MULTIVITAMIN SUPPLEMENTATION IMPROVES MEMORY IN OLDER ADULTS: A RANDOMIZED CLINICAL TRIAL
 
   

Multivitamin Supplementation Improves Memory
in Older Adults: A Randomized Clinical Trial

This section is compiled by Frank M. Painter, D.C.
Send all comments or additions to:
   Frankp@chiro.org
 
   

FROM:   American J Clinical Nutrition 2023 (May 24) [EPUB] ~ FULL TEXT

Lok-Kin Yeung, Daniel M Alschuler, Melanie Wall, Heike Luttmann-Gibson, Trisha Copeland, Christiane Hale, Richard P Sloan, Howard D Sesso, JoAnn E Manson, Adam M Brickman

Taub Institute for Research on Alzheimer's Disease and the Aging Brain,
Vagelos College of Physicians and Surgeons,
Columbia University,
New York, NY, United States.



Background:   Maintenance of cognitive abilities is of critical importance to older adults, yet few effective strategies to slow cognitive decline currently exist. Multivitamin supplementation is used to promote general health; it is unclear whether it favorably affects cognition in older age.

Objectives:   To examine the effect of daily multivitamin/multimineral supplementation on memory in older adults.

Methods:   The COcoa Supplement and Multivitamin Outcomes Study Web (COSMOS-Web) ancillary study (NCT04582617) included 3562 older adults. Participants were randomly assigned to a daily multivitamin supplement (Centrum Silver) or placebo and evaluated annually with an Internet-based battery of neuropsychological tests for 3 y. The prespecified primary outcome measure was change in episodic memory, operationally defined as immediate recall performance on the ModRey test, after 1 y of intervention. Secondary outcome measures included changes in episodic memory over 3 y of follow-up and changes in performance on neuropsychological tasks of novel object recognition and executive function over 3 y.

Results:   Compared with placebo, participants randomly assigned to multivitamin supplementation had significantly better ModRey immediate recall at 1 y, the primary endpoint (t(5889) = 2.25, P = 0.025), as well as across the 3 y of follow-up on average (t(5889) = 2.54, P = 0.011). Multivitamin supplementation had no significant effects on secondary outcomes. Based on cross-sectional analysis of the association between age and performance on the ModRey, we estimated that the effect of the multivitamin intervention improved memory performance above placebo by the equivalent of 3.1 y of age-related memory change.

Conclusions:   Daily multivitamin supplementation, compared with placebo, improves memory in older adults. Multivitamin supplementation holds promise as a safe and accessible approach to maintaining cognitive health in older age. This trial was registered at clinicaltrials.gov as NCT04582617.

Keywords:   aging; clinical trial; cognition; diet; multivitamins; remote testing.



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Acknowledgements



REFERENCES

  1. Strout K. Ahmed F. Sporer K. Howard E.P. Sassatelli E. Mcfadden K.
    What are older adults wellness priorities? A qualitative analysis
    of priorities within multiple domains of wellness.
    Heal Aging Res. 2018; 7e21
    https://doi.org/10.1097/hxr.0000000000000021

  2. Gu Y. Scarmeas N.
    Dietary patterns in Alzheimer’s disease and cognitive aging.
    Curr. Alzheimer Res. 2011; 8: 510-519
    https://doi.org/10.2174/156720511796391836

  3. Friedman D.B. Rose I.D. Anderson L.A. Hunter R. Bryant L.L. Wu B. et al.
    Beliefs and communication practices regarding cognitive functioning
    among consumers and primary care providers in the United States, 2009.
    Prev. Chronic Dis. 2013; 10: 120249
    https://doi.org/10.5888/pcd10.120249

  4. Duthie S.J. Whalley L.J. Collins A.R. Leaper S. Berger K. Deary I.J.
    Homocysteine, B vitamin status, and cognitive function in the elderly.
    Am. J. Clin. Nutr. 2002; 75: 908-913
    https://doi.org/10.1093/ajcn/75.5.908

  5. Balion C. Griffith L.E. Strifler L. Henderson M. Patterson C. Heckman G. et al.
    Vitamin D, cognition, and dementia: a systematic review and meta-analysis.
    Neurology. 2012; 79: 1397-1405
    https://doi.org/10.1212/WNL.0b013e31826c197f

  6. Grima N.A. Pase M.P. MacPherson H. Pipingas A.
    The effects of multivitamins on cognitive performance:
    a systematic review and meta-analysis.
    J. Alzheimers Dis. 2012; 29: 561-569
    https://doi.org/10.3233/JAD-2011-111751

  7. Behrens A. Graessel E. Pendergrass A. Donath C.
    Vitamin B-can it prevent cognitive decline?
    A systematic review and meta-analysis.
    Syst. Rev. 2020; 9: 111
    https://doi.org/10.1186/s13643-020-01378-7

  8. Markun S. Gravestock I. Jäger L. Rosemann T. Pichierri G. Burgstaller J.M.
    Effects of vitamin B12 supplementation on cognitive function,
    depressive symptoms, and fatigue: a systematic review,
    meta-analysis, and meta-regression.
    Nutrients. 2021; 13: 1-18
    https://doi.org/10.3390/nu13030923

