Evidence map›Paper›PMID 38244989›Full record

SynthesisThe American journal of clinical nutrition2024

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.

Chirag M Vyas, JoAnn E Manson, Howard D Sesso, Nancy R Cook, Pamela M Rist, Alison Weinberg, M Vinayaga Moorthy, Laura D Baker, Mark A Espeland, Lok-Kin Yeung and 2 more

3 registry-linked trialsOpen access · greenAbstract readMeta-Analysis
PubMed Full text at PMC Publisher
In one paragraph

Synthesis 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 3 registered trials, which are not on this map. Cited by 26 papers.

0numbers the graph read from it
0cells of the map it votes in
26citing papers in PubMed
16.8field-weighted citation impact, top 1% of its field
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.

NCT02422745 phase4completednot on this map

COcoa Supplement and Multivitamin Outcomes Study

TypeinterventionalSponsorBrigham and Women's HospitalRan2015 to 2023Enrolled21,442ConditionsCardiovascular Disease, CancerArmsCocoa extract, Multivitamin, Cocoa extract placebo, Multivitamin placebo
NCT03035201 completednot on this map

COcoa Supplement and Multivitamin Outcomes Study-Mind

TypeobservationalSponsorWake Forest University Health SciencesRan2016 to 2021Enrolled2,262ConditionsCognitive Impairment, Dementia, Aging
NCT04582617 nacompletednot on this map

COSMOS Web: Investigating the Effects of Cocoa Flavanol on Cognition Assessed Online

TypeinterventionalSponsorColumbia UniversityRan2016 to 2020Enrolled3,959ConditionsAging, Cognitive ChangeArmsCocoa Extract, Cocoa Extract Placebo, Multivitamin, Multivitamin placebo
3 · Its place in the literature

Who cites it

26 citing papers in PubMed, 31 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors at 4 institutions in 1 country.

Chirag M VyasDepartment of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States. Electronic address: cvyas@mgb.org.
JoAnn E MansonDivision of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, United States; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, United States; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, United States.
Howard D SessoDivision of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, United States; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, United States.
Nancy R CookDivision of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, United States; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, United States.
Pamela M RistDivision of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, United States; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, United States.
Alison WeinbergDivision of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, United States.
M Vinayaga MoorthyDivision of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, United States.
Laura D BakerDivision of Gerontology and Geriatric Medicine, Department of Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, NC, United States; Division of Public Health Sciences, Department of Social Sciences and Health Policy, Wake Forest University School of Medicine, Winston-Salem, NC, United States.
Mark A EspelandDivision of Gerontology and Geriatric Medicine, Department of Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, NC, United States; Division of Public Health Sciences, Department of Biostatistics and Data Science, Wake Forest University School of Medicine, Winston-Salem, NC, United States.
Lok-Kin YeungTaub Institute for Research on Alzheimer's Disease and the Aging Brain, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, United States.
Adam M BrickmanTaub Institute for Research on Alzheimer's Disease and the Aging Brain, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, United States; Gertrude H. Sergievsky Center, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, United States; Department of Neurology, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, United States.
Olivia I OkerekeDepartment of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, United States; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, United States. Electronic address: Olivia.Okereke@mgh.harvard.edu.
Brigham and Women's Hospital · USColumbia University · USWake Forest University · USHarvard University · US

Funding

Wake Forest University School of Medicine Alzheimer's Disease Research CenterP30AG072947 · NIA · WAKE FOREST UNIVERSITY HEALTH SCIENCES · PI SUZANNE CRAFT · 2021 to 2026
$24.3M
Cocoa Supplement and Multivitamin Outcomes Study in the Mind (COSMOS-Mind)R01AG050657 · NIA · WAKE FOREST UNIVERSITY HEALTH SCIENCES · PI BAKER, LAURA D., ESPELAND, MARK ANDREW · 2016 to 2020
$3.8M
Effect of randomized cocoa supplementation on inflammaging and epigenetic agingR01HL157665 · NHLBI · AUGUSTA UNIVERSITY · PI DONG, YANBIN, SESSO, HOWARD D · 2021 to 2024
$2.9M
COcoa Supplement and Multivitamins Outcomes Study (COSMOS): Effects on Falls and Physical PerformanceR01AG071611 · NIA · BRIGHAM AND WOMEN'S HOSPITAL · PI CRANDALL, CAROLYN JANET, LEBOFF, MERYL SUSAN · 2021 to 2024
$2.7M
COSMOS Eye: Cataract and AMD in a Trial of a Multivitamin and Cocoa ExtractR01EY025623 · NEI · BRIGHAM AND WOMEN'S HOSPITAL · PI SESSO, HOWARD D · 2016 to 2020
$2.6M
NEI NIH HHS R01 EY025623NHLBI NIH HHS R01 HL157665NIA NIH HHS P30 AG072947NIA NIH HHS R01 AG050657NIA NIH HHS R01 AG071611
6 · The paper itself

Abstract

backgroundLonger effects of multivitamin-mineral (MVM) supplementation on late-life cognitive function remain untested using in-person, detailed neuropsychological assessments. Furthermore, insufficient evidence exists for healthcare providers to recommend daily MVM supplements to prevent cognitive decline.

objectivesThis study aimed to test MVM effects on cognitive change using in-person, detailed neuropsychological assessments and conduct a meta-analysis within COSMOS (COcoa Supplement and Multivitamin Outcomes Study) cognitive substudies for a robust evaluation of MVM effects on cognition.

methodsCOSMOS is a 2 × 2 factorial trial of cocoa extract (500 mg flavanols/d) and/or a daily MVM 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 administered at baseline. For the meta-analysis, we included nonoverlapping participants across 3 COSMOS cognitive substudies: COSMOS-Clinic (n = 573); COSMOS-Mind (n = 2158); COSMOS-Web (n = 2472).

resultsIn COSMOS-Clinic, we observed a modest benefit of MVM compared with placebo on global cognition over 2 y {mean difference [95% confidence interval (CI)] = 0.06 SD units (SU) (-0.003, 0.13)}, with a significantly more favorable change in episodic memory [mean difference (95% CI) = 0.12 SU (0.002, 0.23)] but not in executive function or attention [mean difference (95% CI) = 0.04 SU (-0.04, 0.11)]. The meta-analysis of COSMOS substudies showed clear evidence of MVM benefits on global cognition [mean difference (95% CI) = 0.07 SU (0.03, 0.11); P = 0.0009] and episodic memory [mean difference (95% CI) = 0.06 SU (0.03, 0.10); P = 0.0007]; the magnitude of effect on global cognition was equivalent to reducing cognitive aging by 2 y.

conclusionsIn COSMOS-Clinic, daily MVM supplementation leads to a significantly more favorable 2-y change in episodic memory. The meta-analysis within COSMOS cognitive substudies indicates that daily MVM significantly benefits both global cognition and episodic memory. These findings within the COSMOS trial support the benefits of a daily MVM in preventing cognitive decline among older adults. This trial was registered at COSMOS-clinicaltrials.gov as NCT02422745, at COSMOS-Mind-clinicaltrials.gov as NCT03035201, and at COSMOS-Web-clinicaltrials.gov as NCT04582617.

Indexed as

CacaoCognitive DysfunctionAgedCognitionDietary SupplementsDouble-Blind MethodHumansMineralsRandomized Controlled Trials as TopicVitaminsMineralsVitaminscognitiongeriatricmeta-analysismultivitamin-multimineral supplementationrandomized clinical trial

Identifiers

PMID38244989
PMCPMC11103094
OpenAlexW4390988321

What OpenQuestion holds

Textmetadata
Read underepoch 390

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.