Effects of cocoa extract and a multivitamin on cognitive function: A randomized klinisk prövning

COSMOS-Mind randomized 2,262 adults (mean age 73, 60% female) to cocoa extract, a daily multivitamin, both, or neither for three years. The multivitamin arm improved global cognition by 0.07 SD versus placebo (p=0.007). Memory and executive function composites also favored the multivitamin. The cocoa extract arm showed no benefit on global cognition (0.03 SD, p=0.28). The investigators estimate the multivitamin effect corresponds to roughly 1.8 years of age-related cognitive change, a model-based translation. Participants with cardiovascular disease history showed nominally larger effects. This is one of the first large, long-term trials to support a multivitamin for cognition in older adults. Limitations: the trial population was largely white, well-educated US adults; phone-based testing; and the positive multivitamin result coexists with the earlier Physicians' Health Study II null (N=5,947, ~12 years). The effect is real but small and memory-led. No dementia-prevention claim is supported.

Cocoa extract did not benefit cognition. However, COSMOS-Mind provides the first evidence from a large, long-term, pragmatic trial to support the potential efficacy of a MVM to improve cognition in older adults.