  9. Grodstein F. O’Brien J. Kang J.H. Dushkes R. Cook N.R. Okereke O. et al.
    Long-term multivitamin supplementation and cognitive function in men:
    a randomized trial.
    Ann. Intern. Med. 2013; 159: 806-814
    https://doi.org/10.7326/0003-4819-159-12-201312170-00006

  10. Rautiainen S. Sesso H.D. Manson J.E.
    Large-scale randomized clinical trials of bioactives and nutrients
    in relation to human health and disease prevention –
    lessons from the VITAL and COSMOS trials. Mol. Aspects Med. 2018; 61: 12-17
    https://doi.org/10.1016/j.mam.2017.12.001

  11. Sesso H.D. Manson J.E. Aragaki A.K. Rist P.M. Johnson L.G. Friedenberg G. et al.
    Effect of cocoa flavanol supplementation for the prevention of cardiovascular
    disease events: the COcoa Supplement and Multivitamin Outcomes Study
    (COSMOS) randomized clinical trial.
    Am. J. Clin. Nutr. 2022; 115: 1490-1500
    https://doi.org/10.1093/ajcn/nqac055

  12. Sesso H.D. Rist P.M. Aragaki A.K. Rautiainen S. Johnson L.G. Friedenberg G. et al.
    Multivitamins in the prevention of cancer and cardiovascular disease:
    the COcoa Supplement and Multivitamin Outcomes Study
    (COSMOS) randomized clinical trial.
    Am. J. Clin. Nutr. 2022; 115: 1501-1510
    https://doi.org/10.1093/ajcn/nqac056

  13. Baker L.D. Manson J.E. Rapp S.R. Sesso H.D. Gaussoin S.A. Shumaker S.A. et al.
    Effects of cocoa extract and a multivitamin on
    cognitive function: a randomized clinical trial.
    Alzheimers Dement. 2022; 19: 1308-1319
    https://doi.org/10.1002/alz.12767

  14. Lister J.P. Barnes C.A.
    Neurobiological changes in the hippocampus during normative aging.
    Arch. Neurol. 2009; 66: 829-833
    https://doi.org/10.1001/archneurol.2009.125

  15. Brickman A.M. Khan U.A. Provenzano F.A. Yeung L.-K. Suzuki W.A. Schroeter H. et al.
    Enhancing dentate gyrus function with dietary flavanols
    improves cognition in older adults.
    Nat. Neurosci. 2014; 17: 1798-1803
    https://doi.org/10.1038/nn.3850

  16. Sloan R.P. Wall M. Yeung L.-K. Feng T. Feng X. Provenzano F. et al.
    Insights into the role of diet and dietary flavanols in cognitive aging:
    results of a randomized controlled trial.
    Sci. Rep. 2021; 11: 3837
    https://doi.org/10.1038/s41598-021-83370-2

  17. Brickman A.M. Yeung L.-K. Alschuler D. Ottaviani J.I. Kuhnle G.G. Sloan R.P. et al.
    Dietary flavanols restore hippocampal-dependent memory in older adults
    with lower diet quality and habitual flavanol consumption.
    Proc. Natl. Acad. Sci. U. S. A. 2023; 11: 3837

  18. Rist P.M. Sesso H.D. Johnson L.G. Aragaki A.K. Wang L. Rautiainen S. et al.
    Design and baseline characteristics of participants in the
    COcoa Supplement and Multivitamin Outcomes Study (COSMOS), Contemp.
    Clin. Trials. 2022; 116: 106728
    https://doi.org/10.1016/j.cct.2022.106728

  19. van Praag H. Lucero M.J. Yeo G.W. Stecker K. Heivand N. Zhao C. et al.
    Plant-derived flavanol (-)epicatechin enhances angiogenesis
    and retention of spatial memory in mice.
    J. Neurosci. 2007; 27: 5869-5878
    https://doi.org/10.1523/JNEUROSCI.0914-07.2007

  20. Hale C. Last B.S. Meier I.B. Yeung L.-K. Budge M. Sloan R.P. et al.
    The ModRey: an episodic memory test for nonclinical
    and preclinical populations.
    Assessment. 2019; 26: 1154-1161
    https://doi.org/10.1177/1073191117723113

  21. Korsch M. Frühholz S. Herrmann M.
    Ageing differentially affects neural processing of
    different conflict types-an fMRI study.
    Front. Aging Neurosci. 2014; 6: 57
    https://doi.org/10.3389/fnagi.2014.00057

  22. Squire L.R. Stark C.E.L. Clark R.E.
    The medial temporal lobe.
    Annu. Rev. Neurosci. 2004; 27: 279-306
    https://doi.org/10.1146/annurev.neuro.27.070203.144130

  23. Brickman A.M. Stern Y. Small S.A.
    Hippocampal subregions differentially associate with standardized memory tests.
    Hippocampus. 2011; 21: 923-928
    https://doi.org/10.1002/hipo.20840

