) and 14 cases of dementia. Incidence rates did not differ between those receiving multivitamin-mineral or cocoa extract supplements and those on placebos, although statistical power was limited. However, participants on multivitamin-mineral supplements who later developed mild cognitive impairment (MCI) showed higher and less declined scores in global cognition and executive function compared to the previous year. (3)

These results showed that multivitamin-mineral and cocoa extract supplementation did not lower the risk of cognitive impairment. However, multivitamin-mineral supplementation slowed cognitive declines in individuals who developed mild cognitive impairment (3).

One study explored the impact of taking a multivitamin/mineral supplement on fatigue and cognitive function in healthy women. The trial involved 216 women aged 25-50 in a placebo-controlled, double-blind, randomized setup. They took a multivitamin/mineral for 9 weeks. Cognitive function and mood/fatigue during task performance were assessed before and after the treatment using a Multi-Tasking Framework (4).

The group taking the vitamin/mineral supplement showed reduced negative effects on mood/fatigue during extended tasks. Their multi-tasking performance improved in accuracy across all tasks and in speed and accuracy for specific tasks (Mathematical Processing and Stroop). Analysis of a subset also revealed a significant decrease in homocysteine levels after the supplement. These findings suggested that healthy individuals in the general population may experience benefits in mood, fatigue, and cognitive performance through direct dietary supplementation with vitamins/minerals (4).

Another study explored the effects of four-week multivitamin and mineral supplementation on mood and neurocognitive function in healthy, young adults. Fifty-eight healthy adults, 18-40 years of age participated in this randomized, double-blind, placebo-controlled trial, in which mood and blood biomarkers were assessed at baseline and after four weeks of supplementation. Compared to placebo, multivitamin-mineral supplementation was associated with significantly lowered homocysteine and increased blood B-vitamin levels (p < 0.01). Multivitamin-mineral treatment was also associated with significantly improved mood, as measured by reduced scores on the "depression-dejection" subscale of the Profile of Mood States (p = 0.018). These findings suggested that the four weeks of multivitamin-mineral supplementation may benefit mood, underpinned by elevated B vitamins and lowered homocysteine in healthy young adults (5).

One study investigated the impact of daily vitamin/mineral supplementation on cognitive performance and mood in healthy children aged 8-14. It was a 12-week trial with 81 participants, using a randomized, double-blind, placebo-controlled approach. Laboratory assessments were conducted before, 1 hour, and 3 hours after supplementation on the first and last days, with additional assessments at home after 4 and 8 weeks. Internet-based cognitive tasks measured mood, attention, and memory (6).

Results showed that the group receiving vitamins/minerals performed better on two attention tasks (Arrows choice reaction time and Arrow Flankers choice reaction time) at 4, 8, and 12 weeks. However, there was a decrease in performance in one task (Picture Recognition errors) at 12 weeks. The mood was not significantly affected (6).

The study suggested vitamin/mineral supplementation might enhance brain function, particularly in attention-related tasks. The tests that showed improvements in the study involved assessing accuracy and reaction time in tasks focusing on attention, with no consistent improvement in tasks involving memory. This implies a selective impact on attentional processing rather than a general enhancement in cognitive abilities due to the supplementation (6).

Adequate levels of vitamins and minerals are essential for optimal neural functioning. Due to unhealthy food choices and depleted nutrients in many modern food sources, it is common to see that many individuals, including healthy young adults and children, suffer from deficiencies in one or more vitamins or minerals. The studies mentioned in this blog provide evidence that multivitamin supplementation can help maintain or enhance cognitive functioning not only in later life, which is a top health concern among older adults but also benefits in young healthy people. Multivitamins and minerals can be considered health insurance to take regularly for better health and cognitive function.

References:

1.  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 Jul;118(1):273-282. doi: 10.1016/j.ajcnut.2023.05.011. Epub 2023 May 24. PMID: 37244291; PMCID: PMC10375458.

2. Baker LD, Manson JE, Rapp SR, Sesso HD, Gaussoin SA, Shumaker SA, Espeland MA. Effects of cocoa extract and a multivitamin on cognitive function: A randomized clinical trial. Alzheimers Dement. 2023 Apr;19(4):1308-1319. doi: 10.1002/alz.12767. Epub 2022 Sep 14. PMID: 36102337; PMCID: PMC10011015.

3. Sachs BC, Williams BJ, Gaussoin SA, Baker LD, Manson JE, Espeland MA, Sesso HD, Shumaker SA, Rapp SR; COSMOS-Mind Research Group. Impact of multivitamin-mineral and cocoa extract on incidence of mild cognitive impairment and dementia: Results from the CoCoa Supplement and Multivitamin Outcomes Study for the Mind (COSMOS-Mind). Alzheimers Dement. 2023 Nov;19(11):4863-4871. doi: 10.1002/alz.13078. Epub 2023 Apr 10. PMID: 37035889; PMCID: PMC10562510.

4. Haskell CF, Robertson B, Jones E, Forster J, Jones R, Wilde A, Maggini S, Kennedy DO. Effects of a multi-vitamin/mineral supplement on cognitive function and fatigue during extended multi-tasking. Hum Psychopharmacol. 2010 Aug;25(6):448-61. doi: 10.1002/hup.1144. PMID: 20737518.

5. White DJ, Cox KH, Peters R, Pipingas A, Scholey AB. Effects of Four-Week Supplementation with a Multi-Vitamin/Mineral Preparation on Mood and Blood Biomarkers in Young Adults: A Randomised, Double-Blind, Placebo-Controlled Trial. Nutrients. 2015 Oct 30;7(11):9005-17. doi: 10.3390/nu7115451. PMID: 26529011; PMCID: PMC4663579.

6.Haskell CF, Scholey AB, Jackson PA, Elliott JM, Defeyter MA, Greer J, Robertson BC, Buchanan T, Tiplady B, Kennedy DO. Cognitive and mood effects in healthy children during 12 weeks' supplementation with multi-vitamin/minerals. Br J Nutr. 2008 Nov;100(5):1086-96. doi: 10.1017/S0007114508959213. Epub 2008 May 29. PMID: 18507881.