Is your doctor competent enough to see this and immediately prescribe a protocol on vitamins for you immediately post stroke? You do want your memory boosted and cognitive decline slowed?
Do you prefer your doctor incompetence NOT KNOWING? OR NOT DOING?
Memory Boosted With Daily Multivitamins
Effects strongest for people with underlying cardiovascular disease
Multivitamin supplementation slowed cognitive decline in older adults, the COSMOS-Webopens in a new tab or window study showed.
Compared with placebo, participants who took a daily multivitamin/multimineral supplement had significantly better immediate recall at 1 year (P=0.025) and across 4 years of follow-up on average (P=0.011), reported Adam Brickman, PhD, of Columbia University in New York City, and co-authors in the American Journal of Clinical Nutritionopens in a new tab or window.
Multivitamins improved memory performance above placebo by the equivalent of 3.1 years of age-related memory change, the researchers estimated. The effect was more pronounced in people with underlying cardiovascular disease.
The findings are consistent with data from COSMOS-Mind,opens in a new tab or window another COSMOS ancillary study that showed daily multivitamin use led to better cognition, episodic memory, and executive function. Effects in COSMOS-Mind also were more pronounced in people with cardiovascular disease history.
"There is evidence that people with cardiovascular disease may have lower micronutrient levels that multivitamins may correct, but we don't really know right now why the effect is stronger in this group," Brickman said in a statement.
"Supplementation of any kind shouldn't take the place of more holistic ways of getting the same micronutrients," he cautioned. "Though multivitamins are generally safe, people should always consult a physician before taking them."
COSMOS-Web was designed to examine the effects of dietary flavanol or multivitamin supplementation on hippocampus-mediated cognition in older adults after 1 year.
"There is converging work that the hippocampus is particularly susceptible to the effects of normal aging and our previous intervention studies with dietary supplementation showed a positive effect on the hippocampus, indexed both by neuroimaging and neuropsychological assessment," Brickman and colleagues wrote.
The COSMOS-Web cognitive battery included neuropsychological outcome measures designed to be sensitive to cognitive changes typically seen in older adults, they added.
COSMOS-Web was embedded in the parent COSMOSopens in a new tab or window trial, which tested cocoa flavanol extract versus placebo or a Centrum Silver daily multivitamin versus placebo in people 60 and older. (Flavanol data will be reported in a separate paper, the authors noted.) Randomization occurred between April 2016 and March 2018.
The COSMOS-Web primary outcome was performance after 1 year on the Modified Rey Auditory Verbal Learning (ModRey)opens in a new tab or window immediate recall test of 20 words. Secondary outcomes included change in ModRey immediate recall performance after 2 and 3 years, ModRey retention (ratio of delayed recall to immediate recall, which relates to entorhinal cortex function), and performance on tests of novel object recognition and executive function. Tests were administered through a web-based platform.
The intention-to-treat analysis included 3,562 participants randomized to multivitamin or placebo who completed at least one follow-up measurement at year 1, 2, or 3. Demographic characteristics and baseline performance measures were similar between groups.
Pill compliance was 94.4% at 6 months and 91.8% at 1 year. In a small subset, the researchers assessed blood samples and confirmed increases in folate, vitamin B12, and serum 25(OH)vitamin D with multivitamin supplementation versus placebo.
Compared with those on placebo, participants receiving multivitamin supplementation had significantly greater improvement in ModRey immediate recall memory between baseline and year 1. In the multivitamin group, performance improved from a mean of 7.10 words at baseline to 7.81 words at 1 year; in the placebo group, it rose from 7.21 words to 7.65 words.
The average improvement in memory compared with placebo appeared to be sustained over at least 3 years post-baseline. Secondary outcomes did not differ significantly between groups in any of the follow-up years.
In participants with a history of cardiovascular disease, the effect versus placebo on ModRey scores was higher at 1 year (mean difference of 1.24 words, P=0.009) than it was for people without underlying cardiovascular disease.
The data support growing evidence that nutrition may play a roleopens in a new tab or window in brain heath.
"The finding that a daily multivitamin improved memory in two separate cognition studies in the COSMOS randomized trial is remarkable, suggesting that multivitamin supplementation holds promise as a safe, accessible, and affordable approach to protecting cognitive health in older adults," said co-author JoAnn Manson, MD, of Brigham and Women's Hospital in Boston.
The results might not apply to all older adults, the researchers acknowledged. The sample consisted mostly of white, educated adults. People were required to have a computer and internet connectivity to participate in the study.
Disclosures
The study was supported by grants from Mars Edge and the National Institutes of Health. Multivitamins were supplied by Pfizer (now Haleon).
Researchers reported relationships with Pure Encapsulations, Pfizer, Council for Responsible Nutrition, BASF, NIH, and the American Society of Nutrition.
Primary Source
American Journal of Clinical Nutrition
Source Reference: opens in a new tab or windowYeung L-K, at al "Multivitamin supplementation improves memory in older adults: A randomized clinical trial" Am J Clin Nutr 2023; DOI: 10.1016/j.ajcnut.2023.05.011.
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