  24. Pereira A.C. Huddleston D.E. Brickman A.M. Sosunov A.A. Hen R. McKhann G.M. et al.
    An in vivo correlate of exercise-induced neurogenesis
    in the adult dentate gyrus.
    Proc. Natl. Acad. Sci. U. S. A. 2007; 104: 5638-5643
    https://doi.org/10.1073/pnas.0611721104

  25. Yeung L.-K. Hale C. Rizvi B. Igwe K. Sloan R.P. Honig L.S. et al.
    Anterolateral entorhinal cortex volume is associated with
    memory retention in clinically unimpaired older adults.
    Neurobiol. Aging. 2021; 98: 134-145
    https://doi.org/10.1016/j.neurobiolaging.2020.10.031

  26. Yeung L.-K. Hale C. Last B.S. Andrews H. Sloan R.P. Honig L.S. et al.
    Cerebrospinal fluid amyloid levels are associated with delayed memory
    retention in cognitively normal biomarker-negative older adults.
    Neurobiol. Aging. 2019; 84: 90-97
    https://doi.org/10.1016/j.neurobiolaging.2019.08.010

  27. Chiuve S.E. Fung T.T. Rimm E.B. Hu F.B. McCullough M.L. Wang M. et al.
    Alternative dietary indices both strongly predict risk of chronic disease.
    J. Nutr. 2012; 142: 1009-1018
    https://doi.org/10.3945/jn.111.157222

  28. Matthay E.C. Hagan E. Gottlieb L.M. Tan M.L. Vlahov D. Adler N. et al.
    Powering population health research:
    considerations for plausible and actionable effect sizes.
    SSM Popul. Health. 2021; 14: 100789
    https://doi.org/10.1016/j.ssmph.2021.100789

  29. De-Regil L.M. Peña-Rosas J.P. Fernández-Gaxiola A.C. Rayco-Solon P.
    Effects and safety of periconceptional oral folate
    supplementation for preventing birth defects.
    Cochrane Database Syst. Rev. 2015; 2015: CD007950
    https://doi.org/10.1002/14651858.CD007950.pub3

  30. Webb A.L. Villamor E.
    Update: effects of antioxidant and non-antioxidant vitamin supplementation on immune function.
    Nutr. Rev. 2007; 65: 181-217
    https://doi.org/10.1111/j.1753-4887.2007.tb00298.x

  31. Gaziano J.M. Sesso H.D. Christen W.G. Bubes V. Smith J.P. MacFadyen J. et al.
    Multivitamins in the prevention of cancer in men:
    the physicians’ health study II randomized controlled trial.
    JAMA. 2012; 308: 1871-1880
    https://doi.org/10.1001/jama.2012.14641

  32. Breteler M.M. Claus J.J. Grobbee D.E. Hofman A.
    Cardiovascular disease and distribution of cognitive function
    in elderly people: the Rotterdam study.
    BMJ. 1994; 308: 1604-1608
    https://doi.org/10.1136/bmj.308.6944.1604

  33. Wang D.D. Leung C.W. Li Y. Ding E.L. Chiuve S.E. Hu F.B. et al.
    Trends in dietary quality among adults in the United States, 1999 through 2010.
    JAMA Intern. Med. 2014; 174: 1587-1595
    https://doi.org/10.1001/jamainternmed.2014.3422

  34. Cvetinovic N. Loncar G. Isakovic A.M. von Haehling S. Doehner W. Lainscak M. et al.
    Micronutrient depletion in heart failure:
    common, clinically relevant and treatable.
    Int. J. Mol. Sci. 2019; 20: 1-14
    https://doi.org/10.3390/ijms20225627

  35. Boban M. Bulj N. Kola?evi? Zeljkovi? M. Radelji? V. Krcmar T. Trbusic M. et al.
    Nutritional considerations of cardiovascular diseases and treatments.
    Nutr. Metab. Insights. 2019; 121178638819833705
    https://doi.org/10.1177/1178638819833705

  36. Morris M.C.
    Nutritional determinants of cognitive aging and dementia.
    Proc. Nutr. Soc. 2012; 71: 1-13
    https://doi.org/10.1017/S0029665111003296

  37. Naveh-Benjamin M. Cowan N. Kilb A. Chen Z.
    Age-related differences in immediate serial recall:
    dissociating chunk formation and capacity.
    Mem. Cognit. 2007; 35: 724-737
    https://doi.org/10.3758/bf03193310

  38. Langub M.C. Herman J.P. Malluche H.H. Koszewski N.J.
    Evidence of functional vitamin D receptors in rat hippocampus.
    Neuroscience. 2001; 104: 49-56
    https://doi.org/10.1016/s0306-4522(01)00049-5

  39. Annweiler C. Llewellyn D.J. Beauchet O.
    Low serum vitamin D concentrations in Alzheimer’s disease:
    a systematic review and meta-analysis.
    J. Alzheimers Dis. 2013; 33: 659-674
    https://doi.org/10.3233/JAD-2012-121432

  40. Clarke R. Smith A.D. Jobst K.A. Refsum H. Sutton L. Ueland P.M.
    Folate, vitamin B12, and serum total homocysteine levels
    in confirmed Alzheimer disease.
    Arch. Neurol. 1998; 55: 1449-1455

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