Evidence map›Paper›PMID 25733639›Full record

Trial reportThe American journal of clinical nutrition2015

Cocoa flavanol consumption improves cognitive function, blood pressure control, and metabolic profile in elderly subjects: the Cocoa, Cognition, and Aging (CoCoA) Study--a randomized controlled trial.

Daniela Mastroiacovo, Catherine Kwik-Uribe, Davide Grassi, Stefano Necozione, Angelo Raffaele, Luana Pistacchio, Roberta Righetti, Raffaella Bocale, Maria Carmela Lechiara, Carmine Marini and 2 more

Registry-linked trialAbstract readComparative StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in The American journal of clinical nutrition, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06200883 (Effects of a Nutraceutic Compound on Cognitive Impairment in Frailty Patients), which is not on this map. Cited by 153 papers, 10 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
153citing papers in PubMed, 10 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT06200883 phase4completednot on this mapstarted 2022, after this paper: background citation

Effects of a Nutraceutic Compound on Cognitive Impairment in Frailty Patients

TypeinterventionalSponsorFederico II UniversityRan2022 to 2023Enrolled58ConditionsMild Cognitive ImpairmentArmsPlacebo oral vial, Choline Bitartrate
3 · Its place in the literature

Who cites it

153 citing papers in PubMed, 10 syntheses or guidelines pooled it.

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  4. Dietary Flavonoids and Human Cognition: A Meta-Analysis.Molecular nutrition & food research · 2022
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  10. Effect of cocoa on blood pressure.The Cochrane database of systematic reviews · 2017
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  16. Effects of cocoa extract and a multivitamin on cognitive function: A randomized clinical trial.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2023
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93 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

12 authors.

Daniela MastroiacovoFrom the Geriatric Unit (DM, AR, LP, RR, MCL, and GD) and the Alzheimer's Unit (MCL and GD), "SS Filippo e Nicola" Hospital, L'Aquila, Italy; Mars, Inc., Mclean, VA (CK-U); the Department of Life, Health, and Environmental Sciences, University of L'Aquila, L'Aquila, Italy (DG, SN, CM, CF, and GD); and Complesso Integrato Columbus, Rome, Italy (RB).
Catherine Kwik-UribeFrom the Geriatric Unit (DM, AR, LP, RR, MCL, and GD) and the Alzheimer's Unit (MCL and GD), "SS Filippo e Nicola" Hospital, L'Aquila, Italy; Mars, Inc., Mclean, VA (CK-U); the Department of Life, Health, and Environmental Sciences, University of L'Aquila, L'Aquila, Italy (DG, SN, CM, CF, and GD); and Complesso Integrato Columbus, Rome, Italy (RB).
Davide GrassiFrom the Geriatric Unit (DM, AR, LP, RR, MCL, and GD) and the Alzheimer's Unit (MCL and GD), "SS Filippo e Nicola" Hospital, L'Aquila, Italy; Mars, Inc., Mclean, VA (CK-U); the Department of Life, Health, and Environmental Sciences, University of L'Aquila, L'Aquila, Italy (DG, SN, CM, CF, and GD); and Complesso Integrato Columbus, Rome, Italy (RB).
Stefano NecozioneFrom the Geriatric Unit (DM, AR, LP, RR, MCL, and GD) and the Alzheimer's Unit (MCL and GD), "SS Filippo e Nicola" Hospital, L'Aquila, Italy; Mars, Inc., Mclean, VA (CK-U); the Department of Life, Health, and Environmental Sciences, University of L'Aquila, L'Aquila, Italy (DG, SN, CM, CF, and GD); and Complesso Integrato Columbus, Rome, Italy (RB).
Angelo RaffaeleFrom the Geriatric Unit (DM, AR, LP, RR, MCL, and GD) and the Alzheimer's Unit (MCL and GD), "SS Filippo e Nicola" Hospital, L'Aquila, Italy; Mars, Inc., Mclean, VA (CK-U); the Department of Life, Health, and Environmental Sciences, University of L'Aquila, L'Aquila, Italy (DG, SN, CM, CF, and GD); and Complesso Integrato Columbus, Rome, Italy (RB).
Luana PistacchioFrom the Geriatric Unit (DM, AR, LP, RR, MCL, and GD) and the Alzheimer's Unit (MCL and GD), "SS Filippo e Nicola" Hospital, L'Aquila, Italy; Mars, Inc., Mclean, VA (CK-U); the Department of Life, Health, and Environmental Sciences, University of L'Aquila, L'Aquila, Italy (DG, SN, CM, CF, and GD); and Complesso Integrato Columbus, Rome, Italy (RB).
Roberta RighettiFrom the Geriatric Unit (DM, AR, LP, RR, MCL, and GD) and the Alzheimer's Unit (MCL and GD), "SS Filippo e Nicola" Hospital, L'Aquila, Italy; Mars, Inc., Mclean, VA (CK-U); the Department of Life, Health, and Environmental Sciences, University of L'Aquila, L'Aquila, Italy (DG, SN, CM, CF, and GD); and Complesso Integrato Columbus, Rome, Italy (RB).
Raffaella BocaleFrom the Geriatric Unit (DM, AR, LP, RR, MCL, and GD) and the Alzheimer's Unit (MCL and GD), "SS Filippo e Nicola" Hospital, L'Aquila, Italy; Mars, Inc., Mclean, VA (CK-U); the Department of Life, Health, and Environmental Sciences, University of L'Aquila, L'Aquila, Italy (DG, SN, CM, CF, and GD); and Complesso Integrato Columbus, Rome, Italy (RB).
Maria Carmela LechiaraFrom the Geriatric Unit (DM, AR, LP, RR, MCL, and GD) and the Alzheimer's Unit (MCL and GD), "SS Filippo e Nicola" Hospital, L'Aquila, Italy; Mars, Inc., Mclean, VA (CK-U); the Department of Life, Health, and Environmental Sciences, University of L'Aquila, L'Aquila, Italy (DG, SN, CM, CF, and GD); and Complesso Integrato Columbus, Rome, Italy (RB).
Carmine MariniFrom the Geriatric Unit (DM, AR, LP, RR, MCL, and GD) and the Alzheimer's Unit (MCL and GD), "SS Filippo e Nicola" Hospital, L'Aquila, Italy; Mars, Inc., Mclean, VA (CK-U); the Department of Life, Health, and Environmental Sciences, University of L'Aquila, L'Aquila, Italy (DG, SN, CM, CF, and GD); and Complesso Integrato Columbus, Rome, Italy (RB).
Claudio FerriFrom the Geriatric Unit (DM, AR, LP, RR, MCL, and GD) and the Alzheimer's Unit (MCL and GD), "SS Filippo e Nicola" Hospital, L'Aquila, Italy; Mars, Inc., Mclean, VA (CK-U); the Department of Life, Health, and Environmental Sciences, University of L'Aquila, L'Aquila, Italy (DG, SN, CM, CF, and GD); and Complesso Integrato Columbus, Rome, Italy (RB).
Giovambattista DesideriFrom the Geriatric Unit (DM, AR, LP, RR, MCL, and GD) and the Alzheimer's Unit (MCL and GD), "SS Filippo e Nicola" Hospital, L'Aquila, Italy; Mars, Inc., Mclean, VA (CK-U); the Department of Life, Health, and Environmental Sciences, University of L'Aquila, L'Aquila, Italy (DG, SN, CM, CF, and GD); and Complesso Integrato Columbus, Rome, Italy (RB).

