Trial reportThe American journal of clinical nutrition2024
Effect of cocoa extract supplementation on cognitive function: results from the clinic subcohort of the COSMOS trial.
Trial report in The American journal of clinical nutrition, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02422745 (COcoa Supplement and Multivitamin Outcomes Study), which is not on this map. Cited by 10 papers, 1 of them a synthesis that pooled it.
What it found
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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.
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.
COcoa Supplement and Multivitamin Outcomes Study
Who cites it
10 citing papers in PubMed, 1 synthesis or guideline pooled it, 14 citations in OpenAlex.
- 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.The American journal of clinical nutrition · 2024Pooled it
- Effects of a Functional Cone Mushroom (Nutrients · 2024Trial
- An Anti-Inflammatory Signature Across Pain and Cognition: Not All Mediterranean Diets Are Equal.Nutrients · 2026Article
- Are avocados good for the brain? Most likely yes, in spite of their lack of effect on cognitive performance in a well-conducted 6-month randomized controlled trial.The journal of nutrition, health & aging · 2026Article
- Polyphenols and Neurodegenerative Diseases: Knowledge-Mining Insights, Mechanistic Evidence, and Emerging Nutritional Applications.Nutrients · 2026Review
- Cardiovascular Protective Effects and Mechanisms of Action of Cacao: A Comprehensive Review.Reviews in cardiovascular medicine · 2026Review
- Cocoa polyphenols in brain health: BDNF/CREB-mediated mechanisms in depression, cognition, and the gut-brain axis.Frontiers in nutrition · 2026Review
- Microbial phenolic metabolites at the neurovascular interface: a precision-nutrition framework for brain aging.Frontiers in nutrition · 2026Review
- Effects of Dietary Interventions on Cognitive Outcomes.Nutrients · 2025Review
- Untargeted Metabolomics and Chemometrics Elucidate Dynamic Plasma Profile Changes Induced by Cocoa Shell in Female Rats.Nutrients · 2025Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundSome prior randomized clinical trials (RCTs) that tested the effects of cocoa extract (CE), a source of flavanols, on late-life cognition have yielded promising findings. A long-term RCT using in-person neuropsychological tests covering multiple cognitive domains may clarify the cognitive effects of CE.
objectivesTo test whether daily supplementation with CE, compared with placebo, produces better cognitive change over 2 y.
methodsThe COcoa Supplement and Multivitamin Outcomes Study (COSMOS) is a 2 × 2 factorial RCT of CE [500 mg flavanols/d, including 80 mg (-)-epicatechin] and/or a daily multivitamin-mineral supplement for cardiovascular disease and cancer prevention among 21,442 United States adults aged ≥60 y. There were 573 participants in the clinic subcohort of COSMOS (that is, COSMOS-Clinic) who completed all cognitive tests at baseline; of these, 492 completed 2-y follow-up assessments. The primary outcome was global cognition (averaging z-scores across 11 tests). Secondary outcomes were episodic memory and executive function/attention. Repeated measures models were used to compare randomized groups.
resultsParticipants' mean age (standard deviation) was 69.6 (5.3); 49.2% were females. Daily supplementation with CE, compared with placebo, had no significant effect on 2-y change in global cognition {mean difference [95% confidence interval (CI)]: -0.01 (-0.08, 0.05) standard deviation units (SU)}. CE, compared with placebo, had no significant effects on 2-y change in episodic memory [mean difference (95% CI): -0.01 (-0.13, 0.10) SU] or executive function/attention [mean difference (95% CI): 0.003 (-0.07, 0.08) SU]. Subgroup analyses uncorrected for multiple-testing suggested cognitive benefits of CE supplementation, compared with placebo among those with poorer baseline diet quality.
conclusionsAmong 573 older adults who underwent repeat in-person, detailed neuropsychological assessments over 2 y, daily CE supplementation, compared with placebo, showed no overall benefits for global or domain-specific cognitive function. Possible cognitive benefits of CE among those with poorer diet quality warrant further study.
trial registrationThis trial was registered at clinicaltrials.gov with identifier - NCT02422745.
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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.