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundRecent evidence has indicated that flavanol consumption may have many health benefits in humans, including improved cognitive activities.

objectiveThe aim was to evaluate the effect of flavanol consumption on cognitive performance in cognitively intact elderly subjects.

designThis was a double-blind, controlled, parallel-arm study conducted in 90 elderly individuals without clinical evidence of cognitive dysfunction who were randomly assigned to consume daily for 8 wk a drink containing 993 mg [high flavanol (HF)], 520 mg [intermediate flavanol (IF)], or 48 mg [low flavanol (LF)] cocoa flavanols (CFs). Cognitive function was assessed at baseline and after 8 wk by using the Mini-Mental State Examination (MMSE), the Trail Making Test (TMT) A and B, and the Verbal Fluency Test (VFT).

resultsThe changes in MMSE score in response to the 3 different treatments were not different. In contrast, there was a positive impact of the intervention on specific aspects of cognitive function. Mean changes (±SEs) in the time required to complete the TMT A and B after consumption of the HF (-8.6 ± 0.4 and -16.5 ± 0.8 s, respectively) and IF (-6.7 ± 0.5 and -14.2 ± 0.5 s, respectively) drinks significantly (P < 0.0001) differed from that after consumption of the LF drinks (-0.8 ± 1.6 and -1.1 ± 0.7 s, respectively). Similarly, VFT scores significantly improved among all treatment groups, but the magnitude of improvement in the VFT score was significantly (P < 0.0001) greater in the HF group (7.7 ± 1.1 words/60 s) than in the IF (3.6 ± 1.2 words/60 s) and LF (1.3 ± 0.5 words/60 s) groups. Significantly different improvements in insulin resistance (P < 0.0001), blood pressure (P < 0.0001), and lipid peroxidation (P = 0.001) were also observed for the HF and IF groups in comparison with the LF group. Changes in insulin resistance explained ∼17% of changes in composite z score (partial r² = 0.1703, P < 0.0001).

conclusionsThis dietary intervention study provides evidence that regular CF consumption can reduce some measures of age-related cognitive dysfunction, possibly through an improvement in insulin sensitivity. These data suggest that the habitual intake of flavanols can support healthy cognitive function with age.

Indexed as

AgingAgedAged, 80 and overAntihypertensive AgentsAntioxidantsBeveragesCacaoCognitionCognitive DysfunctionCohort StudiesCombined Modality TherapyDairy ProductsDouble-Blind MethodFemaleFlavonolsFollow-Up StudiesAntihypertensive AgentsAntioxidantsFlavonolsNootropic Agentsblood pressurecocoa flavanolscognitive functioninsulin resistancelipid peroxidation

Identifiers

PMID25733639
PMCPMC4340060

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.